How to Keep Walking With MS Foot Drop
Neurological DisordersMultiple Sclerosis

How to Keep Walking With MS-Related Foot Drop

How to Keep Walking With MS-Related Foot Drop
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Updated on July 28, 2026
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Some people with multiple sclerosis (MS) develop foot drop (sometimes called drop foot), which is a weakness in the ankle and foot muscles that's caused by damage to the nerves of the muscles that flex the ankle. Foot drop makes it hard to walk with a normal heel-toe pattern.

When you have foot drop, your toes touch the ground before your heel, which can cause you to trip or lose your balance. But a variety of treatment options can improve your ability to walk and help you stay active and independent.

Causes of Foot Drop in MS

In addition to nerve damage, spasticity (or tightness in the calf muscle) can contribute to the toes pointing downward, making it even more difficult for the muscles in the front of your leg to lift the foot, says Mandy Rohrig, a physical therapist and the senior programs consultant for Can Do MS.

When you walk with foot drop, you may catch your toes on the ground and trip because you can’t lift the toes out of the way when swinging the foot during a step, says Michelle Fabian, MD, an associate professor of neurology at Mount Sinai Hospital in New York City.

nerves and muscles of the ankle and foot
Foot drop results from poor nerve conduction to the muscles used to flex the ankle.Alamy

“To avoid tripping, people with foot drop may lift their hip up higher than normal, leading to a walking appearance called a steppage gait — they might appear to be going up a step,” Dr. Fabian adds.

Walking differently to compensate for foot drop takes a lot of energy and may tire you even more quickly, making you more prone to falls, says Rohrig.

Even in people who have MS, foot drop can sometimes be caused by something other than MS, like a pinched nerve, Fabian says.

When foot drop is due to MS, it can occur as a new or recurring symptom during a relapse, or it can be a consequence of MS progression, she says.

When an MS relapse causes foot drop, it’s likely to get better over time, often after a course of steroids. But when foot drop occurs in someone with progressive MS, the weakness may stay the same or slowly get worse, adds Fabian.

Diagnosing Foot Drop

If you’re experiencing foot drop symptoms, see your neurologist, who will perform a physical exam, watching how you walk and assessing your leg muscles for weakness. Your doctor may also check to see if you have numbness in your shin or the top of your foot.

In some instances, imaging tests like X-rays, ultrasounds, CT scans, and magnetic resonance imaging may be used to help determine what’s specifically causing the foot drop. Nerve tests like electromyography and nerve conduction studies that measure electrical activity in the muscles and nerves can locate damage along an affected nerve.

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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.

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Jason Paul Chua, MD, PhD

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Jason Chua, MD, PhD, is an assistant professor in the Department of Neurology and Division of Movement Disorders at Johns Hopkins School of Medicine. He received his training at th...

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Resources
  1. Glossary of Multiple Sclerosis Terms. National Multiple Sclerosis Foundation.
  2. Foot Drop: Diagnosis and Treatment. Mayo Clinic. January 15, 2025.
  3. Orthotics for Walking Difficulties With MS. National Multiple Sclerosis Society. September 4, 2024.
  4. Functional Electrical Stimulation (FES) and Multiple Sclerosis. National Multiple Sclerosis Society.
  5. G4 Functional Electrical Stimulation Foot Drop Technology. Neuro Rehab Recovery.
  6. Bioness L300 Go. Bimedis.