Common Diagnosis
Foot Drop
Foot drop is a common diagnosis when the L5 nerve is compressed from a disc herniation, foraminal stenosis, or spondylolisthesis. Patients cannot dorsiflex or lift the foot while walking.
Overview
Foot drop is a common diagnosis when the L5 nerve is compressed from a disc herniation, foraminal stenosis, or spondylolisthesis. Other less common causes include external trauma to the lower leg or nerve sheath tumors and are not addressed here.
A disc herniation at L4-5 or a foraminal disc at L5-S1 can compress the L5 nerve root, producing pain, numbness, or weakness in any combination. Patients 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 someone develops a foot drop, an MRI of the lumbar spine should be performed 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, begins physical therapy.
A foot drop is concerning if it is complete, or if it does not improve over four to eight weeks. In those cases, the surgeon may consider surgical decompression sooner than later.
Symptoms
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Causes
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When to see a specialist
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Non surgical treatment options
We offer comprehensive non surgical treatment plans tailored to each patient's condition, focused on pain relief, mobility improvement, and overall spinal health. While we do not perform these treatments in house, we collaborate with trusted local specialists to ensure you receive the highest level of care.
Physical therapy
We develop personalized physical therapy prescriptions based on your specific needs and refer you to experienced local providers. These programs are designed to improve strength, flexibility, and posture, helping to reduce pain and enhance mobility while promoting long term spinal health.
Epidural injections
For patients who may benefit from epidural steroid injections, we provide expert evaluations and referrals to trusted local physicians who specialize in pain management. These injections can reduce inflammation and nerve related pain caused by conditions such as herniated discs and spinal stenosis, offering significant relief with minimal downtime.
Chiropractic care and acupuncture
Chiropractic care can help patients with leg pain as a component of their condition. Acupuncture works best in the presence of severe muscle spasms. Both are considered alongside physical therapy and medication as part of a comprehensive conservative plan.
View all non surgical options →
The initial course of treatment after diagnosis 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.
Surgical options
Patients are initially evaluated by a physiatrist to ensure all non surgical options, including physical therapy and non narcotic pain management, are exhausted before considering a surgical solution.
Lumbar foraminotomy
A lumbar foraminotomy is a surgical procedure designed to relieve nerve compression by enlarging the foramen, the passage where spinal nerves exit the spinal column. It is most commonly performed at the L3-4, L4-5, and L5-S1 levels. Most surgeons have seen success with this procedure for patients with lumbar foraminal stenosis, which can cause radiating leg pain, numbness, or weakness due to nerve compression.
This procedure is often recommended when conservative treatments such as physical therapy, medication, or injections have failed to provide relief. The surgery takes approximately 60 to 90 minutes. Patients usually go home the same day.
Lumbar microdiscectomy
This surgery is performed for patients with lumbar radiculopathy from a disc herniation or foraminal stenosis. Patients are put to sleep with general anesthesia and turned prone. The level is localized through x ray and accessed through a small incision in the lower back measuring 1.5 inches in length. Using a microscope, a small amount of the lamina is removed and the disc space identified. The disc fragment is then removed, leaving the majority of the non herniated disc intact. The surgery takes approximately 45 minutes. Patients usually go home the same day.
Recovery
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Sources and further reading
Patient questions
Frequently asked questions
Our clinical team explains Foot Drop using your history, examination, and imaging. Symptoms vary by nerve or spinal cord involvement. An accurate diagnosis guides whether conservative care or surgery is the safest next step.
Symptoms may include neck or back pain, arm or leg pain, numbness, weakness, or balance changes when the spinal cord is involved. Severity and duration help determine urgency and treatment options.
Evaluation usually includes a neurological examination and MRI. X ray or CT may assess bone alignment. We correlate imaging with your symptoms before recommending injections, therapy, or surgery.
Physical therapy, medication, activity modification, and selective injections are common first steps. We monitor progress over four to eight weeks and escalate only when symptoms persist or neurologic deficits progress.
Seek urgent care for rapidly worsening weakness, loss of bowel or bladder control, saddle anesthesia, or severe pain after trauma. Call (914) 948 3008 for guidance if you are unsure how quickly to be seen.
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Office
Institute For Spine Surgery244 Westchester Avenue, Suite 209
West Harrison, NY 10604
Phone
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