sudden onset foot drop

[LolaLouise]

As a nurse i should know the answer to this, but i dont, i hold my hands up.

About 10 hours ago i developed foot drop, my lower leg and foot is completely numb and tingley, i cant lift my foot properly whilst walking, walking feels clunky and off balance, i cant flex my foot upwards more than a cm or downwards all the way, i cant spread my toes at all, theres no pain in my lower leg/foot, however my thigh feels fairly achey. There was no injury etc, no prolonged time of being immobile or sitting with my legs crossed or anything, i was at work, throughout my shift i did 18k steps, but one minute ot was fine, the next it wasnt, but it got more pronounced as the shit went on.

Im going to contact my GP, but im not going to lie it concerned me from the persepective of walking was difficult, my job relies on me being mobile and active, and that it was so sudden, not a gradual feeling.

I know some of the causes of foot drop, but not many, and the ones i know are life altering long term conditions. Can anyone offer any reassurance of temporary conditions that start with a sudden onset foot drop problem.

Thank you.

No i know, im going to call in and see what my option are, whether thats swap off the main floor of A&E temporarily into triage which is much less walking, or if im best to call in sick. I dont want to call in sick if i can avoid it though, as i need the money!

Neuro have squeezed me into the apt next wednesday, so theres no option of speeding that up. They were very apologetic today but unfortunately nothing they could do. 111 just sent meto A&E, from an A&E perspeective all the testing they can do is done. An MRI is most likely needed, but not from an emergency portal. Looking at it, and speaking to some other people, the MRI with be a contrast head and spine to look for lesions that point to MS, that isn't an emergency scan. At this point is manage the symptoms, which i cant really as its not causing me pain, its just irritating, and wait. The big "need treating immediately" possibilities have been ruled out.

Bless you. Horrible to have to wait. I'd try to avoid too much walking if you can 🥰

Hi there OP you’re such a trouper but I really think you should be looking after yourself at the moment and not be working until you have it okayed at your appointment next week

Have a look at B12 deficiency while you are waiting. I developed sporadic foot drop out of nowhere following menopause, and it improved when I upped my B12 intake (which may have just been coincidental).

When you walk, you are going to have to lift the affected leg from the knee into a 'marching' position, otherwise you will just trip and fall. You will have no heel/toe gait on that leg. I am really surprised that you haven't been referred for an emergency MRI. Good luck, and please keep us posted.

Ive been having a look around on MS pages on FB for some guidance and information on my apt with neurology and whatthat could look like, just to mentally prepare incase this is MS. Theres people on those pages with similar episodes of numbness and restricted range of movement that are on waiting lists for an initial neuro consult for 18 months! At the minute im just very grateful my referral is only 10 days now they have ruled out other things.

I am however, going to call back my GP tomorrow am, and ask about the possibilty of medications. Ive been reading that often during falir ups, steroids are prescribed to treat the symptoms, im wondering if that would be a possibility for me without diagnosis to see if that can offer some improvement. Im not sure they will without diagnosis, but i think its worth asking the question as the GP suggested thats what they were thinking. And if it isnt MS, steroids may help anyway. This kinda thing is way out of my nursey comfort zone!

My complete right foot drop was caused by a huge L4/5 disc prolapse. To put that into context, a large lumbar disc prolapse would normally be 8-10mm. Mine was 3cm! My orthopaedic consultant said I had 75% more disc damage than he normally saw. Obviously, this was preceded by horrendous lower back pain, which you don't have.

Fingers crossed that you don't have MS. Please keep us posted! Good luck!

Yeah I really hope it isn't MS. It's such a shame you have to wait though. Seems a total postcode lottery.

@BooneyBeautiful My foot drop was also caused by a L4/5 disc protrusion/herniation but weirdly not preceded by severe back pain. I did have a bit of back pain but mainly from my preexisting inflammatory arthritis, it was just the weakness and numbness that caused it. I got referred for an MRI the next day so would have thought they'd want to see if it was caused by disc issues fairly quickly 😔

I had CT that was head neck and spine (i think, i didnt ask, def head though as i had to take out all my piercings) and spinal reviewed and were happy i wasnt for them so im guessing (hoping) disc issues show on a CT and they are satisfied. I have no back issues generally so im quietly confident its something neurological rather than mechanical. Im slightly worried that neuro wont find anything though then ill just be waiting for some other referral (no doubt rheumatology) and be on a list for months and my foot/leg doesnt get any better. But i guess all i can do is wait at the moment.

My GP's registrar went into a complete panic when he diagnosed the foot drop. He knew about the state I was in on the Friday, but couldn't be bothered to come out to me until after morning surgery on the Wednesday. In the meantime, I had been examined by the out-of-hours paramedics on the Sunday. Apparently, they had checked all my nerves and reflexes etc, and didn't find anything untoward. I don't remember much about that as I had had no sleep and I was in a huge amount of pain.

I wasn't very happy about the way he treated me, but despite this, he still ended up becoming a partner at the practice.

@LolaLouise I don't know if you'd see disc problems on a CT or not. MRI is more sensitive, I do know that. Sometimes it can be quite a small bulge or herniation that causes a lot of symptoms. Anyway I hope you get some answers. It is really shit living with the foot drop and weakness but you do start to compensate to some extent. I had bracing on my foot for a short time and a lot of physio and although I'm not back to normal you can't really tell by looking at me walk and I'm on my feet all day at work fine.

@BooneyBeautiful I'm sorry you weren't treated well. I think back pain is so common it's often dismissed sadly! I think my experience was pretty lucky - I went to A&E on the advice of my brother who is a doctor, and had an MRI the next day. Noone seemed that panicked tbh - I think maybe because foot drop/leg weakness is such a classic symptom of disc problems. Luckily managed to avoid surgery but the weakness and numbness hasn't totally cleared up. 🤷

They wanted to admit me immediately, but I insisted I wanted to go home. They allowed that on the strict understanding I went back as soon as they had an appointment for an MRI. They rang the next morning, and my friend and her partner kindly got me up there. It was a very frightening time. To go from backache to a life-changing disability almost overnight.

I wish you well.

I’m sure you’re well aware of this working in healthcare, but an MS diagnosis isn’t necessarily something that will change your day to day life once this initial flare/incident passes.
I literally woke up one morning with symptoms like a stroke (left side not really working, but of foot drop, no coordination) completely out of the blue. After investigations to rule out a stroke I had an MRI and spinal and they diagnosed oars RR MS.
Im on disease modifying treatment (one tablet per day) but aside from that no sign at all of the MS. The initial left side symptoms have pretty much vanished, bar my left pinkie not being as good on the piano but I was never going to be the next Alicia Keys 😂
I can work, do my active hobbies and work out at the gym with no problems. I’ve had no further lesions since then (2020). So although it’s scary looking down the barrel of a diagnosis like MS, please consider that you may be looking back at this as a blip in years to come. Sending good healing vibes for your foot ☺️

We've just been on the MS journey... Not as dramatic as an obvious foot drop, but enough for us to suspect.

Where we are the wait was 18 months on the NHS, and 6 privately, even though private is out of area and cant prescribe any treatment outside of the regional MDT. Essentially if none of the tests are barn door, they'll have to rely on a clinical diagnosis based on relapses, remissions or progression, this took over a year and 3 mri scans (that all had lesions) and wasnt any faster depsite both my wife and I being doctors. Sorry i cant be more helpful, but it seems that anything not definitevely diagnosable or slightly atypical cab take a while to diagnose.

From my perspective as a foot and ankle surgeon, id invest in a foot-up brace that wraps around the ankle and ties to your laces to stop you tripping over, and maybe a night resting splint to prevent an equinus contracture (foot pointing down due to muscle imbalance).

Good lord! 6 months for a private diagnosis? What is WRONG with this country?

I'm so sorry you're going through this 😔

Thats such an awful wait - im sorry you have gone through that! Im so so lucky to have the quick referral to neuro. Whether thats because I presented to A&E or because our consultant in charge was pushing for the neuro review that they couldnt do instantly and as i am staff the consultant got the referral, i dont know, id like to think its the first reason. Im not expecting a quick diagnosis, and fully expect to wait for an MRI too, im hoping an MRI is enough for them to say, ok, its a possibility we will continue to investigate, as it coming back fine and then being back at square one with a footthat refuses to work is whats worrying me more than a possible diagnosis at the minute.

I will look in to foot braces, thank you.

@greenbadger79 thank you for sharing your experiences too. I knew a little bit about MS prior to all this, but i have been looking at it more over the past few days, obviously, and its defintely less scary than it was when they first mentioned that being something to investigate.

I also spoke with work, they feel its better for me to be signed off until i have atleast seen neuro, and until i have enough function back in my left side to mobilise easier, i feel awful being off, as i dont feel ill, i feel fine! But thats what they thought was for the best.

Thank you all again for the replies.

Neurology waiting times are an absolute disgrace - I'm in Northern Ireland where the waits are outrageous. I was appallingly failed by the health service and am more disabled than I needed to be directly because of the health service. I hope you don't have to wait long OP and absolutely fight for good care. I was far too trusting and my MS went undiagnosed for far, far too long.

Hi @LolaLouise just wondering how you are getting on?

Just wanted to echo a previous poster that if it does turn out to be MS, yes I’d prefer not to have it, but it really hasn’t impacted me since my diagnosis. One injection at home per month, I have a full time job and I’m fit and active. I had a similar initial presentation to you, the foot drop has gone and I have slightly reduced feeling in one foot but nothing that hinders me in anyway.

Hope you are doing ok.

Ive not had chance to update the past few days. No improvement in my foot or leg at all. I had my neurology appointment, he didnt really say much, just that he is referring me on for MRIs and for a nerve conduction test, then advised me to stay off work until i can balance better and have use of my foot, but he is confident ill regain function in a week or two - though i have no idea what he is basing that opinion on, as he said it usually resolves in a week, when i said its already been 10 days and its not getting any better he just said i need to give it time. So currently im still in limbo and very bored at home. Thank you for checking in

I had foot drop snd weakness in my right leg recently. Doctor was worried about ms, and mnd. I was terrified. Brain scan was clear(ish) and turned out my vit d was through the floor. Who knew! The wait is horrible OP. Hope you get some answers soon.

Also hope you get some answers soon. Horrible for you (and frustrating, seems to be a lack of urgency from the docs on this which I suppose is somewhat reassuring)

Any further news @LolaLouise? 🥰

Yep - you need A&E now - cauda equina can cause this and along with thigh involvement it is worrying.

Have you lost any sensation in your saddle area/perenium? Experiencing continence issues?

Ooh sorry, I didn’t notice the date on your OP. Saw your OP, cauda equina was my first thought and wanted to post immediately.

sorry you’re not getting any quick answers - I really hope you do soon

I hope it’s something like a pinched nerve rather than the MS or MND that I would be panicking about. Being a nurse makes waiting even harder at these times. Stupidly obvious question, but have you started taking any new meds lately? My dad had MND and there is some suspicion that this may be linked to statin meds. (The evidence is tenuous, but still there…)