Limping

Many different health conditions can cause limping (antalgic gait) when you walk. This can include acute injuries as well as gradually progressing medical concerns. Paying closer attention to when the limping occurs and any symptoms that accompany it can help you determine its origins.

This article will detail the most common causes of and treatments for limping.

Causes of Limping

Limping is associated with many diagnoses, though some are more common than others. Some of the most frequent causes of antalgic gait include:

• Osteoarthritis
• Sprains, strains, or soft-tissue injuries
• Lumbar radiculopathy

Osteoarthritis (OA) occurs when the smooth, slippery coating (called articular cartilage) that lines the endings of bones begins to thin and deteriorate. This can alter the normal movement of a joint and lead to pain.

When the hip, knee, ankle, or foot joints are affected, it can make walking painful and lead to a limp. OA symptoms typically come on gradually, affect individuals over the age of 50, and are worst after periods of being sedentary.

Sprains, strains, and soft-tissue injuries can occur either due to an acute injury or chronic, repetitive activities over time. Sprains affect the body’s ligaments, while strains impact muscle tendons.

In either case, sprains and strains occur when the impacted structure is overstretched or partially torn. This damage can lead to pain and antalgic gait when it occurs in the leg. An injury to several other soft-tissue structures, including a bursa (a fluid-filled sac that reduces friction), meniscus, or fat pad, can also lead to limping.

Lumbar radiculopathy is a condition in which the nerve roots that branch off from the lower (lumbar) portion of the spine become compressed or inflamed. This can occur because of a disc issue (bulging, degeneration, or herniation), bone spurring, or (rarely) due to a growth or tumor in the area.

Because these nerves control movement, sensation, and strength in your legs and feet, irritation in one of them can lead to limping. The antalgic walking pattern from this condition frequently comes on suddenly and is commonly accompanied by back symptoms.

Corresponding Symptoms of Limping

Limping while you walk may be your primary concern, but it is rarely the only complaint. On the contrary, several other associated symptoms may also be present, depending on the cause of your issue. These include:

• Pain
• Joint stiffness
• Limited range of motion
• Clicking or popping
• Leg instability or buckling
• Muscular weakness
• Swelling
• Numbness and tingling (paresthesia)

Osteoarthritis typically results in pain, stiffness, clicking, and occasionally swelling in the affected joint. These symptoms are usually worst first thing in the morning and at the end of a long day of activity. Moving around and “warming up” the joint tends to make OA symptoms feel better.

Sprains, strains, and other soft tissue injuries typically cause swelling, pain, and range of motion limitations. More severe injuries can also make the leg feel unstable and cause it to give way as you walk. Occasionally, bruising may also occur in the area of the injury.

Lumbar radiculopathy commonly leads to shooting pain and paresthesia in the leg. Depending on which nerve is involved, you may also experience muscular weakness in certain areas of the lower extremity. Occasionally, the affected leg also feels like it is going to buckle while you are standing or walking.

How to Treat Limping

From at-home treatments to more invasive interventions, there are several ways to address your limp. Non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen) or Aleve (naproxen), regular exercise, and maintaining a healthy body weight are good first steps for managing antalgic gait caused by osteoarthritis.

Physical therapy can also be helpful for building strength in the muscles that support the arthritic joint and alleviating your symptoms. In more advanced cases, a corticosteroid injection or joint replacement surgery may prove necessary.

Following a sprain, strain, or soft-tissue injury, you can control your initial symptoms by icing, elevating the leg, and resting from any irritating activities.

Depending on the severity of the issue, your healthcare provider may also recommend over-the-counter pain medications, bracing for stability, or physical therapy to restore your range of motion and strengthen the affected area. In rare cases, surgery may be necessary to restore your joint's stability and improve your walking.

Limping from lumbar radiculopathy is initially treated with NSAIDs and muscle relaxants. Your healthcare provider may also counsel you on maintaining a healthy body weight, which can reduce the strain on the affected area of your spine. Physical therapy is also frequently initiated to build strength in your core and alleviate your walking symptoms.

If conservative interventions fail to improve your antalgic gait pattern, a spinal injection or even surgery can reduce the pressure on the nerve root.

Are There Tests That Diagnose the Cause of Limping?

Your healthcare provider may order several different diagnostic tests to determine the cause of your limp. These include:

• X-ray: Visualizes the bones and joints in the body when looking for osteoarthritis or bone spurring
• Magnetic resonance imaging (MRI): Provides a detailed view of the muscles, ligaments, and soft-tissue structures when diagnosing sprains, strains, and lumbar radiculopathy
• Joint aspiration: Tests the fluid within a joint to rule out other forms of arthritis or infection
• Electromyography (EMG): Assesses how your nerves are functioning and helps determine whether your limp is the result of a nerve-root issue

When to See a Healthcare Provider

Your healthcare provider should evaluate any new or worsening limp without delay. This is especially true if it occurs after an acute injury or is accompanied by progressive muscular weakness, the giving way or buckling of the leg, numbness or tingling in the groin region, or incontinence of the bowel and bladder.

The presence of any of these associated symptoms may indicate a more serious condition that should receive immediate attention.

Summary

Limping (antalgic gait) is usually a sign of a larger issue within the leg or low back. The most common causes include osteoarthritis in one of the leg’s joints, lumbar radiculopathy, or an injury to a ligament or tendon.

A thorough medical exam and diagnostic tests like an X-ray, MRI, or EMG can typically determine the origins of your limp. Activity modifications, over-the-counter pain relievers, physical therapy, and (in rare cases) surgery are all useful when treating an antalgic gait.

Though ignoring your limp and pushing through it can be tempting, it is important to discuss your condition with a trusted healthcare provider. Taking this step can help you discover the cause of the problem and help improve the quality of your walking.