The Reality of Foot Drop
By Neurosurgery Singapore
What is Foot Drop?
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.
However this is not a disease. Rather, it is a sign of an underlying neurological, muscular or anatomical problem.
Sometimes this can be temporary, but it can also be permanent. If you have foot drop, you might need to wear a brace on your ankle and foot to hold your foot in a normal position.
Foot drop is usually present when one or both of the following signs are present:
- Difficulty or inability to walk on the heels of the feet
- Loss of balance while standing without support and with the eyes closed
What are some underlying symptoms of Foot Drop?
Usually this occurs when there is a problem with the nerves in the lower spine, leg, or foot or the muscles of the leg and foot.
Typically, if the heel strikes the floor first as the foot lands, a dysfunction of the lower spinal nerve root(s) or peripheral nerve(s) may be suspected. Neurological causes may include one or more of the following:
- Radiculopathy: Symptoms following nerve root irritation or compression in the lumbar spine, for example, radiculopathy of the L5 nerve root
- Neuropathy: Damage to a peripheral nerve in the leg at any point along its path, for example, neuropathy of the common peroneal nerve, deep peroneal nerve, or the sciatic nerve
- Lumbosacral plexopathy: Damage to a group of nerves (plexus) in the lumbar and sacral spine
Foot drop may also occur when the nerves in the leg and/or feet are damaged due to systemic conditions or genetic disorders. A few examples include diabetes, vasculitis (inflammation of blood vessels), and hereditary neuropathy with liability to pressure palsies (HNPP). Rarely, a tumor, blocked blood vessel, or bleeding in the brain may cause such effect.
“Most people will fully recover from foot drop. Some patients who have them is caused by a more serious condition may never recover fully from the condition. If you are having trouble moving your feet, or you notice that you are adjusting the way you walk in order to avoid dragging your toes, contact our doctor.”
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What types of diagnosis?
To diagnose foot drop, our Neurologist will do a physical examination and ask you about your symptoms. Our doctor will also want to see how you walk, and will examine your leg muscles for any weakness or damage.
Our Specialist may order certain tests, including the following:
- Imaging tests, including X-rays, ultrasound, and MRI and CT scans, to look for injuries to the legs, spinal cord, or brain
- Blood tests to check blood sugar levels, and to look for any potential toxins (poisons) that could be causing the condition
- Nerve conduction tests to examine how the nerves are functioning
- Electromyography, a test in which electrodes are placed in the muscles of the legs to measure their electrical activity (how well they transmit signals and sensations).
Possible treatment methods?
Treatment for foot drop depends on the cause. If the cause is successfully treated, the condition might improve or even disappear. If the cause can’t be treated, it can be permanent.
Treatment for foot drop might include:
- Braces or splints. A brace on your ankle and foot or splint that fits into your shoe can help hold your foot in a normal position.
- Physical therapy. Exercises that strengthen your leg muscles and help you maintain the range of motion in your knee and ankle might improve gait problems associated with foot drop. Stretching exercises are particularly important to prevent the stiffness in the heel.
- Nerve stimulation. Sometimes stimulating the nerve that lifts the foot improves its condition.
- Surgery. Depending upon the cause, and if your foot drop is relatively new, nerve surgery might be helpful. If the issue is long-standing, our Specialist might suggest surgery that fuses ankle or foot bones or a procedure that transfers a working tendon and attached muscle to a different part of the foot.