What causes foot drop after lying in bed?

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Last updated: April 25, 2025View editorial policy

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Differential Diagnosis for Foot Drop after Laying in Bed

  • Single most likely diagnosis
    • Peroneal nerve compression: This is the most likely diagnosis because the peroneal nerve can be compressed when laying in bed, especially if the patient has been in a position that puts pressure on the nerve for an extended period. This compression can cause foot drop.
  • Other Likely diagnoses
    • Lumbar radiculopathy (L5 nerve root compression): This can cause foot drop due to compression of the L5 nerve root, which controls the muscles responsible for ankle dorsiflexion.
    • Peripheral neuropathy: Certain types of peripheral neuropathy, such as diabetic neuropathy, can cause foot drop.
    • Muscle weakness: Generalized muscle weakness, such as that seen in myopathies or neuromuscular disorders, can also cause foot drop.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Cauda equina syndrome: This is a serious condition that requires immediate medical attention. It is caused by compression of the cauda equina, a bundle of nerve roots in the lower spine, and can cause foot drop, as well as other symptoms such as urinary retention and loss of sensation in the legs.
    • Spinal cord infarction: This is a rare but potentially devastating condition that can cause foot drop, as well as other symptoms such as loss of sensation and motor function in the legs.
  • Rare diagnoses
    • Guillain-Barré syndrome: This is a rare autoimmune disorder that can cause foot drop, as well as other symptoms such as ascending paralysis and loss of reflexes.
    • Amyotrophic lateral sclerosis (ALS): This is a rare neurodegenerative disorder that can cause foot drop, as well as other symptoms such as muscle weakness and atrophy.
    • Tumor or cyst compressing the peroneal nerve or L5 nerve root: This is a rare but possible cause of foot drop, and would require imaging studies such as MRI or CT to diagnose.

Professional Medical Disclaimer

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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