Physical Exam

Ipswich Touch Test

also known as IpTT; Ipswich test

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Video coming September 2026

How to Perform

With the patient’s eyes closed, lightly rest the tip of your index finger for 1–2 seconds on the tips of the first, third, and fifth toes of each foot, testing each site in turn. Do not push, tap, or poke. Ask the patient to say each time they feel the touch.

How to Interpret

Peripheral Neuropathy

Diabetic Peripheral Neuropathy

Positive Ipswich Touch Test (≥2 of 6 toe sites not felt)

Rule in

Very helpfulDerived CI

Rule out

Somewhat helpfulDerived CI

Evidence:Limited

References

Zhao N, Xu J, Zhou Q, Li X, Chen J, Zhou J, Zhou F, Liang J. Application of the Ipswich Touch Test for diabetic peripheral neuropathy screening: a systematic review and meta-analysis. BMJ Open. 2021 Oct 4;11(10):e046966. doi:10.1136/bmjopen-2020-046966. PMID 34607858; PMCID PMC8491285. Rayman G, Vas PR, Baker N, et al. The Ipswich Touch Test. Diabetes Care. 2011;34(7):1517-1518. doi:10.2337/dc11-0156. Mogilevskaya et al. Diagnostic Accuracy of Screening Tests for Diabetic Peripheral Neuropathy: An Umbrella Review. J Diabetes Res. 2024 (PMID 39664106; PMC11634407).
Rayman G, Vas PR, Baker N, et al. The Ipswich Touch Test: a simple and novel method to identify inpatients with diabetes at risk of foot ulceration. Diabetes Care. 2011;34(7):1517-1518.

Research last updated September 10, 2026.