I have actually met a lot of people with neuropathy and who have no idea that they even had it, and that is causing them to fall. Foot neuropathy can cause imbalance (disequilibrium) and dizziness with standing, along with falls.

In the following article, we will talk about several symptoms of foot neuropathy.

How it Feels

Many people feel a tingly, itchy, or prickly feeling. Some people feel pain almost like they are walking on tacks or they feel like their feet are burning or cold.

These are all distortions of the sensations due to nerve disease in the feet.

However, some people with neuropathy may not have any of those distorted sensations or pains, but they may have numbness in their feet, one of the main symptoms of foot neuropathy.

Difficulty Walking

Many people with foot neuropathy may not have been diagnosed yet, but they may notice difficulty walking with less steadiness on their feet in certain situations.

On Uneven Surfaces

One of the key things I’ve noticed with people with neuropathy is they usually have trouble walking on uneven surfaces. For example, if you have a problem walking on a surface like cobblestone or flagstone, you may indeed have neuropathy, especially if you have the kind that causes numbness in the feet, one of the most common symptoms of foot neuropathy. Since you are not feeling your feet due to numbness, then you are not feeling the uneven ground either.

In the Dark

People with neuropathy may also have more difficulty walking in the dark, because they can’t rely on their vision and their feet aren’t feeling the ground very clearly.

On Compliant Surfaces

Another one of the symptoms of foot neuropathy is having trouble walking on what is called “compliant surfaces.” This would be unsteadiness with walking on sand, grass, thick carpet, or transitioning from tile to carpet. If the ground is not firm and level, sometimes people with neuropathy have trouble balancing.

Tripping over Obstacles

People with foot neuropathy are more likely to trip on things like cracks or any kind of unevenness in a walkway. They may have trouble stepping over or walking around obstacles, because they just can’t coordinate their feet as well. They may generally just feel off balance when they are standing or walking, which is what we call “disequilibrium.”

Shuffling Feet

Oftentimes people with symptoms of foot neuropathy are the folks that you see shuffling their feet on the ground. They are shuffling their feet, so they can feel more information by the friction of their feet on the ground. This is a strategy people use unconsciously when they can’t feel their feet very well.

Dizziness upon Standing

If you have dizziness when you stand up, that may be another one of the symptoms of foot neuropathy. When people have foot neuropathy, the vessels in their legs do always not respond to standing the way they should. They don’t increase the peripheral vascular resistance which should happen when you stand, and so the blood rushes down into the legs.

This lack of appropriate vascular response in the legs causes dizziness with standing for some people that have foot neuropathy. This dizziness can lead to falls.  I wrote this article to describe more about that specific problem.

Talk to Your Doctor

If you believe you may have foot neuropathy, let your doctor know.

The doctor may order bloodwork, or labs, to check your cholesterol and blood sugar levels, etc. They may suggest for you see a specialist, like a podiatrist, endocrinologist, or a cardiologist.

Your doctor will decide what is appropriate for you, but step one is to definitely let your primary doctor know what is happening if notice symptoms of foot neuropathy.

Some of the changes to your feet may be due to normal aging, but sometimes foot neuropathy may be a clue that you are developing some other medical issue. That is why it is important to notify your doctor if you have any of the foot sensations described above, or numbness in your feet.

If you have fallen, you may want to consult a physical therapist or home safety specialist to find out ways to reduce your risk of falling at home.

Learn More

To learn about a few possible causes of foot neuropathy outside of normal aging, check out my blog post Causes of Foot Neuropathy.

I also share safety tips for people with symptoms of foot neuropathy, in this blog.

If you are interested in some additional education and exercises you can do at home along with your treatment plan to help reduce your symptoms and the risk of falling due to foot neuropathy, I have created an online course called Foot Therapy Program for Fall Prevention.


This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.

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