Understanding Foot Drop: Causes and Foot Drop Treatment

Foot drop, also known as drop foot, is when a person has trouble lifting the front part of their foot while walking. Many people with foot drop tend to drag their toes on the ground. This condition usually affects only one foot but can also happen in both feet. It may indicate an underlying issue, such as a problem with the nervous system. Below, we outline what causes foot drop and discuss foot drop treatment options as part of comprehensive foot and ankle care.

Individuals with foot drop often walk by lifting their knees higher, like they are climbing stairs (this is called steppage gait). Fortunately, treatments are available to help people walk more normally and reduce or eliminate any pain they may experience.

What Causes Foot Drop?

Foot drop can occur when the peroneal nerve, which goes from the lower back down the leg, gets compressed as a pinched nerve or sustains nerve damage. This can happen for various reasons, like injury to the spinal discs, damage to the knee or pelvis, or complications during childbirth. Foot drop is also frequently seen in people with multiple sclerosis (MS) and can affect those with conditions like Lou Gehrig's disease, muscular dystrophy, and cerebral palsy. Other causes include strokes, issues with the sciatic nerve, or diabetes. Even sitting or crossing your legs for too long might lead to temporary foot drop.

To figure out the right treatment for foot drop, an orthopedic surgeon or a foot and ankle orthopaedic surgeon will ask about your symptoms and perform a physical exam. They may ask you to walk normally and also to walk on your heels. They will check for weaknesses in your leg muscles and inquire about any pain or numbness. If they believe the foot drop is caused by something pressing on the nerve, like a bone overgrowth or a tumor, they might suggest imaging tests such as X-rays, ultrasounds, MRIs, or CT scans. They may also order a nerve conduction study (NCS) to check how well your nerves and muscles are functioning.

When to Seek Treatment for Foot Drop

Foot drop treatment depends on what caused it. Sometimes foot drop can get better on its own, especially if it's due to an injury that heals.

An orthopedic surgeon typically recommends starting with non-surgical options, such as braces, shoe inserts (orthotics), foot splints, exercises, or physical therapy. Some patients may benefit from nerve stimulation techniques.

If foot drop is due to an injury, it might be possible to fix the damaged nerve. However, if it's caused by a disease or disorder, the issue may be permanent. In such cases, the surgeon may still offer treatments to help manage the effects of foot drop.

If non-surgical options do not work, surgery might be suggested. An orthopedic surgeon might choose from several procedures based on the situation, such as:

• Decompression surgery
• Nerve sutures or grafting
• Nerve or tendon transfer
• Fusing the foot and ankle joints

Most surgeries are performed in hospitals, usually under general anesthesia, and might require a hospital stay.

After surgery, patients are monitored until they wake up from anesthesia. Recovery times vary based on the procedure. A cast may be put on the foot, which should be kept elevated during recovery. Typically, patients will need to use crutches and avoid putting weight on their foot for several weeks or longer. During this time, exercises will help reduce tightness and swelling. The orthopedic surgeon may also recommend physical therapy to help patients relearn how to walk normally.

Learn More About Our Foot & Ankle Center

Our Foot & Ankle Center is committed to providing excellent education and surgical care through our specialist foot and ankle surgeon, Dr. Paul Maloof. At our foot & ankle center, we provide comprehensive foot and ankle care. He focuses on treating patients conservatively, opting for surgery only when absolutely necessary. Dr. Maloof brings advanced treatments to our center, specializing in both surgical and non-surgical care for various conditions, including foot drop.

If you're considering treatment, it's essential to find an orthopedic doctor experienced in foot issues like foot drop. Dr. Paul Maloof has the expertise to help patients recover quickly and safely. We have locations in Hampton and Williamsburg to suit your needs.

References

• The Cleveland Clinic. (n.d.). Foot Drop: What It Is, Causes, Treatment, and Symptoms. Foot Drop: What It Is, Causes, Symptoms & Treatment
• Mayo Clinic. (n.d.). Foot drop: Causes and treatment. Foot drop - Diagnosis and treatment - Mayo Clinic

Health note: This article is for general education and is not a medical diagnosis. If you develop sudden or severe weakness lifting the front of your foot (foot drop), major swelling, numbness or tingling in your leg or foot, new trouble walking or frequent tripping, or you can’t move your ankle, foot, or toes normally—especially after an injury—seek medical care right away.

Frequently Asked Questions

Question: What is foot drop and how does it affect the way I walk?

Short answer: Foot drop is difficulty lifting the front of the foot during walking, which often causes the toes to drag. Many people compensate with a “steppage gait,” lifting the knee higher as if climbing stairs. It typically affects one foot but can occur in both and may signal an underlying nerve or neurological issue.

Question: What are the most common causes of foot drop?

Short answer: Foot drop often results from compression or damage to the peroneal nerve running from the lower back down the leg. Triggers include spinal disc injury, knee or pelvic trauma, complications of childbirth, multiple sclerosis, Lou Gehrig’s disease (ALS), muscular dystrophy, cerebral palsy, stroke, sciatic nerve problems, and diabetes. Prolonged sitting or leg crossing can also cause temporary foot drop.

Question: How is foot drop diagnosed?

Short answer: An orthopedic or foot and ankle orthopaedic surgeon will review symptoms and perform a physical exam, observing normal and heel walking, checking leg muscle strength, and asking about pain or numbness. If nerve compression is suspected, imaging (X-ray, ultrasound, MRI, or CT) may be ordered, along with a nerve conduction study (NCS) to assess nerve and muscle function.

Question: What treatments are available, and can foot drop get better on its own?

Short answer: Treatment depends on the cause. Some cases improve as an injury heals. Initial care typically includes non-surgical options such as braces, shoe inserts (orthotics), foot splints, exercises, physical therapy, and sometimes nerve stimulation. If foot drop stems from a disease or disorder, it may be permanent, but therapies can still help manage symptoms and improve walking.

Question: When is surgery considered, and what does recovery involve?

Short answer: Surgery is considered when non-surgical care doesn’t help or when a fixable structural issue is identified. Procedures may include decompression surgery, nerve sutures or grafting, nerve or tendon transfer, or fusion of foot and ankle joints. Most surgeries are done in hospitals under general anesthesia and may require a short stay. Recovery varies by procedure and can include wearing a cast, elevating the foot, avoiding weight-bearing with crutches for several weeks or longer, performing exercises to reduce tightness and swelling, and attending physical therapy to relearn normal walking.

Question: Why choose the Foot & Ankle Center and Dr. Paul Maloof for care?

Short answer: The center emphasizes comprehensive education and conservative treatment, using surgery only when necessary. Dr. Paul Maloof specializes in both surgical and non-surgical care for conditions including foot drop, offering advanced treatments to help patients recover safely and efficiently. Convenient locations are available in Hampton and Williamsburg.