Guide to Foot Drop
The peroneal nerve includes a branch of the sciatica nerve that enables movement and supplies sensation to one’s feet, toes, and lower legs.
Peroneal neuropathy or common peroneal dysfunction results from nerve damage outside the brain or spinal cord. It can strike individuals at any age and cause issues, such as foot drop or drop foot.
Peroneal nerve damage is most common in extremely thin people, who have certain autoimmune conditions or nerve damage from other medical issues, or who suffer from the Charcot-Marie-Tooth disease.
You can also incur this nerve damage from:
- Trauma, pressure, or injury to the knee
- A fibula fracture
- A tight plaster cast or another form of long-term constriction in the lower leg
- Wearing high boots or crossing one’s legs regularly
Peroneal nerve damage disrupts the function of the myelin sheath, which covers the axon. If the axon is also injured, it can cause more severe symptoms than foot drop. If you or someone you know suffers from drop foot, this article covers everything you should know about the ailment.
What Is Foot Drop?
Foot drop or drop foot causes stiff legs that result in walking difficulty. A weakness in the foot’s dorsiflexors can make one’s forefoot weak or paralyzed. That means you cannot lift your forefoot or the front part of your foot.
Individuals with drop foot often have an antalgic gait and can have problems with balance as it makes walking difficult. Individuals suffering from foot drop tend to drag their toes while walking or lift their knees unusually high to avoid pain. Some individuals even swing the affected leg in a wide arc to walk without dragging their toes.
Causes of Foot Drop
Drop foot is caused by weakness or paralysis in the foot’s muscles that work to lift it. It can affect one or both feet, and its onset can strike at any age.
It is often a symptom of an underlying disorder and can be temporary or permanent, depending on the cause. The treatment depends on the cause.
Foot drop is primarily caused by:
- Nerve injuries
- Spinal or brain disorders
- Muscular disorders
As previously mentioned, drop foot is primarily caused by peroneal neuropathy, which involves damage or an injury to the peroneal nerve that wraps the front of the shin from the back of the knee.
Peroneal neuropathy often results in pain or numbness along the shin or top of the foot and can arise due to compression or damage from:
- A hip or knee replacement surgery
- Genetic disorders, such as diabetes
Drop foot can also manifest due to:
- Radiculopathy: Compression or nerve root irritation in the lumbar spine.
- Lumbosacral plexopathy: Damage to nerve groups (e.g., plexus) in the lumbar or sacral spine.
Spinal or Brain Disorders
Neurological conditions that may contribute to foot drop include:
- Multiple sclerosis (MS)
- Cerebral palsy
- A stroke
- Charcot-Marie-Tooth disease
Since drop foot is also caused by muscle weakness, it can also stem from muscular disorders, such as:
- Muscular dystrophy
- Amyotrophic lateral sclerosis or Lou Gehrig’s disease
Foot Drop vs. Flail Foot, What’s the Difference?
Drop foot and flail foot are two different ailments that people often confuse. But unlike foot drop, flail foot inhibits not only one’s affected foot but also ankle movements in any direction. It usually indicates a severe medical injury, such as a stroke or the cauda equina syndrome.
Foot Drop Characteristics
Drop foot may manifest differently among individuals, so it is vital to know its main characteristics to prevent it from occurring.
- Foot drop may not consistently pose a hindrance or be extremely obvious. Individuals may only occasionally trip or feel that their footwear is loose. These mild symptoms indicate the initial stages of nerve dysfunction-induced drop foot.
- Foot drop may manifest without any other pain or discomfort. Aches associated with nerve injury or compression may not always manifest, and drop foot can be the only symptom.
- Foot drop can be resolved by addressing the cause. Whether nerve damage or a muscular disorder is to blame, treating the underlying cause of drop foot can cure it as it is ultimately a symptom and not the problem.
A severe case of foot drop is often characterized by:
- Intense weakness and immobility in the foot
- Severe numbness and pain
- Loss of bowel or bladder control
- Loss of appetite and decrease in weight
Treating drop foot involves solving the underlying problem.
So let us look at the different ways to treat foot drop based on its causes.
Treating Foot Drop
Drop foot can be a hindrance, but it does not have to be a permanent obstacle that stops you from living your life. There are ways to treat it to improve your condition or reduce its strain.
Address the Underlying Issue
If your foot drop is associated with a curable health issue or nerve damage, doing so may entirely or at least partially resolve it.
- Steroid injections can help reduce inflammation that may be causing nerve compression in the spine.
- Correcting blood sugar levels can improve diabetes-related nerve damage.
- Getting a dislocated kneecap put back in place can decompress the peroneal nerve.
Use a Drop Foot Brace
A relatively inexpensive way to reduce the discomfort and tripping hazard caused by foot drop is to use a brace to correct the foot’s flopping. These support braces that come in various kinds can help lift the foot.
Known as dorsiflexion assist ankle-foot orthotics (AFO), these braces can provide much-needed support throughout the day. Night splints are also helpful to reduce the strain on other areas of your body.
Do Exercises and Stretches
Exercises that help strengthen and promote flexibility in the foot, ankle, and leg muscles are crucial when dealing with drop foot. Therefore, physiotherapy is essential.
Some helpful exercises and stretches include:
- Seated ball lifts
- Marble pickups
- Modified toe raises
- Toe-to-heel rocks
- Towel stretches
- Ankle eversions
- Ankle rotations
Drop foot can be extremely difficult to deal with. Fortunately, there are treatments and surgeries to solve it. If the pain and discomfort become unbearable, you can try to relieve the pain by soaking your feet in hot water and Epsom salts. You can also use essential oils in these soaks or massage them to relieve pain. Some beneficial essential oils include peppermint, lemongrass, and black pepper. Shoe inserts can also help reduce discomfort.