Dr. Gott: Pursue cause of foot drop

Dear Dr. Gott: I am an 80-year-old woman who seems to be stuck with what my doctors are calling a “drop foot.” I acquired this malady after caring for my husband, who passed away several months ago. I also have back problems and have had surgery and physical therapy. The foot is more of a nuisance than anything else, since I have to use a cane or a walker to avoid falling. My doctors say it could return to normal in time, but there is a chance it won’t. Do you know of any other treatments for this?

Dear reader: Foot drop, or as your doctors called it, drop foot, is basically a difficulty lifting up the front part of the foot. The condition is not a disorder, but rather a symptom of an anatomical, neurological or muscular problem.

Depending on the cause, foot drop may be temporary or permanent. If the cause is trauma or nerve damage, improvement or complete recovery is often seen. If it is due to a progressive neurological disorder, it will likely be permanent.

Treatment is aimed at identifying and, if possible, repairing the underlying cause. Direct treatments are available. Most people respond well to using lightweight leg braces and shoe inserts that keep the foot and ankle in a more stable position. Exercise therapy to strengthen the muscles of the foot may also be beneficial. Permanent damage may benefit from surgically fusing the ankle and foot into a more normal walking position.

You say that you are currently suffering from back problems and have had surgery and physical therapy. Were the surgery and therapy for your back or foot? Nerve damage from surgery and spinal problems could be the cause of your foot drop.

Return to your physician, and discuss the option of a leg and ankle brace, which may eliminate your need for the walker and cane. It is important to discover the cause of your foot drop, because treating the underlying condition may in fact improve or cure your problem.

If your physician is unable or unwilling to provide you with treatment options, request a referral to an orthopedic specialist, who should be able to provide the most up-to-date treatment options and quality braces.

Dear Dr. Gott: You recently wrote about a 45-year-old female with back pain. You were right to suggest she get a better diagnosis than notalgia paresthetica.

I am writing because I may have a possible diagnosis for her. When she described her back as being noticeably more developed on one side, my first thought was scoliosis. It’s possible that she had mild, undiagnosed scoliosis for a long time that is now progressing at a faster rate.

Dear reader: Scoliosis (curvature of the spine) is an excellent suggestion. If this is her problem, she would need to have an X-ray to confirm the deformity. Depending on the severity of the curvature, surgery to implant pins and rods to prevent further bending may be necessary.

Thank you for writing to share your possible diagnosis.