Symptoms and treatment of Foot drop

Description

Foot drop, sometimes called drop foot, is a general term for difficulty lifting the front part of the foot. If you have foot drop, the front of your foot might drag on the ground when you walk.

Foot drop is not a disease. Rather, it is a sign of an underlying neurological, muscular or anatomical problem.

Sometimes foot drop is temporary, but can be permanent. If you have foot drop, you might need to wear a brace on your ankle and foot to support the foot and keep it in position.

Symptoms

The fall of the foot makes it difficult to lift the front part of the foot, so that it could drag on the ground when you walk. To help the foot to clear the floor, a person with foot drop may lift the thigh more than usual when walking, as if to climb the stairs. This unusual type of foot, called steppage gait, could cause the foot to slap down on the ground with each step. In some cases, the skin of the top of the foot and the toes of the feet feels numb.

Depending on the cause, the fall of the feet can affect one or both feet.

When to see a doctor

If the toes drag on the ground when walking, talk to your health professional. If the foot drop is not treated, it can cause a loss of mobility and function. This can lead to chronic pain, which can affect a person's quality of life.

Causes

Foot drop is caused by weakness or paralysis of the muscles involved in lifting the front part of the foot. Causes of the fall of the foot may include:

The nerve injury.The most common cause of foot drop is the compression of a nerve in the leg, which controls the muscles involved in lifting the foot. This nerve is called the peroneal nerve. A serious knee injury can lead to the nerve is compressed. You can also be injured during hip or knee replacement surgery, which can cause foot drop. A lesion of the nerve root — "pinched nerve" — in the spine can also cause foot drop. People who have diabetes are more susceptible to disorders of the nerves, which are associated with foot drop.
Muscle or nerve disorders. Various forms of muscular dystrophy, an inherited disease that causes progressive muscle weakness, can contribute to foot drop. So can other neurological disorders, such as polio or Charcot-Marie-Tooth disease.
Brain and spinal cord disorders. Disorders that affect the spinal cord or the brain, such as stroke, multiple sclerosis or amyotrophic lateral sclerosis (ALS) — may cause foot drop.

The nerve injury. The most common cause of foot drop is the compression of a nerve in the leg, which controls the muscles involved in lifting the foot. This nerve is called the peroneal nerve. A serious knee injury can lead to the nerve is compressed. You can also be injured during hip or knee replacement surgery, which can cause foot drop.

A lesion of the nerve root — "pinched nerve" — in the spine can also cause foot drop. People who have diabetes are more susceptible to disorders of the nerves, which are associated with foot drop.

Risk factors

The peroneal nerve controls the muscles that lift the foot. This nerve passes near the surface of the skin on the side of the knee closest to the hand. Activities that compress the nerve may increase the risk of foot drop. Examples include:

Leg crossing. People who habitually cross their legs can compress the peroneal nerve of the leg up.
Prolonged kneeling. Occupations that involve prolonged squatting or kneeling — such as the collection of strawberries or tile — can result in foot drop.
Wearing a leg cast. Plaster casts that cover the ankle and at the end, just below the knee can exert pressure on the peroneal nerve.

Diagnosis

Foot drop is usually diagnosed during a physical exam. Your health care professional will watch you walk and check your leg muscles for weakness. Your healthcare provider may also check for numbness in your leg and the top of the foot and the toes of the feet.

Imaging tests

Foot drop is sometimes caused by a mass pressing on a nerve. This can be an excessive growth of the bones in the spinal canal or a tumor or a cyst pressing on the nerve in the knee or spine. Imaging tests may help to identify these types of problems.

The x-ray plain x-rays use a low level of radiation to visualize a mass of soft tissue or bone injury that could be the cause of your symptoms.
Ultrasound. This technology, which uses sound waves to create images of the internal structures, you can check for cysts or tumors in the nerve or show inflammation in the nerve compression.
CTscan. This combines X-ray images taken from different angles to form a cross-section of the structures inside the body.
Magnetic resonance imaging (MRI). This test uses radio waves and a strong magnetic field to create detailed images of the bones and soft tissues. MRI is especially useful in the visualization of soft-tissue injuries that may be compression of the nerve.

Nerve tests

Electromyography (EMG) and nerve conduction studies to measure the electrical activity in muscles and nerves. These tests may be uncomfortable, but they are useful in the determination of the location of the damage along the nerve affected.

Treatment

Treatment for foot drop depends on the cause. If the cause is successfully treated, the foot drop may improve or even disappear. If the cause cannot be treated, the foot drop may be permanent.

Treatment for foot drop may include:

Braces or splints. A brace on the ankle and the foot or splint that fits your shoe can help you maintain the foot in a normal position.
The physical therapy. The exercises can strengthen the muscles of the legs, and helps to maintain the range of motion in the knee and the ankle. These exercises can improve gait of the problems associated with foot drop. The stretching exercises are particularly important to prevent stiffness in the calf and heel.
The stimulation of the nerve. Sometimes, the nerve stimulation that lift the foot enhancement of the fall of the foot.
Surgery. Depending on the cause, and if the foot drop is relatively new, the surgery of the nerves can be useful. If the foot drop is long-standing, your healthcare provider may suggest surgery to the transfers of a tendon to a different part of the foot to improve the function.

Lifestyle and home remedies

Due to the fall of the feet can increase your risk of tripping and falling, consider taking these precautions around your home:

Keep the floors free of obstacles.
Avoid the use of carpets.
Move electrical cords away from the catwalks.
Make sure that the rooms and the stairs are well lit.
Replace fluorescent tape on the top and the bottom of the steps of the stairs.

Preparing for your appointment

It is likely to start by seeing your family health care provider. Depending on the suspected cause of the foot drop, you may be referred to a doctor who specializes in brain and nerve disorders, called a neurologist.

Here's some information to help you prepare for your appointment.

What you can do

Make a list of:

Their symptoms, even those that seem unrelated to the reason for which you scheduled the appointment, and when they began.
Key personal information, including major stresses or recent life changes.
All medications, vitamins or supplements that you take, including over-dose.
Questions to ask your health care professional.

For drop foot, questions to ask your care team include:

What is the cause of my symptoms?
What tests do I need?
Is my condition likely temporary or chronic?
What treatment do you recommend it?
Do you have brochures or other printed material I can have?

Do not hesitate to ask other questions.

What to expect from your doctor

Your healthcare provider is likely to ask questions, such as:

Your symptoms are present all the time, or come and go?
Nothing seems to improve the symptoms?
Does anything seem to make your symptoms worse?
How to note the weakness in your legs?
How your foot slap the floor when you walk?
Do you have numbness or tingling sensation in the foot or leg?
Do you have pain? If so, how is it and where is it located?
Do you have a history of diabetes?
Do you have any other muscle weakness?