Peripheral neuropathy: when diabetes causes pain and tingling in your feet

Burning, “pins and needles” tingling, or numb feet that feel worse at night. For many people with diabetes, these are the first signs of peripheral neuropathy, a type of nerve damage that, according to the NIH, typically affects the feet and legs, and less often the hands and arms.^[1]

How common is it?

Diabetes is very common in the United States, and a large share of people who have it don’t know it yet:^[2]

Source: CDC, National Diabetes Statistics Report (updated 2026).^[2]

And according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), up to one-half of people with diabetes have peripheral neuropathy.^[1]

Symptoms

NIDDK describes these symptoms, which usually occur on both sides of the body and are often worse at night:^[1]

• Burning
• Tingling, like “pins and needles”
• Numbness
• Pain
• Weakness

Why it matters: the risks to your feet

Losing feeling means a wound can go unnoticed. NIDDK warns that neuropathy can lead to blisters and sores on the feet, and that diabetes makes these wounds hard to heal. Other possible complications include:^[1]

• Changes in the shape of the feet and toes and, rarely, Charcot’s foot (damage to the bones and tissue of the foot)
• Falls and fractures from loss of balance
• Grief, anxiety and depression linked to chronic pain

How the pain is treated

NIDDK says your doctor may prescribe antidepressants, anticonvulsants such as gabapentin and pregabalin, and lidocaine creams or patches, noting that they ease pain but do not change the nerve damage. It also mentions physical therapy.^[1]

The CDC’s 2022 clinical guideline agrees on nonopioid options for neuropathic pain: tricyclic, tetracyclic and SNRI antidepressants; selected anticonvulsants (pregabalin, gabapentin enacarbil, oxcarbazepine); and capsaicin or lidocaine patches.^[3]

No medication should be taken without medical advice: each one has contraindications and side effects.

Prevention: what is in your hands

According to NIDDK, the main way to prevent or slow the damage is to manage your blood glucose, blood pressure and cholesterol: staying close to your goals can keep nerve damage from getting worse.^[1]

It also recommends:^[1]

1. Checking your feet every day for wounds, blisters or changes.
2. Taking good care of your feet every day.
3. Having your doctor examine your feet at least once a year, or more often if you already have foot problems.

If you have diabetes and notice burning, tingling or pain in your feet, an assessment can help you manage the pain and protect your feet before complications appear.