Diabetes, Numb Feet, and Balance: Why Neuropathy Raises Fall Risk

November is National Diabetes Month, and in Connecticut it arrives with the clocks turned back and wet leaves on the front steps. Over 40 million Americans, about 12 percent of the population, are living with diabetes (opens in a new tab), and up to half of people with diabetes have peripheral neuropathy (opens in a new tab), nerve damage that typically affects the feet and legs. Numb feet need daily care. They also make you less steady.

Your feet tell your brain where the ground is: how firm it is, which way it tilts, how far your weight has shifted. Nerve damage dulls that report, so you have less to go on when a rug edge, a curb or a dark hallway asks for a quick correction, and a stumble is harder to catch. That's why neuropathy raises fall risk. Balance training can help you stand and walk more steadily with the feeling you have left, and it works alongside your diabetes care, not in place of it.

Numbness or weakness that comes on suddenly, especially on one side of the body, or sudden trouble walking, dizziness or loss of balance (opens in a new tab) can be a sign of a stroke, so call 911 right away, and the other urgent signs are listed further down. Numbness that has crept into both feet over months is a different problem, the one this post is about, and one that shouldn't wait for your next appointment.

Neuropathy can make your feet burn, tingle or go numb

With neuropathy, your feet may burn, tingle like pins and needles, go numb, hurt or feel weak, and the symptoms are often worse at night. Numbness and tingling usually start in the feet or hands and can spread up the legs or arms. Loss of feeling can be as plain as not noticing when something touches your skin.

Sorting out whether this is neuropathy, and what's behind it, is your doctor's job. A foot doctor, also called a podiatrist, may be part of your diabetes care team. If your feet have started to tingle, burn or lose feeling, see your regular doctor or foot doctor right away (opens in a new tab) so they can work out what's causing it.

Numb feet make it harder to keep your balance

Much of staying upright happens without thought, because the nerves in your feet and legs keep reporting where your weight sits and what the ground is doing. That sense of where your body is, called position sense or proprioception, is one of the things neuropathy takes. Losing it can leave you unable to coordinate complex movements like walking or to keep your balance with your eyes shut (opens in a new tab), and the same damage can take away the feel of vibration and touch in the feet. On a lit, level floor, your eyes can cover for some of that. On an uneven lawn at dusk, or while you're watching a grandchild instead of the step, your eyes can't cover for it as well.

Sensation is only part of it. Muscle weakness, a changed walking pattern and slower reflexes also work against balance in diabetic neuropathy (opens in a new tab). Taken together, these problems can make a fall more likely, and with it the chance of a fracture or other injury.

Balance training can steady you, but it doesn't replace diabetes care

Physical therapy to improve strength and balance is one of the treatments for diabetic neuropathy, and a physical therapist can offer exercises and strategies to help you move more safely.

A 2025 review of twelve studies found that balance training does seem to improve balance in people with diabetic neuropathy. An earlier review found that gait, balance and functional training together also eased the fear of falling (opens in a new tab). The American Diabetes Association (ADA) goes further, saying balance training can lower the risk of falls by improving balance and walking, even when peripheral neuropathy is present (opens in a new tab). It recommends balance exercises two to three times a week for adults with diabetes aged 50 and older, particularly those with neuropathy.

The nerve damage itself is a separate job. Medicines for nerve pain can help with the pain but don't change the nerve damage, and staying close to your glucose goal numbers can keep the damage from getting worse. The glucose part belongs to you and your diabetes care team. The balance part is where physical therapy or a balance program comes in.

The determination of which exercise is right for you depends on your feet. Activities that are easy on the feet include walking, dancing, yoga or stretching, swimming and bike riding. Two cautions from the ADA narrow that list for anyone whose feet have lost feeling: if your walking pattern has changed, lean toward activities that don't put weight on your feet, and avoid weight-bearing exercise while a foot ulcer hasn't healed.

If you take insulin or another medicine that lowers blood glucose, physical activity can lower your blood glucose during the activity and for hours afterward, so you may need to check it before, during and after exercise (opens in a new tab). Ask your doctor what's safe for you before you start something new, especially if you have an open sore.

Diabetes can make you unsteady in other ways, too

Neuropathy isn't the only way diabetes reaches your balance. Low blood glucose can leave you shaky or jittery, dizzy, light-headed or confused. If you begin to feel that way, check your blood glucose, and if it's low, treat it right away the way your health care team has shown you. Autonomic neuropathy, nerve damage of a different kind, can make you feel light-headed or faint when you stand up from lying down or sitting, or when you do a physical activity. It can also hide the symptoms of low blood glucose, so you don't feel them coming. Tell your doctor about any low blood glucose episodes and about feeling faint when you stand. If your blood pressure drops when you stand, you can get in the habit of standing up slowly, and there are medicines that can steady it.

Some medicines raise the risk of falling because they cause dizziness or confusion. Even small changes in sight and hearing are linked to a higher risk of falls. When you talk to your doctor about the numbness, mention your medicines and any change in your eyesight or hearing.

Numb feet can't warn you, so check them every day

Check your feet every day, even if they feel fine. With less pain to warn you, a cut, blister or sore can go unnoticed, and a daily look helps you catch problems early, before they get worse. Wear shoes and socks at all times, and don't walk barefoot or in just socks, even indoors. Ask your health care team to check your feet at each visit, and see a foot doctor every year, more often if you have nerve damage.

Heat is a particular risk, because with nerve damage you may burn your feet and not know you did. Don't put a hot water bottle or heating pad on your feet. Our post on heat or ice for a sore muscle or sprain has more on who should be careful with both.

Some foot problems need a call the day you spot them. A blister, sore or ulcer, an infected corn or an ingrown toenail is a reason to see your regular doctor or foot doctor right away (opens in a new tab). Call your health care provider right away if a cut or bruise on your foot doesn't start to heal after a few days, or if skin on your foot becomes red, warm or painful (opens in a new tab), which can be signs of infection.

Stroke signs, a severe low or a hard fall need help right away

These three situations can't wait. Call 911 right away for sudden numbness or weakness in the face, arm or leg, especially on one side of the body, or sudden confusion, trouble speaking or understanding speech (opens in a new tab). Sudden trouble seeing, sudden trouble walking, dizziness, loss of balance or lack of coordination, and a sudden severe headache with no known cause are 911 calls too. Stroke symptoms that go away after a few minutes may have been a transient ischemic attack (TIA), which is a medical emergency too, so call 911 right away anyway.

Low blood glucose becomes an emergency when it drops so low you can't treat it yourself, and you may pass out or have a seizure. Severe low blood glucose is dangerous and needs to be treated right away (opens in a new tab). The people around you should know to call 911 right away after giving you glucagon, or if you don't have a glucagon emergency kit with you.

The third situation is a fall. If you're hurt or can't get up on your own, ask someone for help or call 911 (opens in a new tab). Hitting your head adds another layer of risk, especially if you take a blood thinner, so see your doctor right away to make sure you don't have a brain injury. The people checking on you should call 911 or take you to an emergency department right away for danger signs such as a headache that gets worse and does not go away, repeated vomiting, a seizure, or if you pass out or can't be woken up. CDC lists the rest of the danger signs (opens in a new tab).

Always tell your doctor if you've fallen since your last check-up, even if you didn't feel pain when you fell. Look your feet over afterward, too, since with numb feet a problem can be there without any pain to flag it.

Where to get help for numb feet and unsteady balance

The first conversation is with your doctor, about the numbness itself: whether it's neuropathy, how your glucose is doing, and how often you should see a foot doctor. If unsteadiness is part of what you've noticed, ask in the same conversation whether physical therapy or a balance program makes sense for you, and mention near falls as well as falls.

At Omni, our Performance & Balance Training program, ProPerformance, addresses fall risk, balance and stability concerns, and gait and steadiness at all five of our Connecticut offices. No referral is needed. Your first session is a computerized balance evaluation, and your provider builds your plan from there. If worry about falling has started to keep you home, mention that at your evaluation, too. Performance and balance training is a self-pay service and is not billed through insurance, so contact your Omni office for session pricing. Our earlier post on balance training describes the evaluation.

Physical therapy at our Wallingford office treats balance and fall risk, too. A referral is always needed to receive physical therapy at Omni. If you don't have one yet, you can get one from your physician or from one of our chiropractic physicians, who can refer you to our physical therapists in house. Then call our Wallingford office and our staff will take care of the rest.

Wherever you go for balance work, make sure whoever works with you knows about your diabetes and the numbness in your feet. To ask about a balance evaluation at the office nearest you, call (203) 562-8600. Insurance, what to bring and office hours are on our FAQ page.