The symptom of foot drop, characterized by the inability to control the front half of the foot, causes the dragging of the toes while walking. Caused by a variety of conditions, physicians take the symptom of foot drop quite seriously and will want to quickly determine the cause and find if the symptoms will respond to treatment.
Causes of Foot Drop
Foot drop has a root cause of nerve injury, muscle or nerve disorders, or disorders of the brain or spinal cord. Nerve injury can occur from degenerative changes to the spine, such as ruptured discs, stenosis of the canal or foramina, or even fractures causing nerve compression, as well as the result of damage to the peroneal nerve that travels through the hip and knee during joint replacement or after a fracture. Muscle wasting disorders can cause foot drop in some cases, as well as chronic and progressive brain and spine disorders such as MS, and ALS, or acute issues affecting the brain and spine such as a stroke. Most often in encountering foot drop in an orthopedic clinic the foot drop presents acutely from the compression of sciatic nerve in the lumbar spine.
Treating Foot Drop
Treatments for foot drop in orthopedics fall into two categories: foot drop from degenerative changes to the spine causing compression of the sciatic nerve, and foot drop after a severe fracture or rare surgical complication that affects a branch of the sciatic nerve called the peroneal nerve.
Foot Drop from spine issues
Degenerative changes to the lower portion of the spine, called the lumbar spine, can cause nerve compression to the sciatic nerve causing radiating pain, numbness, tingling, and potentially foot drop. While any radiating symptoms down one leg or both indicate the need to see a spine specialist the presence of foot drop indicates a level of severity that requires quick medical intervention. Patients presenting with an acute foot drop should reach out to their physician immediately to inform them of their current symptoms.
Treating foot drop from nerve impingement
Evaluation of the location and extent of the compression will require the ordering of an MRI. Oral and injectable steroids may alleviate symptoms temporarily, permanently, or in some cases not at all. Physicians often resolve nerve compression issues with oral, injectable, or imaging guided steroids in conjunction with physical therapies, stretching and strengthening the supporting structures of the back and abdomen. Patients that do not respond well to conservative treatments may find that to prevent permanent nerve damage their surgeon will recommend surgical intervention. In this case the procedure recommended varies depending on the nature and severity of the degeneration.
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