Foot Drop

Diagnosis

Foot drop is typically diagnosed during a physical examination. Your healthcare provider will observe your walking pattern (gait) and check your leg muscles for weakness. They may also test for numbness or reduced sensation along your shin, foot, and toes — areas commonly affected by nerve problems.

Imaging Tests

Sometimes, foot drop is caused by a mass or structural issue pressing on a nerve. This could be due to an overgrowth of bone, a tumor, or a cyst in the knee, spine, or surrounding tissues. Imaging tests help locate and assess these problems:

• X-ray:
  Uses low levels of radiation to detect bone overgrowths or lesions that may be compressing a nerve.

• Ultrasound:
  Uses sound waves to create images of soft tissues. It can identify cysts, tumors, or swelling around the nerve caused by compression.

• CT scan (Computed Tomography):
  Combines multiple X-ray images to produce detailed cross-sectional views of bones and soft tissues, helping pinpoint structural abnormalities.

• MRI (Magnetic Resonance Imaging):
  Uses radio waves and magnetic fields to create high-resolution images of bones, muscles, and nerves. MRI is particularly effective in spotting soft tissue or nerve compression.

Nerve Tests

To evaluate nerve and muscle function, your healthcare provider may perform:

• Electromyography (EMG):
  Measures the electrical activity of muscles during rest and contraction.

• Nerve conduction studies:
  Assess how quickly electrical signals travel through your nerves to detect the site of damage or compression.

Although these tests can cause mild discomfort, they are highly valuable in identifying the exact location and extent of nerve injury causing foot drop.

Treatment

Treatment for foot drop depends on the underlying cause. In some cases, foot drop improves or resolves completely once the cause is addressed. However, if the nerve damage is permanent, symptoms may persist.

Treatment options include:

• Braces or Splints:
  An ankle-foot orthosis (AFO) or splint helps support the foot in a normal position, improving stability and walking ability.

• Physical Therapy:
  Exercises strengthen the leg muscles, enhance mobility, and prevent stiffness in the calf or heel. Stretching and gait training help improve balance and prevent falls.

• Nerve Stimulation:
  Functional electrical stimulation (FES) may be used to activate the nerve responsible for lifting the foot, improving walking motion.

• Surgery:
  If foot drop is caused by nerve compression, nerve decompression surgery may help restore function. In long-standing cases, tendon transfer surgery — where a working tendon is moved to assist with foot movement — can improve mobility and stability.

Early diagnosis and prompt treatment improve the chances of recovery and help prevent long-term complications associated with foot drop.