What is the management of foot drop after intramuscular (IM) injection?

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Last updated: February 25, 2025View editorial policy

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From the Research

Management of foot drop after intramuscular injection requires a multidisciplinary approach, with initial treatment focusing on physical therapy, ankle-foot orthosis, and electrical stimulation therapy, as supported by the most recent study 1. The goal of treatment is to improve mobility, prevent falls, and reduce pain.

  • Physical therapy should include range-of-motion exercises, stretching, and strengthening of the anterior tibialis and peroneal muscles, typically 2-3 sessions weekly for 6-12 weeks.
  • An ankle-foot orthosis (AFO) should be prescribed immediately to prevent contractures and facilitate walking by maintaining the foot in a neutral position.
  • Electrical stimulation therapy may be beneficial, applied for 20-30 minutes daily to the affected muscles.
  • Anti-inflammatory medications such as ibuprofen (400-600mg three times daily) or naproxen (250-500mg twice daily) can help reduce inflammation around the affected nerve. In cases where the foot drop resulted from local anesthetic injection, recovery typically occurs within hours to days as the medication wears off, as noted in 2. For steroid-induced or traumatic injection injuries, recovery may take weeks to months. Surgical decompression is rarely needed but may be considered if no improvement occurs after 3-6 months of conservative management, as suggested by 3. The prognosis depends on the severity of nerve damage, with complete recovery possible in many cases, especially when treatment begins promptly after injury, as reported in the highest quality study 1. Tendon transfer procedures have also been shown to be a safe and effective treatment option, resulting in a high level of patient satisfaction and restoration of quality of life, as demonstrated in 1. Overall, the management of foot drop after intramuscular injection should prioritize a multidisciplinary approach, with a focus on prompt intervention and individualized treatment plans, as supported by the most recent and highest quality study 1.

References

Research

The Interdisciplinary Management of Foot Drop.

Deutsches Arzteblatt international, 2019

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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