Foot drop is a symptom rather than a condition or injury. It describes the inability to raise the foot upwards (dorsiflex the ankle) as if pulling the toes up towards the shin.
A patient with foot drop may drag the foot along the floor when walking. Or, in order to combat this, they may raise the hip and knee higher so that the foot clears the ground. They may also slap the foot back to the floor once the heel hits the ground as they cannot control the downward motion.
Foot drop may be a temporary condition or may be permanent, depending on its cause. There are many different causes which may include:
- Injury to the peroneal nerve (peroneal nerve palsy) is a common cause of foot drop.
- Injury to the ankle dorsiflexor muscles, such as Tibialis Anterior.
- Spinal canal stenosis.
- Peripheral neuropathies.
- Compartment syndromes.
- Muscular conditions such as Muscular Dystrophy.
- Neurodegenerative disorders such as Multiple Sclerosis.
- Foot drop may develop following a stroke.
- Motor neuron disorders, e.g. Polio.
- Following surgery (such as knee replacement). This may be due to a hematoma causing compression or irritation of the nerve which is temporary, or nerve damage during surgery.
- Habitual crossing of the legs when sitting – compresses the peroneal nerve.
It is important to establish the cause of foot drop. In some cases, it will be obvious and in others, it may be more complicated.
If you have foot drop you should visit your Doctor who will observe the injury and look at your medical history for possible causes. If the cause is not clear then diagnostic tests such as an MRI scan, CT scan, EMG (electromyography – to look at the nerves) or blood tests for detecting conditions such as Diabetes.
Treatment of varies depending on the cause of the problem and how temporary or permanent the condition may be. A foot drop splint is often the first line of treatment. These help to hold the foot up off the ground to make walking easier. These tend to be plastic splints which are inserted into the shoe.
Physical therapy may be used to ‘re-educate’ a patients gait cycle (walking pattern). A physical therapist may also be used in treating the underlying cause of the foot drop. For example a back strengthening rehabilitation programme for those with spinal canal stenosis.
Nerve stimulation may be effective in those which dropped foot is due to a stroke. A battery-operated unit may be strapped to the leg just below the knee, or in some cases, a tiny stimulator may be implanted within the leg.
Treatments for other causes of foot drop may include epidural or steroid injections and anti-inflammatory medications. Surgery may be required in a number of the conditions listed above, usually, once non-surgical treatment has failed. Surgery will vary depending on the cause of the drop foot. It may be aimed at the cause such as with spinal canal stenosis or other back problems or may be used to fuse the ankle joint to prevent the downward drop.
Kuanguka kwa mguu ni dalili badala ya hali au jeraha. Ni hali ya kutoweza kuinua mguu juu (dorsiflex ya mguu) kama vile kuvuta vidole vya miguu juu kuelekea shin. Mgonjwa aliye na ugonjwa wa kushuka kwa mguu anaweza kuvuta mguu wake sakafuni anapotembea. Au, ili kupambana na hilo, huenda wakanyanyua kiuno na goti juu zaidi ili mguu uondoke ardhini. Pia wanaweza kupiga mguu nyuma kwenye sakafu mara tu kisigino kinapogonga ardhi kwa sababu hawawezi kudhibiti mwendo wa chini. Kuanguka kwa mguu kwaweza kuwa hali ya muda mfupi au ya kudumu, ikitegemea kisababishi chake. Kuna sababu nyingi tofauti ambazo zinaweza kujumuisha: - Majeraha ya neva ya peroneal (paralyia ya neva ya peroneal) ni sababu ya kawaida ya kuanguka kwa mguu. - Majeraha ya misuli ya dorsiflexor ya mguu, kama vile Tibialis Anterior. - Mshtuko wa mfereji wa uti wa mgongo. - Ugonjwa wa neva wa pembeni. - Ugonjwa wa sehemu. - Hali za misuli kama vile Dystrophy ya Misuli. - Ugonjwa wa neurodegenerative kama vile Multiple Sclerosis. - Kuanguka kwa mguu kunaweza kutokea baada ya kiharusi. - Matatizo ya neva za motor, kwa mfano Ugonjwa wa polio. - Baada ya upasuaji (kama vile uingizwaji wa goti). Hii inaweza kuwa kutokana na hematoma kusababisha compression au kuchochea ya neva ambayo ni ya muda, au uharibifu wa neva wakati wa upasuaji. - Kuunganisha miguu kwa kawaida unapoketi <unk> hufinya neva ya peroneal. Ni muhimu kujua ni nini kinachosababisha miguu ianguke. Katika visa fulani, itakuwa wazi na katika vingine, inaweza kuwa ngumu zaidi. Ikiwa una mguu wa kushuka unapaswa kumtembelea Daktari wako ambaye ataangalia jeraha na kuangalia historia yako ya matibabu kwa sababu zinazowezekana. Kama sababu haijulikani, basi uchunguzi wa utambuzi kama vile MRI, CT scan, EMG (electromyography) au uchunguzi wa damu kwa ajili ya kugundua hali kama vile kisukari. Matibabu ya ugonjwa huo hutofautiana kulingana na kisababishi cha tatizo hilo na jinsi hali hiyo inavyoweza kuwa ya muda mfupi au ya kudumu. Mara nyingi matibabu ya kwanza ni kutumia kiunzi cha kuingiza maji kwenye mguu. Hizi husaidia kushikilia mguu juu ya ardhi ili kufanya kutembea kuwa rahisi. Hizi huwa ni splits za plastiki ambazo huingizwa ndani ya kiatu. Tiba ya kimwili inaweza kutumika "kuelimisha upya" mzunguko wa kutembea kwa wagonjwa (mfano wa kutembea). Mtaalamu wa tiba ya kimwili aweza pia kutumiwa kutibu kisababishi cha kushuka kwa mguu. Kwa mfano mpango wa kuimarisha mgongo kwa wale walio na stenosis ya mfereji wa uti wa mgongo. Kuchochea neva kunaweza kuwa na matokeo kwa wale ambao miguu yao imeshuka kwa sababu ya kiharusi. Kituo cha kuendesha betri kinaweza kushikamana na mguu chini ya goti, au katika visa fulani, kichocheo kidogo chaweza kupandikizwa ndani ya mguu. Matibabu ya visababishi vingine vya kuanguka kwa mguu yaweza kutia ndani sindano za epidural au steroid na dawa za kuzuia uvimbe. Upasuaji waweza kuhitajiwa katika hali kadhaa zilizoorodheshwa hapo juu, kwa kawaida, mara tu matibabu yasiyo ya upasuaji yameshindwa. Upasuaji utatofautiana ikitegemea kisababishi cha mguu wa kushuka. Inaweza kuelekezwa kwa sababu kama vile stenosis ya mfereji wa uti wa mgongo au matatizo mengine ya mgongo au inaweza kutumika kuunganisha kifungo cha mguu ili kuzuia kushuka chini.