Foot Drop

What is foot drop?

Foot drop (also called drop foot) happens when you can’t raise the front part of your foot due to weakness or paralysis of the muscles that lift it. It’s a symptom of several possible underlying conditions and can be temporary or long-term (chronic).

Due to weakness or paralysis, people who have foot drop often drag their toes when they walk. They may also have to lift their knee higher than usual to avoid dragging their toes. Walking this way may increase your risk of tripping and falling.

Foot drop can affect one of your feet (unilateral) or both of them (bilateral).

What are the possible causes of foot drop?

Foot drop has several possible causes, typically due to an issue with your nerves and/or muscles. The most common causes are lumbar radiculopathy and peroneal nerve injury.

Other causes include:

• Brain conditions.
• Motor neuron conditions.
• Peripheral neuropathies.
• Muscle conditions.

Lumbar radiculopathy

Radiculopathy happens when one of your nerve roots (where your nerves join your spinal column) is compressed or irritated.

Lumbar radiculopathy refers to a pinched nerve in your low back. Nerves that start in this area of your back extend down to your legs and feet. Your lumbar spine consists of the five bones (vertebra) in your lower back, labeled L1 to L5.

L5 radiculopathy specifically is a common cause of foot drop.

Radiculopathy usually happens due to narrowing of the space where your nerve roots exit your spine. This can be from:

• Spinal stenosis.
• Bone spurs.
• Herniated disk.
• Lumbar spondylosis.

Peroneal nerve injury

Your common peroneal nerve is a peripheral nerve that extends down your leg. It’s a branch of the sciatic nerve that travels from the back of your thigh along the outside of your knee to the front of your lower leg. It supplies movement and sensation to your lower legs, feet and toes.

Several things can damage your common peroneal nerve and cause foot drop. Often, peroneal nerve injuries develop because of a traumatic injury to your knee, leg or ankle. These injuries include:

• Ankle fracture.
• Fibula fracture.
• Knee dislocation.
• Knee fracture.

Injuries to your sciatic nerve in your buttock or back of your thigh can also cause a foot drop.

Your risk of peroneal nerve damage increases if you:

• Often sit with your legs crossed at your knee.
• Have your leg in a cast.
• Are on bed rest.
• Have lost weight.

Sometimes, a tumor or cyst in your peroneal nerve can cause a foot drop. Inflammatory conditions, such as rheumatoid arthritis or lupus, can also damage your peroneal nerve.

Your peroneal nerve is a peripheral nerve (nerves outside your brain and spinal cord). Any condition that affects peripheral nerves, such as Charcot-Marie-Tooth disease or acquired peripheral neuropathy, can affect your peroneal nerve and cause foot drop.

Other causes of foot drop

Brain conditions that can cause foot drop include:

• Multiple sclerosis (MS).
• Stroke.
• Cerebral palsy.
• Parkinson’s disease.

Motor neuron disorders that can cause foot drop include:

• Polio.
• Spinal muscular atrophy.
• Amyotrophic lateral sclerosis (commonly known as Lou Gehrig’s disease).

Less commonly, muscle conditions, such as muscular dystrophy or myositis, can also lead to foot drop.

People who have any of these conditions usually have other muscular and/or neurological symptoms.

How is foot drop diagnosed?

To diagnose foot drop, a healthcare provider will perform a physical exam, which may show:

• Loss of muscle control in your lower leg(s) and foot/feet.
• Muscle atrophy in your foot or leg.
• Difficulty lifting your foot and toes.

The provider may order any of the following tests to find the underlying cause of foot drop:

• Imaging tests, such as X-rays, ultrasound and/or MRI scans, to look for compression or damage in your legs, spine or brain.
• Certain blood tests, such as a blood sugar test to check for diabetes and diabetes-related neuropathy.
• Nerve conduction tests to examine how your nerves are functioning.
• Electromyography to measure the electrical activity in your leg muscles.

Nerve conduction studies and electromyography are very useful in finding where the nerve problem is.

What is the treatment for foot drop?

Foot drop treatment depends on what’s causing it. In some cases, treating the cause will also fix foot drop. If the cause is a chronic condition, like multiple sclerosis or ALS, foot drop may be permanent.

Possible treatments include:

• Physical and occupational therapy to help stretch and strengthen your muscles and help you walk better.
• Braces, splints or shoe inserts (orthotics) to help support your ankle and foot and keep it in a more natural position.

In some cases, people need surgery to relieve pressure on their peroneal nerve or to try to repair it.

For chronic foot drop, your provider may suggest fusing your ankle or foot bones. Or you may have tendon surgery in which a surgeon transfers a tendon from your other leg to the muscle in your affected leg to help it pull your foot up.

Can drop foot fix itself?

If the cause of foot drop is temporary, such as nerve inflammation or minor nerve damage from compression, foot drop can go away on its own once your nerve heals. In other cases, it may go away with treatment. For people who have underlying chronic conditions, like a neurodegenerative condition, foot drop is usually permanent.

As foot drop has several possible causes, there’s no way to know for sure what’s causing your case and if it will fix itself. Because of this, it’s important to see a healthcare provider so you can get a proper diagnosis.

What can I do at home to help foot drop?

You’re at higher risk of tripping and falling if you have a foot drop. Some steps you can take to help avoid this include:

• Using a walking aid, such as a cane or walker.
• Removing clutter from the floors in your home.
• Removing things you could trip on in your home, such as loose rugs.
• Using handrails when walking up or down stairs.

When should foot drop be treated by a doctor or healthcare provider?

If you’re unable to lift your foot or feet like you used to, see a healthcare provider. They’ll need to find the underlying cause to form a treatment plan.

A note from Cleveland Clinic

Not being able to control your foot like you used to can be alarming. The good news is that drop foot can be temporary, and many cases go away completely with treatment. See a healthcare provider if you notice weakness in your foot and/or have difficulty walking. They’ll order tests to figure out the cause, and together, you’ll decide on a treatment plan.