What can cause right foot drop and mid-thoracic (middle chest) pain?

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Last updated: April 28, 2025View editorial policy

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Differential Diagnosis for Foot Drop and Mid Thoracic Pain

  • Single most likely diagnosis
    • Lumbar radiculopathy (L5 nerve root compression): This is a common cause of foot drop, and mid thoracic pain can be referred pain from the lower spine. The L5 nerve root is responsible for controlling the muscles that lift the foot, and compression of this nerve can lead to foot drop.
  • Other Likely diagnoses
    • Peripheral neuropathy: Conditions such as diabetes or peripheral artery disease can cause nerve damage leading to foot drop. Mid thoracic pain can be unrelated or a separate issue.
    • Spinal stenosis: Narrowing of the spinal canal can compress nerves, leading to foot drop and pain in the thoracic region.
    • Herniated disk: A herniated disk in the thoracic or lumbar spine can compress nerves, causing foot drop and mid thoracic pain.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Cauda equina syndrome: A serious condition where the nerves in the spinal canal are compressed, leading to foot drop, pain, and potentially permanent damage if not treated promptly.
    • Spinal cord tumor: A tumor in the spinal cord can compress nerves, leading to foot drop and mid thoracic pain. Early diagnosis is crucial for treatment and preventing further damage.
    • Aortic dissection: A tear in the aorta can cause mid thoracic pain and potentially lead to nerve compression, resulting in foot drop. This is a medical emergency that requires immediate attention.
  • Rare diagnoses
    • Guillain-Barré syndrome: A rare autoimmune disorder that can cause nerve damage, leading to foot drop and potentially other neurological symptoms.
    • Charcot-Marie-Tooth disease: A genetic disorder that affects the nerves, leading to foot drop and other neurological symptoms.
    • Neurosyphilis: A rare condition caused by syphilis infection, which can lead to nerve damage and foot drop.

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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