Foot drop refers to the difficulty or inability to lift the front part of your foot off the ground. It affects your walking pattern. If you have this condition, you will be unable to completely lift off your foot while walking, and the front portion will drag on the ground. It can affect one or both feet. Foot drop occurs due to a neurological or muscular condition. It can be temporary but may last longer in certain cases. Foot drop can be treated with physiotherapy, nerve stimulation, ankle braces, or surgery in severe cases.
Foot drop can be caused due to multiple reasons. One of the most common causes of foot drop is nerve injury. The nerve that plays a role in lifting the front part of your feet off the ground is known as the peroneal nerve. Any direct damage to the foot or ankle may affect this nerve. This nerve can also be injured during knee or hip replacement procedures. In some cases, compression of nerves that supply your legs and foot can also cause this condition. This can occur in the case of spinal cord disorders. Diabetic people have a higher tendency to develop such nerve disorders. Some possible neurological causes include stroke, cerebral palsy, multiple sclerosis, spinal disc herniation, leprosy, poliomyelitis, and Charcot-Marie-Tooth disease.
Foot drop can also occur if your ankle muscles are affected by an underlying disease. Muscular dystrophy is a common cause in which the muscles of your body undergo progressive weakness. Diseases that cause muscular dystrophy include Duchenne muscle dystrophy, myotonic dystrophy, desmin myopathy, etc. In rare cases, foot drop can also be caused by the use of certain medications. These medications include vincristine, auranofin, allopurinol, thalidomide, and others.
The risk of foot drop is higher if your peroneal nerve gets injured or pinched. People with a habit of sitting cross-legged may develop foot drop if their nerve gets pinched. If you are in a job that requires you to squat or kneel on the ground for long hours, you may develop this condition. A family history of neurological or muscular conditions that affect the area around your ankles can also be a risk factor. In case of a fracture, if you have to wear a plaster cast for a prolonged period, it may also compress your peroneal nerve and cause foot drop.
The incidence of foot drop is 1 in 25000 people. It can develop at any age, but it is more common among older people with pre-existing nerve or muscle diseases. Foot drop is more predominant among males than females.
Foot drop has some noticeable signs that can be observed while walking. It makes it difficult to lift the front part of your affected foot or feet off the ground. When you walk, the front portion drags on the floor. For this reason, people with foot drop have to raise their legs higher (as if climbing stairs) to take a normal step. It is known as steppage gait. People with foot drop are unable to flex their ankles upwards or walk in a normal pattern. If your nerve is injured or compressed, you may also feel numbness in the front part of your foot. In case of muscular dystrophy, you will feel weakness in your foot muscles and difficulty walking.
For diagnosis of foot drop, your medical history and a detailed physical examination is required. Your doctor will check your affected side of the leg to look for possible injuries or abnormal growths. The strength, movement, and stretchability of the muscles are also noted. You are asked to walk so your walking pattern can be observed. In many cases, foot drop can be diagnosed on the basis of physical presentation alone. But tests are necessary to figure out the possible cause. These may include diabetes tests, electromyography, x-rays, CT scans, and MRI. Depending on your condition, your doctor may require additional tests if necessary.
Some other neurological conditions may present with similar symptoms as foot drop. These conditions include L5 radiculopathy, motor neuron disease, sciatic nerve palsy, lumbosacral plexopathy, peripheral neuropathy, spasticity, dystonia, and diabetic amyotrophy.
Treatment of foot drop depends on the treatment of the underlying cause. If you have a medical condition that cannot be treated, you may have a permanent foot drop. Different techniques can be used to improve the flexion of your foot and walking pattern. Braces or splints are suggested to hold your foot in a normal position. These are worn for a few weeks or months until your symptoms have improved. Physical therapy exercises are also recommended to improve the stretchability of your foot. These exercises also strengthen your muscles. Nerve stimulation is another technique that can be used in some cases. In case of severe nerve injury or a prolonged foot drop, surgical options can be the last resort.
Medications are prescribed according to your underlying condition. Foot drop itself cannot be treated by the use of medications.
Prognosis of foot drop is good in case of nerve injury. Treatment measures can help repair the injured nerve and recover a normal walking pattern. Prolonged foot drop can occur if you have a genetic disease or neurological condition that cannot be treated completely.
It is difficult to prevent foot drop since it occurs mostly due to a neurological or muscular disease. Nerve injury or nerve compression can be prevented to a certain extent by avoiding sitting cross-legged or squatting on the ground for long. If you feel numbness in the front part of your foot that does not seems to improve, consult with a doctor for a better diagnosis.
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 19, 2023.
Foot Drop Syndrome | National Institute of Neurological Disorders and Stroke (nih.gov)
Foot drop - Symptoms and causes - Mayo Clinic