Foot Drop

Overview

Foot drop is common diagnosis when the L5 nerve is compressed from a disc herniation, foraminal stenosis, or spondylolisthesis. Other less common diagnoses include external trauma to the lower leg or nerve sheath tumors however, those topics will not be discussed here. A disc herniation at L4-5 or a foraminal disc at L5-S1 can compress the L5 nerve root causing pain, numbness, or weakness including any combination of those symptoms. Patients will develop a “foot drop” or “floppy” foot where they cannot dorsiflex or lift the foot upwards while walking. The foot drags and often causes the patient to trip making it very difficult to go down stairs. Any time some one develops a foot drop, an MRI of the Lumbar Spine should be done to rule out nerve root compression. If a disc herniation is found, the patient is usually started on oral steroids to reduce pain and when tolerable, the patient can start physical therapy. A foot drop is concerning if it is (1) complete or, (2) if it does not get better over 4 – 8 weeks. In those particular cases, the surgeon may consider surgical decompression sooner than later.

Treatment

Non-operative. The initial course of treatment after the diagnosis has been made is oral steroids, rest, and non-steroidal anti-inflammatory agents. Once the pain has lessened, you may be referred for a course of Physical Therapy.  Other options include an epidural injection to help with the pain.

Surgery. Patients are referred to a surgeon if there is a persistent weakness that does not improve after 8 –12 weeks or the pain is intolerable. Surgery includes a Micro-Foraminotomy or Diskectomy where the arthritis is removed through a small incision (1.5 inches), takes approximately 45 minutes, and patients go home the same day.

FAQs

What Is Foot Drop and What Causes It?

Foot drop is a condition characterized by difficulty lifting the front part of the foot, which can lead to a high-stepping gait or frequent tripping. It is most commonly caused by weakness or paralysis of the muscles responsible for dorsiflexion. Underlying factors can include nerve compression (such as from a herniated disc or spinal stenosis), nerve injury, muscle disorders, or even certain systemic conditions.

How Is Foot Drop Diagnosed?

Diagnosis begins with a detailed review of your medical history and a physical examination to assess muscle strength, range of motion, and gait. Your doctor may also recommend imaging studies (like MRI or CT scans) to identify any spinal issues or nerve impingements. In some cases, nerve conduction studies or electromyography (EMG) are used to evaluate the electrical activity of the muscles and determine the precise location of nerve damage.

What Treatment Options Are Available for Foot Drop?

Treatment for foot drop depends largely on the underlying cause. Options may include:

  • Physical Therapy: To strengthen the muscles and improve gait.
  • Orthotic Devices: Such as an ankle-foot orthosis (AFO) to help stabilize the foot.
  • Medications: To reduce inflammation or manage pain, especially if nerve compression is involved.
  • Surgical Intervention: In cases where a structural issue (like a herniated disc or spinal stenosis) is causing the nerve compression, surgery may be necessary to relieve pressure and restore function.

Can Early Treatment Improve the Outcome for Foot Drop?

Yes, early diagnosis and treatment can significantly improve outcomes. Addressing the underlying cause promptly—whether through conservative measures like physical therapy and orthotic support or, when necessary, surgical intervention—can help prevent further nerve damage and improve mobility. The sooner treatment begins, the better the chances for recovery and regaining strength in the affected muscles.

Contact Us Today

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Main Office
New York Brain & Spine Surgery, P.C.
244 Westchester Avenue, Suite 209
West Harrison, NY 10604

info@instituteforspinesurgery.com

914-948-3008

914-992-7401 (fax)

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