The Best Therapy for Foot Drop

Foot drop is a condition characterized by difficulty lifting the front part of the foot. It is not, however, a disease in itself, but the symptom of an underlying condition that's muscular, neurological or anatomical in nature. Foot drop can typically be cured by treating the underlying condition; however, should the condition be permanent, the best treatments and therapies that exist are centered around improving mobility.

Causes and Symptoms

• The potential causes of foot drop are myriad. Non-specific conditions can include an injury that causes damage to the muscles of ankles and toes or nerve damage in the lower spine or leg, the latter of which can result from diabetes (neuropathy). Temporary foot drop can occur through something as simple as sitting with your legs crossed for an extended period of time, as that can damage the nerves in the ankle.

  A variety of specific conditions can cause foot drop as well. They include muscular dystrophy, stroke, multiple sclerosis, cerebral palsy, Lou Gehrig's disease and compartment syndrome (the compression of nerves and blood vessels), among others. Additionally, chemotherapy drugs and drugs used to treat multiple sclerosis can lead to foot drop.

  The most common symptoms of foot drop is the simple inability or difficulty lifting the front part of the foot. As you walk it may drag along the ground, leading to stepping gait, wherein the thigh is lifted to walk. It can affect one or both feet and can sometimes be accompanied by pain, numbness or tingling in the foot.

Therapy

• The first step in treating foot drop is to determine the underlying condition and treating that. Secondary treatment focuses on alleviating discomfort and attempting to restore mobility. The most common cause of this is through shoe inserts or leg braces known as ankle-foot orthotics. This can often be combined with physical therapy and exercise to improve the strength of the leg and foot, as well as to help improve stepping gait.

  Stimulating the nerves with a small electrical-device that straps to or is implanted in the leg may be helpful. When walking, a small electric current is applied to the peroneal nerve, which is responsible for lifting the foot with each step. This can be effective for those whose foot drop is the direct result of a stroke. According to a study published in the January 2008 issue of the American Journal of Physical Medicine and Rehabilitation, patients who used the NESS L300™ Foot Drop System over the course of a year experienced significant improvement in their gait and overall mobility. The system senses when the leg is in the air or touching the ground and sends signals to a microprocessor implanted just below the knee, which stimulates the nerves.

Surgery

• In the event that the foot drop is caused by injuries to the spinal cord or certain nerves, such as those in the lower back, surgery may be necessary to repair the damage. In some cases the ankle and foot joint may be fused together, or a tendon from a leg muscle may be transferred to the ankle.

  Dr. Rahul K. Nath of the Texas Nerve and Paralysis Institute is a leading foot drop surgeon who has pioneered a form of surgery that is effective in patients whose foot drop is caused by hip replacement surgery or other associated injuries. It involves the transferring of nerves from the adjacent tibial nerve to the affected area, with the best results coming from surgery performed no longer than eight months after the onset of the condition.