Foot Drop

Foot drop is a general term for difficulty lifting the front part of the foot

foot drop is a sign of an underlying neurological, muscular or anatomical problem.

Sometimes foot drop is temporary, but it can 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

Symptoms

Foot drop makes it difficult to lift the front part of your foot, so it might drag on the floor when you walk. This can cause you to raise your thigh when you walk, as though climbing stairs (steppage gait), to help your foot clear the floor. This unusual gait might cause you to slap your foot down onto the floor with each step.

Causes

Foot drop is caused by weakness or paralysis of the. Causes of foot drop might include:

• Nerve injury. The most common cause of foot drop is compression of a nerve in your leg that controls the muscles involved in lifting the foot (peroneal nerve). This nerve can also be injured during hip or knee replacement surgery, which may cause foot drop.

A nerve root injury — "pinched nerve" — in the spine can also cause foot drop.

• Muscle or nerve disorders. Various forms of muscular dystrophy, an inherited disease that causes progressive muscle weakness, can contribute to foot drop, such as polio or Charcot-Marie-Tooth disease.
• Brain and spinal cord disorders. Disorders that affect the spinal cord or brain — such as amyotrophic lateral sclerosis (ALS), multiple sclerosis or stroke — may cause foot drop.

Diagnosis

Foot drop is usually diagnosed during a physical exam. Your doctor may watch you walk and check your leg muscles for weakness. He or she may also check for numbness on your shin and on the top of your foot and toes.

Imaging tests

• X-rays. To see the bony structure of the affected limb or spine
• Ultrasound. This technology, which uses sound waves to create images of internal structures, can check for cysts or tumors on the nerve or show swelling on the nerve from compression.
• Magnetic resonance imaging (MRI).  MRI is particularly useful in visualizing soft tissue lesions that may be compressing a nerve.

Nerve tests

Electromyography (EMG) and nerve conduction studies measure electrical activity in the muscles and nerves. These tests are useful in determining the location of the damage along the affected nerve.

Treatment

Foot drop

Treatment for foot drop depends on the cause. If the cause is successfully treated, foot drop might improve or even disappear. If the cause can't be treated, foot drop 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.  stimulating the nerve that lifts the foot improves foot drop.
• Surgery. Depending upon the cause, and if your foot drop is relatively new, nerve surgery might be helpful. If foot drop is long-standing, your doctor 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.