Foot drop

About foot drop

Foot drop is also sometimes called a drop foot, because it can cause you to drag your foot on the ground when you walk.

It is a sign of an underlying problem rather than a condition itself. This could be muscular, caused by nerve damage in the leg, or the result of a brain or spinal injury.

Foot drop usually only affects one foot, but both feet may be affected, depending on the cause. It can be temporary or permanent.

Causes of foot drop

Foot drop is due to weakness or paralysis of the muscles that lift the front part of your foot. This can be caused by a number of conditions including:

Conditions causing muscle weakness

Muscular dystrophy is a group of inherited genetic conditions that cause gradual muscle weakness and can sometimes lead to foot drop.

Foot drop can also be caused by other muscle wasting conditions, such as spinal muscular atrophy or motor neurone disease.

Peripheral nerve problems or neuropathy

Foot drop is often caused by compression (squashing) of the nerve that controls the muscles that lift the foot.

Sometimes, nerves around the knee or lower spine can become trapped. The nerves in the leg can also be injured or damaged during hip replacement or knee replacement surgery.

Foot drop can sometimes be caused by nerve damage linked to diabetes. 

Inherited conditions that cause peripheral nerve damage and muscle weakness, such as Charcot-Marie-Tooth disease, can also sometimes lead to foot drop.

Brain and spinal cord disorders

Foot drop can also be caused by conditions that affect the brain or spinal cord, such as:

• stroke
• cerebral palsy
• multiple sclerosis

Diagnosing foot drop

Foot drop is often diagnosed during a physical examination. Your GP will look at the way you walk and examine your leg muscles.

In some cases, imaging tests, such as an X-ray, ultrasound scan or computerised tomography (CT) scan, may be needed.

Managing foot drop

If you have foot drop, you'll find it difficult to lift the front part of your foot off the ground. This means you'll likely scuff your toes along the ground, increasing your risk of falls. To prevent this, you may lift your foot higher than usual when walking.

Recovery depends on the cause of foot drop and how long you've had it. In some cases it can be permanent.

Making small changes in your home, such as removing clutter and using non-slip rugs and mats, can help prevent falls. There are also things you can do to help make your foot stable and help improve your walking.

These include:

• physiotherapy – to strengthen your foot, ankle and lower leg muscles
• wearing an ankle-foot orthosis (splint) – to hold your foot in a normal position
• electrical nerve stimulation – in certain cases it can help lift the foot
• surgery – an operation to fuse the ankle or foot bones may be possible in severe or long-term cases

See more information on treatments below.

Ankle-foot orthosis

An ankle-foot orthosis (AFO) (or splint) is worn on the lower part of the leg to help control the ankle and foot. It holds your foot and ankle in a straightened position to improve your walking.

If your GP thinks an AFO will help, they'll refer you for an assessment with an orthotist.  An orthotist is a specialist who measures and prescribes orthoses. They will also answer any questions you may have about an AFO.

Electrical nerve stimulation

In some cases, an electrical stimulation device, similar to a TENS machine, can be used to improve walking ability. It can help you walk faster, with less effort and more confidence.

If your GP or consultant thinks you'll benefit from using an electrical stimulation device, you'll be referred to an orthopaedic foot and ankle surgeon for an assessment. You may then be referred to a specialist unit to try the device and see if it is suitable.

For long-term use, it may be possible to have an operation to implant the electrodes under your skin. The procedure involves positioning the electrodes over the affected nerve while you're under general anaesthetic.

Surgery

Surgery may be an option in severe or long-term cases of foot drop that have caused permanent movement loss from muscle paralysis.

Speak to your GP or orthopaedic foot and ankle specialist if you're thinking about having surgery for foot drop. They'll be able to give you more information about the available procedures.

More useful links

• How to use your health services