From the Guidelines
Foot drop, also known as peroneal nerve palsy, is primarily caused by compression or injury to the peroneal nerve, which can occur due to prolonged crossing of legs, wearing tight casts, or direct trauma to the knee area, as well as nerve disorders like diabetic neuropathy, herniated discs, stroke, multiple sclerosis, and amyotrophic lateral sclerosis (ALS) 1.
Causes of Foot Drop
The causes of foot drop can be categorized into several groups, including:
- Nerve damage: Compression or injury to the peroneal nerve, which wraps around the neck of the fibula bone near the knee, is a common cause of foot drop.
- Nerve disorders: Diabetic neuropathy, which damages peripheral nerves, is a significant cause of foot drop, as it can lead to loss of protective sensation and altered biomechanics in the foot 2.
- Trauma: Direct trauma to the knee area, such as from a car accident or a fall, can cause foot drop.
- Medical conditions: Certain medical conditions, such as herniated discs in the spine, stroke or brain injury affecting motor pathways, multiple sclerosis damaging the central nervous system, and amyotrophic lateral sclerosis (ALS) causing progressive muscle weakness, can also cause foot drop.
Risk Factors
Several risk factors can increase the likelihood of developing foot drop, including:
- Diabetes: People with diabetes are at higher risk of developing foot drop due to peripheral neuropathy and altered biomechanics in the foot 3.
- Poor glucose control: Poor glucose control can increase the risk of developing foot drop in people with diabetes.
- Cardiovascular disease: People with cardiovascular disease are at higher risk of developing foot drop due to peripheral artery disease (PAD) and decreased blood flow to the feet.
- Previous trauma: Previous trauma to the knee or leg can increase the risk of developing foot drop.
Diagnosis and Treatment
Early diagnosis and treatment of foot drop are crucial to improve mobility and prevent complications like falls. Treatment depends on the underlying cause and may include physical therapy, braces or ankle-foot orthoses, nerve decompression surgery, or addressing the primary condition 4.
Quality of Life
Foot drop can significantly impact a person's quality of life, causing difficulty walking and increasing the risk of falls and other complications. Therefore, it is essential to prioritize early diagnosis and treatment to improve mobility and prevent long-term disability.
From the Research
Causes of Foot Drop (Peroneal Nerve Palsy)
The causes of foot drop, also known as peroneal nerve palsy, can be attributed to various factors, including:
- Neurological injuries 5
- Muscular dysfunction 5
- Nerve compression 5, 6, 7
- Vascular compromise 5
- Lumbar degenerative disease 6
- Common peroneal nerve injury at the fibular head (fibular tunnel) 7
- Lumbar spine nerve root damage 7
- Sciatic nerve palsy at the sciatic notch 7
- Central or peripheral lesions of the nervous system 8
Specific Conditions Associated with Foot Drop
Foot drop can be a symptom of various conditions, including:
Importance of Understanding the Cause of Foot Drop
Understanding the etiology and assessing the severity of foot drop is essential for implementing appropriate management strategies and ensuring better patient outcomes 5. A multidisciplinary approach, involving critical care physical therapists, neurologists, and other healthcare professionals, is crucial in the comprehensive care of patients with foot drop syndrome 5.