Foot drop is a very serious condition caused most of the time by abnormal pressure on a nerve either in the lower back or at the knee.
Recently we had a serious case of foot drop walk (better yet, hobbled) into our clinic. Anytime I see something like that, I have to have a talk with my parents and let them know that is serious and certain things need to be done right away to better understand what's causing it and the probably outcome.
In this case, I had a young lady with what she called "numbness" in her foot for about 2 weeks after a yoga class. What was most unusual was the lack of lower back pain. My exam started as soon as I watched stand up in the waiting room and walk into my treatment room. There it was, unmistakable, the classic "steppage gait" associated with foot drop.
In less than 24 hours we had our patient get a lumbar MRI which showed a severe disc bulge pressing on a nerve in the lower back. The patient was also referred to see a spine surgeon to get a second opinion (who agreed that a course of conservative care should be done before thinking about doing surgery to decompress the nerve impingement) and she eventually got a nerve conduction study and electromyography which confirmed the problem was coming from her lower back.
We began an aggressive course of treatment which included chiropractic manipulation, mechanical flexion distraction, laser therapy, electrical muscle stimulation, Mckenzie lumbar extension and ELDOA exercises. Fortunately for us and for the patient, we had a very compliant patient who did everything we suggested.
Within one to two treatment she began showing signs of improvement in her leg and foot sensitivity. This was very promising, but I was most concerned about seeing improvement in muscle strength, with was zero when she began care.
Over the first 4 weeks of care we saw significant improvement in sensitivity, but almost none in strength. Somewhere during the 3rd or 4th week of treatment we started seeing some improved motor function in her big toe. This continued to improve over the next 3 weeks and at 6 to 7 weeks of care her motor strength was at 95%! Unless you were a doctor with a keen eye, you wouldn't be able to tell her gait was still slightly off.
At this point, our patient is about 99% better and well on her way to a great recovery. Foot drop is a very serious condition, but it's great to know that many times it can be treated without surgery.
Below is our patient's actual review of her experience in our office.
Dr. Eric Nepomnaschy - 310-993-8482
"I hobbled into Dr Eric's office almost 6 weeks ago now. I had seen my primary care physician for some numbness in my leg a few days earlier and had been told it was likely a little sciatica caused by over-stretching in yoga and would go away on its own. Two days later I woke up with no feeling or function in my lower left leg. It was a pretty terrifying situation and a friend recommended I go see Dr Eric. I've never seen a chiropractor before but I called at 8am, spoke with Angie on the front desk who immediately got me in to see Dr Eric at 9am. As soon as Dr Eric saw me he referred me for an MRI and helped get me scheduled as a priority. I had severe foot drop and no sensory or motor function in my leg from the knee down. The MRI came back to show a herniated disc completely impinging the sciatic nerve. I met with a neurosurgeon who thought surgery might be the only way forward but he wanted to wait 6 weeks before making that decision. Avoiding surgery was our goal! Dr Eric and Dr Monica treated me 5-6 times a week for those first few weeks, working to decompress the spine to get the disc off the nerve. They used laser treatment on both my lower back and my leg and electric stimulation to get the nerves working again. I was an interesting case because I had no pain and the neurosurgeon thought my issues could either come from the nerve in my back or from the nerve at the side of the knee. Dr Eric did a lot of extra research on my situation and really went out of his way to ensure I was getting the best treatment and rehab. Every tiny bit of progress was a huge deal, not just for me but for Dr Eric and Dr Monica and the whole team at Bay Chiropractic (Dr T, Ben, Angie and Elizabeth). From being able to move one toe again, to being able to move all of my toes a couple of weeks later, every small win was celebrated. Finally after 5 weeks of treatment I can flex my ankle and my foot drop is almost gone. It's not quite a catwalk strut yet, but it's definitely not a zombie drag anymore! I go back to see my neurosurgeon in a few days and I'm confident he'll say no surgery required. I also think he'll be stunned at the difference 6 weeks of rehab has made. I can't recommend the team here highly enough - they're highly knowledgable and they truly care. I feel so lucky to have had them in my corner throughout this ordeal and will be forever grateful." Fiona K. 8/26/`8