Foot drop, or drop foot, involves a difficulty in lifting the front part of the foot, which can causes challenges while walking. It’s a common symptom of multiple sclerosis (MS), but it can also be caused by other neurological syndromes or physical damage to a nerve.
People with this symptom tend to walk by lifting the knee, as though they were walking up stairs. Other muscle- and nerve-related symptoms of MS can compound the challenges presented by this condition.
There are many treatment options, ranging from braces to physical therapy to surgery. They may not completely restore a normal gait, but they can often reduce symptoms significantly and make walking easier.
Because MS disrupts communication between the brain and the body, nerve-related problems are common. Feelings of numbness or tingling in the extremities are often the earliest signs of MS.
Nervous system problems can develop into more serious complications. Foot drop is the result of a weakness in the tibialis anterior muscle, which is controlled by the deep peroneal nerve.
Foot drop-related walking problems can be made worse by other symptoms of MS.
Numbness in the feet can become so severe that someone with MS may have difficulty feeling the floor or knowing where their feet are in relation to the floor. This condition is called sensory ataxia. Ataxia is a muscle control problem that prevents the coordination of movement.
Many symptoms of MS can cause difficulties with walking. The general sense of fatigue that accompanies MS causes leg muscles to become tired, and tightness or spasms in the leg muscles can add to walking problems. Even without foot drop, walking can be a challenge for people with MS.
While MS is a common cause of foot drop, the gait-related problem is also associated with other conditions and health events. These include:
- amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig’s disease
- muscular dystrophy
- Charcot-Marie-Tooth disease (CMT), a neurological disorder
Foot drop can also be caused by injuries to the nerves that control the muscles that lift the foot. The affected nerves may be in the knee or in the lower spine.
Foot drop treatment depends primarily on the cause of the condition and the extent of the disability. Treating a herniated disc, for example, may eliminate foot drop. But spinal surgery may not solve the problem for people with MS.
A variety of orthotics, such as braces and splints, are available. Some are worn in the shoes, while others are worn around the ankle or near the knee.
One widely used device is the ankle foot orthosis (AFO). It helps keep the foot at a 90-degree angle to the lower leg to support it. While it can help improve your gait, it may require a larger shoe to accommodate the brace. An AFO may also become uncomfortable if worn for long periods of time.
Electrical stimulation while walking can also help reduce the symptoms of foot drop. This treatment is also known as functional electrical stimulation (FES). Small devices worn near the knee respond to the movement of the leg and send mild electrical stimuli to the muscle to help it move properly.
A 2013 study showed that both AFO and FES treatment improved gait speed for people with stroke-related drop foot.
Physical therapy may also help. A variety of exercises can strengthen the leg muscles and improve flexibility. Working with a physical therapist who has a knowledge of MS and foot drop can be especially helpful.
If orthotics or physical therapy don’t sufficiently manage the condition, there are several surgical solutions that may help.
A tendon transfer is one potential solution. Typically, this involves transferring a tendon that usually goes to a different part of the foot and directing it instead to the top of the foot to replace the tibialis anterior.
Another type of surgery fuses the foot and ankle to remove the burden from the peroneal muscle. However, this procedure reduces the flexibility of the ankle.
All surgeries carry risks, so it’s important to reach out to your doctor about all your treatment options. If you’re going to have surgery, be sure to understand the risks, benefits, and long-term results of your choice.
Walking with foot drop can make you self-conscious and can tire you more easily. But like some other MS symptoms, it can often be managed successfully.
You don’t have to endure foot drop without help. Talking with your doctor and working with a physical therapist are two steps you can take to treat foot drop.