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back pain

Foot Drop

Foot drop is a somewhat common and scary lower back pain symptom most often associated with herniated discs in the lower lumbar spine. A dropped foot is not always a tell tale sign of nerve compression, unless it is studied to make sure that the diagnosis actually fits the symptomatic profile. There are many other structural and psychosomatic reasons why a dropped foot may occur, so be sure to compare all diagnostic tests to the actual clinical expression in order to establish a firm tie between the muscular issue and the suspected spinal causation.

Foot Drop

What is Foot Drop?

This condition is described as a weakness in the muscles which elevate the front of the foot, called a dorsiflexion deficit. Patients will have difficulty lifting their toes and often stumble when walking. Some patients feel a reduction in the ability to raise the foot, while others suffer a complete loss of this ability. Dropped foot testing is common for orthopedists and neurologists to perform during any lower back pain exam and can be very telling as to the potential causes of the pain.

Foot Drop Causes

The most common explanation for a dropped foot is a herniated disc at L4/L5 or L5/S1. The most logical reason for this to occur is compression of the L5 nerve root, although on occasion, the L4 or S1 nerves are implicated as well. Spinal osteophytes can also take the blame for impingement of the affected nerve, as can spondylolisthesis, scoliosis and other spinal issues, such as severe lumbar spinal stenosis.

Although all these conditions can enact a dropped foot if the diagnosis is correct, many times, the theory is mistaken and the symptoms will exist for another reason. Circulatory concerns and other neurological problems can create a dropped foot, but one of the most common sources is certainly regional ischemia.

Foot Drop from Ischemia

Oxygen deprivation of the lower lumbar structures is one of the most common expressions of this terrible condition. When ischemia is severe and lasting, the very nerve roots can lose structural integrity and the ability to function correctly. This can cause a dropped foot and many other related symptoms, such as tingling, numbness, weakness and pain throughout the lower body.

When the symptoms are too widespread and far ranging to be accounted for by a single diagnosed structural issue, the condition is almost always ischemic. This is why a detailed symptomatic profile is needed, although rarely performed by most back doctors, who simply assume the structural issue is to blame… No wonder all the subsequent treatments fail… the diagnosis is wrong.

Complete and well defined dropped foot, without extraneous symptoms, has a better chance of coming from a pinched nerve, while incomplete or diverse symptomologies are likely to be from some other source altogether…

Foot Drop to Back Pain Home 1/13/10


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