Medicines for Foot drop

What it is

Foot drop is difficulty lifting the front part of the foot (raising the toes towards the shin), so that the foot tends to drag or slap the ground when walking. To compensate, a person may lift the knee higher than usual (a "high-stepping" gait) or swing the leg, and they may trip more easily. Foot drop is not a disease in itself but a sign of an underlying problem affecting the nerves, muscles, or, sometimes, the brain or spinal cord that control the movement. The most common cause is a problem with the nerve that lifts the foot (the peroneal nerve), for example from compression at the side of the knee (such as from prolonged crossing of the legs, sitting in certain positions, or pressure), injury, or other causes; it can also result from problems higher up — such as a trapped nerve in the lower back (sciatica-type problems), or conditions affecting the nerves more widely, the muscles, or the brain and spinal cord (such as after a stroke or with neurological conditions). It can be temporary or lasting, on one or both sides. Because the causes vary from readily reversible to more serious, foot drop is assessed to find the underlying reason.

How it is treated

Assessment aims to identify the cause, which guides treatment. A doctor examines the leg and foot, tests the nerves and muscles, and may arrange investigations such as nerve conduction studies, imaging of the back or affected area, or other tests depending on the likely cause. Treatment then targets the underlying problem: for example, if a compressed peroneal nerve at the knee is responsible, relieving the pressure (such as avoiding leg-crossing or the causative position) may allow it to recover; a trapped nerve in the back is treated accordingly; and any wider neurological or muscle condition is managed. Alongside treating the cause, measures help with function and safety: physiotherapy to strengthen and maintain movement, and an ankle-foot orthosis (a splint or brace that holds the foot in a better position) which greatly improves walking and reduces tripping in many people; in some cases other devices or, occasionally, surgery are considered. The outlook depends on the cause — some cases (such as a temporarily compressed nerve) recover fully, while others need ongoing management. The reassuring message is that foot drop is a symptom that can be assessed to find its cause, and that treatment of the cause, together with physiotherapy and supportive devices such as a foot splint, can improve walking and safety.