How to Keep Walking With MS Foot Drop

Treating MS-Related Foot Drop

Treatment for foot drop can greatly improve mobility and make walking less tiring. Treatment options include the following:

Physical Therapy Physical therapy can help improve strength and stiffness for people who have foot drop. According to Rohrig, your physical therapist will identify whether weakness, spasticity, or both are causing the foot drop, and will then prescribe specific exercises for you. The therapist will also determine how foot drop is impacting your functioning and will investigate whether an assistive device might help you get around better.

Braces A brace called an ankle foot orthosis (AFO) is commonly recommended to help manage foot drop, according to the National Multiple Sclerosis Society. The brace, typically made of plastic, is worn around the lower leg and foot. Most AFO braces hold the ankle and foot in a fixed position, but some have a hinge that allows the ankle to move.

There are various types of AFO braces. Some fit inside regular shoes; for others, you’ll need to wear an extra-deep shoe. A physical therapist can help you select the best one for your needs.

Functional Electrical Stimulation (FES) FES involves the application of a mild electrical stimulus to a muscle in order to help it move better. In some cases, when MS causes nerve damage, the muscle no longer receives the correct message from the central nervous system. FES typically involves a wearable device that delivers an electrical current to stimulate the peroneal nerve just below the knee and therefore the muscle needed to lift the front of the foot, Rohrig says. The stimulation is timed to lift the foot during the swing phase of walking to prevent it from dropping or dragging.

FES devices that can help alleviate foot drop include the G4 from Neuro Rehab Recovery and the L300 Go from Bioness. They are both relatively small and battery-powered, and you typically wear them the whole time you are walking around. On the plus side, many people find FES devices easier to wear and more convenient than an AFO. But they are also much more expensive — from $3,000 to $4,500 — and may not be covered by insurance. 

While FES devices have been shown to help improve walking speed, they won’t help everyone with foot drop. A rehabilitation specialist with experience in MS can help you choose the right assistive device for you.

Surgery Surgery is not an option for foot drop that’s caused by MS because the nerve injury originates in the spinal cord, which causes a disruption to the pathway that lifts the foot, Fabian says. “Other conditions, such as a herniated disk or compressed nerve, might be fixed by surgery, as there is something pressing on the pathway — the disc or other mass can be removed. But an MS lesion is a different problem and cannot be fixed with surgery,” she says.