Foot Drop

Foot drop, also known as drop foot, is a neuromuscular condition that causes difficulty lifting the front part of the foot. [1] This article covers the definition, symptoms, foot drop causes, and when to seek help, helping you or your loved one recognize and respond to foot drop early.

What Is Drop Foot?

Drop foot (or drop foot syndrome) refers to the inability to lift the front part of the foot due to weakness or paralysis of the muscles that control dorsiflexion. People with this condition may drag their toes while walking, increasing the risk of falls, and may trip frequently or struggle with walking on flat surfaces. [1]

The severity can vary. In mild cases, the issue may come and go or worsen with fatigue. [2] In more severe foot drop cases, walking unaided becomes challenging, requiring orthotics or braces.

While it’s not a disease itself, foot drop is often a symptom of an underlying neurological, muscular, or anatomical issue. Understanding foot drop symptoms, causes, and risk factors is essential for early diagnosis and effective foot drop treatment.

Is Drop Foot an Autoimmune Disease?

No, foot drop is not an autoimmune disease, but it can be caused by autoimmune disorders. Conditions like multiple sclerosis (MS), lupus, and chronic inflammatory demyelinating polyneuropathy (CIDP) can lead to nerve inflammation or damage that results in a dropped foot. Diagnosing the root cause requires comprehensive testing.

What Is the Difference Between Foot Drop and Neuropathy?

Foot drop is a symptom, while neuropathy is a broader condition involving nerve damage. Peripheral neuropathy can cause foot drop, but not all neuropathies result in this specific symptom. Foot drop usually involves motor nerves (such as the peroneal nerve), while neuropathy may affect sensory nerves, motor nerves, or both.

Is Drop Foot a Symptom of Parkinson’s?

Yes, foot drop can be observed in Parkinson’s disease, although it is not one of the hallmark symptoms. In Parkinson’s, reduced stride length, rigidity, and balance issues may mimic or mask drop foot. If you have Parkinson’s and are noticing tripping or gait changes, consult your neurologist for a detailed assessment.

Foot Drop Symptoms

The primary symptom of foot drop is a high-stepping gait: lifting the leg higher than normal. This compensatory walk helps avoid dragging the toes. This is often paired with foot slapping upon landing. [1]

Patients may also experience muscle weakness, numbness, or tingling in the lower leg or foot. Symptoms can affect one or both feet depending on the underlying cause.

Additional drop foot symptoms include imbalance on stairs, loss of foot coordination, and shoe wear patterns from toe dragging. 

Early Signs of Foot Drop

Early signs of foot drop can be subtle. You might notice difficulty clearing the floor with your toes when walking, or a tendency to trip more often. Footwear may feel looser, and uneven wear patterns on shoes could appear. Muscle fatigue in the shin or calf after short walks is also common in the early stages.

When to Seek Medical Attention

Don’t wait until symptoms become severe. If you notice early signs of foot drop, seek medical evaluation. Timely diagnosis can prevent progression and improve outcomes.

Is Foot Drop an Emergency?

Foot drop isn’t typically a medical emergency. However, sudden onset, especially after trauma, surgery, or rapid leg weakness, can signal a serious neurological problem. Seek immediate care if you experience sudden or severe foot drop, especially if it’s accompanied by back pain, numbness, or bladder issues.

Drop Foot Causes

Foot drop has multiple potential causes, each affecting the nerves, muscles, or brain/spinal cord pathways that control dorsiflexion. The most common causes of foot drop include:

• Peroneal nerve entrapment is the most common peripheral nerve cause of foot drop, with an estimated 19 per 100,000 people affected annually. [1] The most frequent cause, typically from knee trauma, leg crossing, or prolonged compression (e.g., tight braces or casts). It disrupts the motor signals to the foot. 
• Lumbar radiculopathy: A pinched nerve in the lower back can interrupt the neural pathway to the foot.
• Stroke or brain injury: Damaged motor centers in the brain may reduce control of foot movement.
• Muscular dystrophy: This inherited condition weakens muscles over time, including those used for dorsiflexion.
• ALS (amyotrophic lateral sclerosis): Progressive motor neuron damage leads to muscle paralysis, including foot drop.
• Multiple sclerosis (MS): Immune attacks on the nervous system affect coordination and movement.
• Diabetic neuropathy: Elevated blood sugar damages peripheral nerves, including those controlling the feet.[3]
• Vitamin deficiencies: Deficiencies in B12 and vitamin E may cause peripheral neuropathy, sometimes resulting in foot drop.[4]

Why Did I Suddenly Get Foot Drop?

Sudden foot drop often results from acute nerve injury, such as trauma during sports, prolonged leg crossing, or complications from hip or knee surgery. Lumbar disc herniation can also compress the nerve roots supplying the leg. A sudden dropped foot warrants immediate clinical attention to identify what causes drop foot in your case.

Risk Factors for Foot Drop

Certain individuals are at higher risk of developing foot drop:

• Prolonged leg crossing or squatting
• Recent orthopedic surgeries (especially hip or knee)
• Diabetes (due to peripheral neuropathy)
• Neurological diseases (MS, ALS, Parkinson’s)
• Poorly managed B12 deficiency
• Wearing leg braces or cast that compress nerves [2]
• Prolonged kneeling [5]

Women over 60 are statistically more likely to experience foot drop, especially following hip replacement surgeries. [3]

Complications of Foot Drop

Untreated or chronic foot drop can result in long-term complications:

• Increased fall risk
• Muscle atrophy in the leg and foot
• Joint stiffness in ankles and knees
• Pain in hips or lower back from compensatory gait
• Reduced independence in daily activities

Early treatment can help minimize these effects.

Can You Drive with a Drop Foot?

Driving with drop foot depends on the severity of the condition. Mild cases may not affect driving ability. However, if dorsiflexion is severely impaired, pushing pedals safely can be difficult. Discuss with your healthcare provider whether it’s safe to drive and explore local regulations or assessment programs for medical driving clearance.

What to Do If You Notice Foot Drop Symptoms

If you suspect you’re developing foot drop symptoms, whether subtle or severe, don’t ignore them. Moore MyoWorx offers advanced neuromuscular assessment, treatment and personalized recovery plans. If you’re experiencing drop foot or have questions about its causes, our team is here to help you get back on your feet, literally.