Acupuncture for the Treatment of Foot Drop- A case Report
Foot drop is characterized by difficulty or
inability to move the ankle and toes
upward (dorsiflex). The dropping of the
forefoot is most commonly caused by a
central or peripheral neurological
disorder. Less commonly is foot drop a
result of musculoskeletal disorders or
side effects from pharmaceutical
medication.1 Foot drop causes
asymmetry in the gait, affecting the
swing phase, the step length, and the
stance time between steps; resulting in a
slower and unstable gait. Furthermore,
foot drop consequently leads to
increased falls and injuries,2 and limits
the ability to perform daily activities.
Thus, negatively affecting quality of life.3
Current treatment methods include
orthotics/braces4, physical therapy5,
nerve stimulation6, medication for
muscular spasticity and surgery7.
Acupuncture for the Treatment of Foot Drop: A Case Report
Lung-Sheng Hsiao, MD (China)
Judith Miller, MAOM
Nathan Yeargin, DC, MAOM
A 75 year-old male presented with left
foot drop to the SCU Health System,
Whittier, CA starting in July of 2013.
The onset of the foot drop occurred
four weeks prior and was concurrent
with a deep/sharp pain in the low back
that radiated down the leg and into the
foot. The patient needed a cane to
assist him in walking. The low back
pain was significantly decreased after
chiropractic treatment, but the foot
drop still remained unchanged. The
patient has a history of episodic
chronic low back pain spanning over
twenty years due to disc rupture.
Previous x-rays show lumbar and
In his initial visit the patient had numbness on his left leg and dorsal area of his foot, subjectively
characterized as “heaviness”. Average pain was reported as a 2 out of 10 on the Visual Analogue
Pain Scale (VAS) and occurred 25-50% of time. Pain occurred in the low back and traveled into the
leg. There was no other significant past medical history or family history reported. Positive physical
exam findings included no muscular contraction (grade 0/5) of his left ankle and big toe (dorsiflexion).
Also his left C5/C6 and left L4 dermatome showed hypoesthesia (grade 1). His tongue was purple
with a wide body, hammer tip, and white coating. The pulse was thin and slippery. His Traditional
Chinese Medicine diagnoses were determined as wei syndrome with damp accumulation.
At the end of six treatments, the patient
reported he no longer had any pain in his low
back or leg, and the range of motion of the
ankle improved from 0o to 47o/50o; dorsiflexion
strength increased from grade 0 to grade 4-/5;
Big Toe dorsiflexion strength increased from
grade 0 to grade 4/5. Additionally, the patient
did not have to use a cane to assist with
walking and reported feeling more confident
when walking because he no longer was
tripping over the foot or having to lift the hip/
thigh up to move the left foot forward.
Additionally, it was observed that the patient
still had some mild muscular weakness causing
the toe off phase and swing phase to still be
Overall, the patient responded positively to
treatment and made significant improvements
in muscular contraction and range of motion.
However, it is important to note that the patient
was simultaneously seeking occasional chiropractic
care to manage his low back pain and was given
ankle joint taping. He was also advised to do at home
exercises to increase muscular function, strength, and
mobility. It is unknown how this may have affected the
outcome. The patient discontinued regular treatment
after the sixth visit and it would have been interesting
to record if there was increased improvement after the
use of electro-acupuncture.
During our literature search, we found little
information on the specific study of acupuncture for
dfoot drop. However, acupuncture has been reported
to have immediate effects on reducing or alleviating
pain8, strength performance, restoring neuromuscular
function9 and improving quality of life10. More
importantly, the contemporary use of scalp
acupuncture has found to be effective in treating the
numerous chronic and acute central nervous system
disorders. Scalp acupuncture follows the western
mapping of the cerebral cortex and the regions
chosen for acupuncture should correspond to the
brain’s neruo-anatomy11. Thereby, demonstrating that
acupuncture may be useful in the management and
treatment of foot drop.
1. Liu K, Zhu W, Shi J, et al. Foot Drop Caused by Lumbar Degenera?ve Disease: Clinical Features, Prognos?c Factors of Surgical Outcome
and Clinical Stage. PLoS ONE. 2013;8(11).
2. Suat E, Fatma U, NilgÜn B. The eﬀects of dynamic ankle-foot orthoses on func?onal ambula?on ac?vi?es, weight bearing and spa?o-
temporal characteris?cs of hemipare?c gait. Disabil Rehabil. 2011;33(25/26):2605-2611.
3. Graham J. Foot drop: explaining the causes, characteris?cs and treatment. Br J Neurosci Nurs. 2010;6(4):168-172 5p.
4. Stein RB, Everaert DG, Thompson AK, et al. Long-term therapeu?c and ortho?c eﬀects of a foot drop s?mulator on walking
performance in progressive and nonprogressive neurological disorders. Neurorehabil Neural Repair. 2010;24(2):152-167.
5. Taylor P, Barre` C, Mann G, Wareham W, Swain I. A Feasibility Study to Inves?gate the Eﬀect of Func?onal Electrical S?mula?on and
Physiotherapy Exercise on the Quality of Gait of People With Mul?ple Sclerosis. Neuromodula:on. 2014;17(1):75-84.
6. Wilkenfeld AJL. Review of electrical s?mula?on, botulinum toxin, and their combina?on for spas?c drop foot. J Rehabil Res Dev.
7. Ward AB. Managing spas?c foot drop ader stroke. Eur J Neurol. 2014;21(8):1053-1054.
8. The Eﬃcacy of Acupuncture for the Treatment of Scia?ca: A Systema?c Review and Meta-Analysis. Evid-Based Complement Altern Med
ECAM. 2015;2015:1-12 12p.
9. Hübscher M, Vogt L, Ziebart T, Banzer W. Immediate eﬀects of acupuncture on strength performance: a randomized, controlled
crossover trial. Eur J Appl Physiol. 2010;110(2):353-358.
10. Frisk J, Källström A-C, Wall N, Fredrikson M, Hammar M. Acupuncture improves health-related quality-of-life (HRQoL) and sleep in
women with breast cancer and hot ﬂushes. Support Care Cancer Oﬀ J Mul:natl Assoc Support Care Cancer. 2012;20(4):715-724.
11. Hao JJ, Hao LL. Review of Clinical Applica?ons of Scalp Acupuncture for Paralysis: An Excerpt From Chinese Scalp Acupuncture. Glob Adv
Health Med. 2012;1(1):102-121.
A total of six acupuncture treatments, once per
week for 30 minutes were provided. Scalp
acupuncture was administered on the right side
of the patient’s head. The scalp areas used
included the lower limb region of the Motor Line
and the Sensory Line, and the Leg Motor and
Sensory Line. Mild manual manipulation was
performed, then the patient was asked to walk
short distances (approximately 10 feet) with the
needles retained. The clinician would watch for
visible changes in the gait and also ask the
patient to report if it became easier to lift his foot
for the heel strike. Acupuncture points on the
body included: ST 36, SP 9, GB 34, ST 40 on the
left side of the body during the first five courses
of treatment. Left ST 41, SP 6, GB34, and ST40
were also stimulated using electro-acupuncture
on the sixth treatment.
The current case may provide insight to a
promising alternative approach to managing
acute cases of foot drop with acupuncture. More
rigorous clinical trials are needed to determine
both traditional and scalp acupuncture’s role in
treating drop foot and understand its specific
mechanisms of action, especially if
acupuncture can treat more serious and
chronic cases of foot drop.
Summary of Pa3ent Results
• Low back and leg pain resolved
• Dorsiﬂexion range of mo?on increased a total of
• Dorsiﬂexion of ankle and big toe muscle strength
increased from a grade 0 to a grade 4-/5
Summary of Treatment
• Six consecu?ve weekly
• Scalp acupuncture on the
Motor Line, Sensory Line
and the Leg Motor and
• Acupuncture at led ST36,
SP9, GB34, ST40
• Electro-acupuncture used
on sixth treatment at SP6
to GB41 & ST40 to GB34