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Difficulty Walking: Symptoms & Causes

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Last updated February 24, 2022

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Understand difficulty walking symptoms, including 10 causes & common questions.

10 most common causes

Trochanteric Pain
Vitamin B12 Deficiency
Pinched Nerve
Peripheral Artery Disease
Rheumatoid Arthritis
Illustration of a person thinking with cross bandaids.
Transient Ischemic Attack
ALS
Spinal Stenosis
Illustration of a person thinking with cross bandaids.
Foot weakness
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Multiple sclerosis (MS)

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Difficulty walking symptoms

Walking is a complex interplay between multiple systems of the body; the nervous system, musculoskeletal system and cardiovascular system are all necessary for the control of walking. Balance, reflexes, sensory function, motor function and many other systems need to be intact in order for walking to proceed normally. As a result, the act and process of walking is very susceptible to impairment that can easily and quickly disturb everyday life.

Difficulty walking or gait abnormality characteristics

If you're experiencing difficulty walking, it can likely be described by:

  • Propulsive gait: Slouched, rigid posture in which the person walks with their head and neck pushed forward.
  • Scissors gait: The knees and thighs cross or hit each other in a scissor-like fashion because the person walks with their legs bent inwards.
  • Spastic gait: Stiff movement in which the person drags their feet while walking.
  • Steppage gait: Toes scrape the ground during walking because the toes point downward.
  • Waddling gait: Person waddles side to side when walking.

Common accompanying symptoms of difficulty walking

In addition to the type of gait abnormality you experience, you may also have additional walking difficulty symptoms, including:

  • Pain or shooting pain in the lower extremities
  • Low back pain
  • Numbness
  • Tingling
  • Weakness
  • Stiffness
  • Redness or warmth
  • Imbalance
  • Confusion
  • Limping

Your walking difficulties and associated symptoms may be brief or long-lasting depending on the cause, so it is important to see your physician promptly if you experience any of these signs.

When difficulty walking is an emergency

Seek medical attention immediately if you experience, walking difficulty symptoms such as:

  • Sudden-onset numbness or weakness that impedes your ability to stand up or get up from a chair
  • New bladder or bowel dysfunction (incontinence or retention)
  • Sudden-onset sexual dysfunction: These could be signs of serious, life-threatening conditions such as stroke and spinal injury

Difficulty walking causes

The causes of walking difficulty are truly broad and varied, making it even more important for you to see your physician in order to get an appropriate diagnosis and treatment.

Neurologic walking difficulty causes

Walking difficulty due to neurological conditions may be related to the following.

  • Central: The central nervous system contains the brain and the spinal cord and acts as the main control center for many bodily functions, including walking. The central nervous system controls important functions such as balance, sensation and control. When there is dysfunction or injury to the central control center such as in stroke many of these systems will be affected.
  • Peripheral: The peripheral nervous system contains the nerves that leave the brain and spinal cord and provide sensation and motor function to different parts of the body. Multiple conditions can affect the peripheral nervous system without affecting the central nervous system and result in gait abnormalities and associated symptoms. For example, there are many infections that can affect the peripheral nerves and result in difficulty walking.

Musculoskeletal walking difficulty causes

Walking difficulty may be the result of musculoskeletal abnormalities or ailments.

  • Mechanical: Problems in alignment and orientation of the parts of the leg such as the hips, the knee, and the ankle can result in gait abnormalities. Furthermore, lack of flexibility and strength in the muscles of the leg can also affect alignment and gait. These mechanical causes can affect how you walk and result in associated walking difficulty symptoms.
  • Destructive: There are conditions that cause direct damage and injury to the muscles of the lower extremities that result in weakness that makes it physically difficult to walk. Muscular dystrophy is a common condition that results in this type of muscular weakening that often presents in young age.

Inflammatory walking difficulty causes

Walking difficulty may occur due to the following inflammatory conditions.

  • Arthritis: Arthritis is a general term for multiple conditions that cause painful inflammation and stiffness of the bones and joints. Arthritis can affect the bones and fluid-filled areas of the knees, ankles and even hips resulting in significant difficulties with walking.
  • Autoimmune: Many inflammatory diseases that result in the body attacking itself can also affect the nerves and muscles and cause injuries that result in gait abnormalities. Conditions such as multiple sclerosis and lupus are examples of such autoimmune diseases that can attack multiple components of the systems necessary for walking.

Injury

Walking difficulty may occur due to injuries you may have sustained.

  • Traumatic: Trauma from motor vehicle accidents and other serious injuries can result in fractures and sprains of the bones and ligaments of the lower extremities (respectively). Such injuries can result in mechanical issues as noted above that result in walking abnormalities. Do not forget that falls can also be considered traumatic injuries, especially in the elderly.
  • Overuse: The lower extremities are the most stressed part of the body, and as a result, with time and increasing age they become more susceptible to injury simply due to overuse.

This list does not constitute medical advice and may not accurately represent what you have.

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Stroke or tia (transient ischemic attack)

Transient ischemic attack, or TIA, is sometimes called a "mini stroke" or a "warning stroke." Any stroke means that blood flow somewhere in the brain has been blocked by a clot.

Risk factors include smoking, obesity, and cardiovascular disease, though anyone can experience a TIA.

Symptoms are "transient," meaning they come and go within minutes because the clot dissolves or moves on its own. Stroke symptoms include weakness, numbness, and paralysis on one side of the face and/or body; slurred speech; abnormal vision; and sudden, severe headache.

A TIA does not cause permanent damage because it is over quickly. However, the patient must get treatment because a TIA is a warning that a more damaging stroke is likely to occur. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history; physical examination; CT scan or MRI; and electrocardiogram.

Treatment includes anticoagulant medication to prevent further clots. Surgery to clear some of the arteries may also be recommended.

Rarity: Common

Top Symptoms: dizziness, leg numbness, arm numbness, new headache, stiff neck

Symptoms that never occur with stroke or tia (transient ischemic attack): bilateral weakness

Urgency: Emergency medical service

Spinal stenosis

The spine, or backbone, protects the spinal cord and allows people to stand and bend. Spinal stenosis causes narrowing in the spine. The narrowing puts pressure on nerves and the spinal cord and can cause pain.

Next steps including visiting a primary care physician. For this condition, a physician might suggest further investigation including imaging of the spine. Treatments may include medications, physical therapy, or braces. For severe cases, surgery is sometimes recommended.

Rarity: Common

Top Symptoms: lower back pain, back pain that shoots down the leg, back pain that shoots to the butt, difficulty walking, thigh pain

Urgency: Primary care doctor

Rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing them to become thickened and painful. It can also affect other parts of the body such as the heart, lungs, eyes, and circulatory system.

Rheumatoid arthritis is an autoimmune disease, which means the body's immune system turns against itself for unknown reasons.

Most at risk are women from ages 30-60. Other risk factors are family history, smoking, and obesity.

Early symptom include warm, swollen, stiff, painful joints, especially the fingers and toes; fatigue; and fever. Usually, the same joints on both sides of the body are affected.

If untreated, irreversible joint damage and deformity can occur, with other complications. Early diagnosis can allow preventive treatment to begin as soon as possible.

Diagnosis is made through physical examination; blood tests; and x-ray, CT scan, or MRI.

There is no cure for rheumatoid arthritis, but the disease can be managed to improve quality of life. Treatment includes nonsteroidal anti-inflammatory drugs; steroids; anti-rheumatic drugs; physical therapy; and sometimes surgery to repair the joints.

Pinched nerve in the neck

A pinched nerve in the neck is also called cervical radiculopathy. It means that a nerve in the neck, at a point where it branches off from the spinal cord, is being compressed by the surrounding bones, muscles, or other tissues.

It can be caused by a traumatic injury, such as from sports or an automobile accident, especially if the injury results in a herniated disk. It may also arise from the normal wear and tear of aging.

Symptoms include sharp, burning pain with numbness and tingling from the neck to the shoulder, as well as weakness and numbness into the arm and hand.

Diagnosis is made through patient history, physical examination, and simple neurological tests to check the reflexes. Imaging such as x-ray, CT scan, or MRI may be done, as well as electromyography to measure nerve impulses in the muscles.

A pinched nerve in the neck often improves with simply a few days or weeks of rest. Physical therapy, nonsteroidal anti-inflammatory drugs, and steroid injections into the spine can all be very helpful.

Rarity: Common

Top Symptoms: pain in one shoulder, spontaneous shoulder pain, pain that radiates down arm, pain in the back of the neck, severe shoulder pain

Urgency: Primary care doctor

Peripheral arterial disease (PAD)

Peripheral artery disease (PAD) is a chronic condition that reduces blood flow in the arteries, usually arteries that lead to the legs. This reduced blood flow happens when clumps of fat (called plaques) build up inside these arteries, causing them to narrow. Symptoms include leg numbness, foot and thigh pain, cold feet, and muscle fatigue. These symptoms often occur when walking or exercising. The risk of developing PAD is higher in those who smoke or have diabetes. High blood pressure, high cholesterol, being overweight, and not getting much exercise also can put one at higher risk.

You should consider visiting a healthcare provider in the next two weeks to discuss your symptoms. Your provider can evaluate PAD with a review of your symptoms and a physical exam. An MRI may be performed as well. Once diagnosed, treatment involves medication, surgery, or procedures to open or bypass blocked arteries. Lifestyle changes regarding diet, exercise, and smoking cessation may also help.

Rarity: Common

Top Symptoms: leg numbness, spontaneous foot pain, decreased exercise tolerance, cold feet, thigh pain

Symptoms that never occur with peripheral arterial disease (pad): calf pain from an injury, thigh pain from an injury

Urgency: Primary care doctor

Multiple sclerosis (MS)

Multiple sclerosis, or MS, is a disease of the central nervous system. The body's immune system attacks nerve fibers and their myelin covering. This causes irreversible scarring called "sclerosis," which interferes with the transmission of signals between the brain and the body.

The cause is unknown. It may be connected to a genetic predisposition. The disease usually appears between ages 20 to 50 and is far more common in women than in men. Other risk factors include family history; viral infections such as Epstein-Barr; having other autoimmune diseases; and smoking.

Symptoms include numbness or weakness in arms, legs, or body; partial or total loss of vision in one or both eyes; tingling or shock-like sensation, especially in the neck; tremor; and loss of coordination.

Diagnosis is made through patient history, neurological examination, blood tests, MRI, and sometimes a spinal tap.

There is no cure for MS, but treatment with corticosteroids and plasma exchange (plasmapheresis) can slow the course of the disease and manage symptoms for better quality of life.

Rarity: Rare

Top Symptoms: severe fatigue, constipation, numbness, decreased sex drive, signs of optic neuritis

Urgency: Primary care doctor

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Greater trochanteric pain syndrome

Greater trochanteric pain syndrome, also called trochanteric bursitis or GTPS, is an inflammation of the bursa of the greater trochanter.

Bursae are the small "cushions" between tendons, bones, and muscles. The greater trochanter is the larger of two bony knobs at the top of the thigh bone. Overuse, trauma, or infection can cause inflamed and irritated bursae around the greater trochanter.

Most susceptible are individuals with low back pain, osteoarthritis, and obesity.

Symptoms include chronic, persistent pain on the outside of the hip that radiates down the outside of the leg, sometimes to the knee.

The symptoms are similar to other conditions such as degenerative joint disease, and so a medical provider should be seen for an accurate diagnosis.

Diagnosis is made through physical examination and observation of simple movements.

Treatment largely involves managing the symptoms through weight loss, physical therapy, and over-the-counter nonsteroidal anti-inflammatory drugs. In some cases, corticosteroid injections into the hip work well to relieve pain, and surgery can sometimes help.

Foot weakness

Any foot weakness is a sign of nerve damage, which is very worrisome and requires you to go see a doctor immediately!

Rarity: Uncommon

Top Symptoms: foot weakness, lower leg weakness, severe pelvis pain, hearing voices or seeing things that aren't there, arm weakness

Urgency: Hospital emergency room

B12 deficiency

Vitamin B12 deficiency means a shortage of cobalamin, which is one of the complex of B vitamins.

Cobalamin, or B12, is needed to make DNA, nerves, and red blood cells, but the human body cannot make its own B12. It must be consumed in food or as a vitamin supplement.

B12 deficiency is most often seen among vegetarians, since this vitamin is mainly found in animal protein foods. Conditions that interfere with the body's ability to absorb vitamins from food can cause the deficiency, including Crohn's disease; taking proton pump inhibitors for heartburn; and any form of weight-loss surgery such as stomach stapling or gastric bypass.

Symptom include numbness and tingling in the hands; difficulty with coordination and walking; joint pain; jaundice (yellowed skin;) and shortness of breath.

If not treated, B12 deficiency can progressively worsen into memory problems, severe depression, and even paranoia or hallucinations.

Diagnosis is made through physical examination and blood test.

Treatment simply involves supplementing vitamin B12, either with food choices, vitamin tablets, or B12 injections.

Amyotrophic lateral sclerosis (ALS)

Amyotrophic lateral sclerosis is also called ALS or Lou Gehrig's Disease. It is a degenerative disease that destroys nerve cells, which eventually leads to loss of control over muscle function.

The cause of ALS is not known. It may be inherited and/or due to a chemical imbalance, faulty autoimmune response, or exposure to toxic environmental agents.

Symptoms include weakness; difficulty with speaking, swallowing, walking, or using the hands; and muscle cramps. The muscles of the arms, hands, legs, and feet are most involved at first. It does not affect the senses or a person's mental ability.

ALS is progressive, meaning it worsens over time. There is no cure, but supportive care can keep the patient comfortable and improve quality of life.

Diagnosis is made through several tests including blood tests; urine tests; MRI; electromyography (EMG) to measure muscle activity; nerve conduction studies; and sometimes muscle biopsy or spinal tap (lumbar puncture.)

Treatment involves medications to both slow the progression of the disease and ease the symptoms; respiratory therapy; physical therapy; occupational therapy; and psychological support.

Difficulty walking treatments and relief

Walking difficulty requires medical attention. Treatment will depend on your specific diagnosis and extent of your walking difficulty symptoms.

Medical treatments for difficulty walking

Your physician may suggest one or all of the following interventions:

  • Physical therapy or rehabilitation: Your doctor may prescribe physical therapy/rehabilitation program to help you restore range of motion, strength, and stability of your gait regardless of the cause. A physical therapist can assess problems with your gait and other musculoskeletal issues in order to develop a rehabilitation plan that best applies to your situation.
  • Non-inflammatory medications: Your doctor may prescribe this type of medication to combat arthritic processes that are causing your walking difficulties.

Questions your doctor may ask about difficulty walking

  • How would you describe your walk?
  • Have you been experiencing dizziness?
  • Did you just suffer from a high impact injury (e.g., a fall, collision, accident or sports trauma)?
  • Do your symptoms get worse when you exercise?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

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