Multiple sclerosis foot drop: Signs, symptoms and recovery

If you or your loved one is living with multiple sclerosis, the simple act of walking or standing can become extremely challenging. Multiple sclerosis foot drop is a common symptom of MS, but it is also one that is manageable.

Multiple sclerosis is a chronic neurological condition that affects the brain and spinal cord. In most cases, the immune system attacks the myelin, the protective layer surrounding nerve fibers. These layers of fat act as a protective barrier around the cells of the nervous system and brain. Once damaged, it can disrupt communication between the brain and the rest of the body, including the feet.

Karla Santis, a physical therapist at Encompass Health Rehabilitation Hospital of Sunrise, said the nerve damage that MS causes disrupts signals from the brain to the muscles and joints.

“Since the foot is the farthest from the brain, it can lead to symptoms of numbness, poor communication to and from the muscles, impaired timing and coordination, fatigue and even paralysis,” Santis said.

Common symptoms of MS

There are several types of MS, and symptoms may vary from person to person depending on the severity and location of nerve damage. Common symptoms that may develop overtime include:

• Muscle spasms
• Numbness
• Loss of balance and coordination
• Fatigue
• Dizziness
• Cognitive difficulties

What is MS foot drop

MS foot drop is a condition that makes it difficult to lift part of the foot. This can increase the risk of falls, injures and fractures. Individuals may experience balance and coordination issues and muscle weakness in the legs. They may have to lift their knees higher than usual to avoid dragging their foot.

“Patients with MS will experience muscle weakness, spasticity, sensation impairments or pain,” Santis said. “It is possible that symptoms can become more noticeable if the patient’s core temperature increases. It is common for patients with foot drop to have a higher fall risk and difficulty with mobility.”

MS foot drop is caused by a disruption in nerve pathways. The nerves responsible for muscle control in the foot and ankle are affected, leading to weakness and limited mobility.

There are several factors other than MS that may lead to foot drop. The most common include:

• Neurological disorders. In addition to MS, conditions such as stroke, Parkinson’s and diabetes can cause nerve damage and foot drop.
• Peripheral nerve damage. Injury or illnesses that damage the peroneal nerve, often due to trauma or surgery, can cause foot drop.

Early signs of foot drop

Early detection is key to managing MS foot drop. Signs may include:

• Difficulty lifting the front part of the foot
• A high stepping walk (stepping gait)
• Frequently falling
• Numbness in foot
• Muscle weakness

Is foot drop a lifelong condition?

It can be, depending on the underlying cause of foot drop. Foot drop is reversible, but it may become a lifelong condition if associated with severe nerve damage. Whether it is caused by MS, stroke or other chronic illnesses, it is best to consult a physician for further evaluation.

Managing MS symptoms and footdrop

Inpatient rehabilitation plays a vital role in helping individuals manage MS symptoms, including foot drop. Therapy programs and treatment plans are tailored to meet each patient’s unique needs.

Together, care teams — including doctors, nurses, therapists, dietitians and case managers — collaborate to design treatment plans that help individuals regain their independence. These plans address physical, cognitive and emotional needs to support recovery.

“Inpatient rehabilitation addresses areas of concern that the patient has by helping help patients restore and retain the nervous system and body function for safer and more efficient movement,” Santis said. “We assess how MS is causing foot drop. During therapy, we focus on strengthening and neuromuscular reeducation of the muscles causing foot drop, promoting improvement in motor control based on neuroplasticity.”

Exercises and adaptive tools and devices

Your care team may recommend strengthening programs that can benefit your unique needs when you return home. Diaz advises patients to walk at least 30 minutes a day or complete household chores to stay active.

“Home exercise programs and continued therapy through home health or outpatient services are beneficial,” she said. “MS is a progressive disease and requires the patients to stay active. Tools may vary depending on the patient’s impairments. The use of a walker or cane may help increase stability and reduce the risk of falls.”

Orthotics might also be recommended to reduce the symptoms of food drop. Orthotics are supportive devices that can help reduce pain, improve limb function and correct musculoskeletal alignment. During recovery, your care team will determine if orthotics are needed to support your recovery.

“Therapists determine the need of an assistive device such as an ankle-foot orthosis or functional electrical stimulation,” Santis said. “These tools reinforce normal walking and reduce fatigue, allowing the patient to gain stamina and independence.”

Support for individuals with MS and their families

Recovery can be intensive and challenging for patients and their families. Inpatient rehabilitation offers educational support, disease management and learning opportunities to support your loved one once they return home.

• Advocate for comprehensive assessments: Encourage thorough evaluations to determine the best treatment
• Stay informed: Learn about MS, foot drop and rehabilitation options
• Be present: Attend therapy sessions and family education programs
• Monitor progress: Track improvements or setbacks and communicate with health care providers

While MS is a lifelong condition, many individuals live fulfilling lives with the right support and treatment. Focusing on goals, maintaining a positive outlook and building a supportive network can ensure a higher quality of life.

To learn more about MS and support for caregivers, visit the National Multiple Sclerosis Society for more information.