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Leg Limping - Causes, Symptoms, Types, Investigations, and Treatment

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Limping is the abnormal walking pattern of using one leg over the other. Read the article to learn about the causes and treatment for the condition.

Medically reviewed by

Dr. Anuj Gupta

Published At February 9, 2023
Reviewed AtJuly 17, 2023

Introduction

Leg limping is an abnormality of the gait caused due to numerous reasons, from trauma to structural defects of the leg. It is common in adults or older populations. A small number of children also present with leg limping. The doctor must find the correct cause of limping and provide appropriate treatment for the condition.

What Is Leg Limping?

A limp is an asymmetrical manner of walking. It can vary from mild to severe forms where the person is unable to walk. The exact cause must be found and corrected to reduce the symptoms of limping and provide relief to the patient.

What Are the Causes of Leg Limping?

Leg limping occurs due to various reasons. They are:

  • Injury to the leg can cause limping. Since the patient has pain, they try to place the body weight on the affected leg only for a short time and then switch to the other leg. Injury to the hip joint can also result in limping.
  • Limping can occur due to structural defects that are present since birth. When there is a difference in the length between the two legs, the gait is affected, resulting in limping.
  • Genetic conditions like muscular dystrophy cause weakness and loss of muscle mass.
  • Spinal cord compression due to injury or degenerative disease leads to weakness in the leg, causing limping.
  • Any infection or inflammatory diseases affecting the leg and causing its weakness.
  • Patients with neurological conditions can experience limping in older stages of life.
  • Patients with psychological disorders and cardiorespiratory diseases may also present with leg limping.

The most common cause of limping is trauma or injury to the leg. In the absence of trauma history, the next common cause is transient synovitis (inflammation of the hip joint capsule). Children affected with Legg-Calve-Perthes syndrome (a hip disorder in children due to lack of blood supply to the thigh bone).

What Are the Symptoms of Leg Limping?

The patient presenting with abnormal gait has any of the following symptoms suggestive of limping:

  • Pain in the leg or feet.
  • Pain in the hip region.
  • Difficult to stand after sitting for a long time.
  • A sensation of weakness or numbness in the leg or feet.
  • Difficulty in balancing.
  • The patient feels intense pain in the back of the legs.
  • The patient will be unable to move the toes.

In children, the most important symptoms that require immediate treatment are:

  • Presence of rash or bleeding of unknown cause.
  • Severe pain that disturbs sleep at night time.
  • Presence of inflammation at the joints.
  • Worsening of the limp and stiffness of the leg in the morning.

Hence, a child less than three years old who is unable to tolerate the pain has an abnormal walking pattern and shows the above red-flag symptoms that must be checked with the doctor and treated as soon as possible.

What Are the Types of Limping?

Before describing the types of limping, the normal gait is known. The normal walking pattern has a stance and a swing phase. The stance phase is when a person’s foot is on the ground. The swing phase is when the foot is advanced from the ground and returns to the stance phase. Limping is different from normal walking and has three types: antalgic, paralytic, and short-legged.

1. Antalgic Limp: Persons with pain in the affected limb have this type of limp. The affected foot will have a shorter stance phase, and more weight is put on the unaffected limb for a more extended period.

2. Paralytic Limp: Paralysis due to neuromuscular diseases causing weakness of one or more muscles can result in limping. Since the muscles are weakened, the body cannot balance the weight, and the upper part of the body is over the affected leg causing a limp.

3. Short-Legged: A leg length discrepancy between the two legs of more than five centimeters is significant and produces limping, where the body moves towards the short-legged side while walking.

What Are the Investigations Done for a Person With a Leg Limp?

  • First, a thorough medical history is taken by gathering information about recent trauma, fever, infection, or underlying medical illness.
  • If a child is consulted for limping, a complete medical history and any family history of arthritis are noted.
  • The type of limping and the time at which they usually limp are discussed to arrive at the proper cause.
  • Next, the doctor examines the way the affected person is walking. They usually lean towards one side and walk.
  • Both the legs and feet are examined for the presence of injury, swelling, or inflammation. The arms are also checked for any injuries.
  • The functioning of the knee and hip joints is checked thoroughly, and any associated pain or swelling is noted. The doctor examines the spine for any rash, pain, or stiffness.
  • The nervous system is checked if the patient has none of the above signs. The signs like a tight Achilles tendon (a tendon between the calf muscle to the heel), high arched foot on one of the legs, or claw toes indicate a nervous system disorder. The reflexes at the joints and the overall balance of the body are also checked.
  • Apart from the history and physical examination of the patient, the doctor runs a series of imaging studies such as the X-ray, bone scan, MRI (magnetic resonance imaging), or ultrasound. X-rays are enough to detect the cause of a limp. If the cause is unclear even on X-rays, then a bone scan (an X-ray taken along with a radiopaque dye to find any mild fractures, infection, or tumors) is used. MRI can show swelling or infection at the joints. Ultrasound helps to reveal any fluid in the joints.
  • Finally, the physician advises the patient to undergo a laboratory test to check their blood count and the presence of infection in their body. This helps detect conditions like arthritis.

What Are the Treatments Available for Limping?

The physician decides on the treatment modality suitable for the patient depending on the cause of the limping. The following are the treatments available for limping.

  • Crutches or Walking Boot - Provides extra support to the patient and helps reduce the weight load on the affected leg in cases of injuries.
  • Leg Elevation - Elevating the affected leg improves blood circulation, and ice packs can be placed to reduce the pain.
  • Physiotherapy - The patient is advised to undergo physiotherapy if the cause is an injury or muscle weakness. A physiotherapist performs massages or manual therapy and instructs the patient to follow some exercises.
  • Medications - The doctor prescribes medications to reduce inflammation in inflammatory conditions.
  • Weight Loss - In obese patients, weight loss is encouraged to reduce the weight load on the legs.

The patient must rest for a few days for the pain to subside and stay hydrated. Any changes noticed that worsen the condition must be reported to the doctor. Regular follow-ups must be maintained to check the progress of the patient.

Conclusion

Leg limping is an asymmetrical walking pattern that occurs in adults as well as children. The doctor decides the correct treatment for the condition based on the cause of the limping. Most patients with limping get relieved after the appropriate treatment. They usually heal faster, but cases with infections or tumors require a prolonged treatment duration to improve their condition in an interdisciplinary approach.

Dr. Anuj Gupta
Dr. Anuj Gupta

Spine Surgery

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