Gait Disorders: Causes, Treatment & Help

Gait disorders are not uncommon, but can be attributed to a variety of causes, some of which require very different treatments and others that are difficult to prevent.

What are gait disorders?

The causes of gait disorders are very diverse and, accordingly, so are the therapies. Orthopedic causes, for example, can be treated by physical therapy. Gait disorders refer to movement disorders that cause walking movements to deviate from their typical pattern. However, gait disorders must be distinguished from movement disorders. Gait disorders can therefore be manifested by a slight limp, but also by disorders that make walking almost impossible. Their causes are particularly varied and entail quite different treatment methods. The success of treatment is as varied as the treatment methods. Some gait disorders can be completely eliminated again, others can be minimized only strongly to slightly.

Causes

A number of very different causes can be considered for gait disorders. First, gait disorders can occur when muscles or bones are injured, malformed, or affected in some other way. In this case, medical science refers to orthopedic causes. If a disease of the internal organs is the trigger for a gait disorder, we speak of internal causes. If the gait disorders are caused by damage to the nerves, they are referred to as neurological causes. Thus, since an orthopedic, an internal or a neurological cause can underlie a gait disorder, a number of very different triggers come into question. Typical orthopedic causes include bone conditions such as fractures, muscle injuries such as strains or tears, spinal conditions such as herniated discs, or joint conditions such as osteoarthritis. Internal causes can be circulatory disorders or thrombosis, but also too low or too high blood pressure, lack of fluids, dizziness, alcohol and other toxins, cardiovascular diseases, sunstroke and others. Neurologically induced gait disorders, for example, can be attributed to conditions such as multiple sclerosis, Parkinson’s disease, or epilepsy.

Diseases with this symptom

  • Bone fracture
  • Fracture of the thigh (femur fracture)
  • Circulatory disorders
  • Alcohol addiction
  • Cardiovascular disease
  • Muscle cramps
  • Lower leg fracture
  • Muscle strain
  • Thrombosis
  • Stroke
  • Heart attack
  • Multiple sclerosis
  • Herniated disc
  • Osteoarthritis
  • Hypertension
  • Pericarditis
  • Diabetic foot syndrome
  • Parkinson’s disease

Diagnosis and progression

A gait disorder is clearly manifested by a disorder of the musculoskeletal system and is therefore easy to diagnose by a medical professional. To find out the exact cause of the gait disorder, on the other hand, is sometimes much more difficult. For this purpose, the doctor asks the patient about recent accidents, previous illnesses, paralysis and signs of paralysis, complaints such as dizziness and sensory disturbances, alcohol consumption or medication. This is followed by a physical examination to determine the nature and severity of the gait disorders. This is usually followed by a neurological examination to examine the patient’s reflexes, motor function and sensation to determine whether neurological causes may be responsible for the gait disorder. This requires the patient to perform a series of exercises. Coordination exercises, for example, show whether a disturbance of the sense of balance is present or can be ruled out. Hearing tests, blood tests, computer tomographies, magnetic resonance imaging, electroencephalographies, cerebrospinal fluid tests and other procedures may also be used to make a diagnosis. Depending on the severity of the gait disorder and how difficult it is to determine its cause, a primary care physician may refer the patient to a specialist. Depending on the cause of a gait disorder, the gait disorder may take a different course. A simple fracture, muscle strain, or other cause may heal on its own in some cases, and the gait disorder will disappear with it. As a rule, however, a gait disorder must be treated by a doctor.

Complications

Gait disorders can have very different causes. Usually the musculoskeletal system is impaired and sometimes the sense of balance is disturbed. But there can also be an underlying disease of the brain, a brain tumor or a stroke, for example. So the patient should always go to the doctor, he will determine exactly the cause of the gait disorder. Now the doctor can initiate a therapy. If the gait disorder is due to the musculoskeletal system, surgery can help, but complications can occur here as well. For example, it is not impossible that viruses and bacteria influence the healing process. However, it is also possible that the body does not accept a prosthesis. Nevertheless, it is the most successful therapy to eliminate the gait disorder. In some diseases, physiotherapy is also advised, here the balance and muscles are trained. These exercises should also be done at home, so the gait disorder should be alleviated. In certain diseases, no cure is sought, here the gait disorder can only be stopped, such as in Parkinson’s disease or multiple sclerosis. However, if the cerebellum is damaged, even the doctor cannot do anything, the gait disorder remains. In this case, the patient can only train the gait and prevent a possible fall. Affected people often avoid walking and do not move outside the house at all. This is wrong, because it depletes the last physical reserves and patients end up in social isolation. This has a bad effect on the overall prognosis and is often compounded by depression. Therefore, people should exercise the gait, even if it is difficult.

When should people see a doctor?

Since gait disorders can be the symptom of various diseases, accurate diagnosis by a doctor is especially important. This is because timely detection increases the chances of recovery and thus the success of treatment. The visit to the doctor should therefore be tackled immediately if the disturbances occur suddenly and obviously without any external causes. Consequently, those affected who have no relevant previous illnesses should not hesitate. This includes in particular cases in which pain-free movements can no longer be performed independently. Otherwise, there is a risk of sustaining further injuries as a result of any falls, which could aggravate already existing symptoms and make everyday life considerably more difficult. A visit to the doctor, on the other hand, is less urgent if treatment is already taking place and the attending physician has initiated initial treatment steps. In these cases, close consultation is still necessary. However, it will usually only be necessary to visit the doctor’s office after the already known complaints have worsened. If the gait disturbances are the result of an external cause (such as a fall or an accident), seeing a doctor is inevitable. Only in the case of symptoms that make independent walking possible without major obstacles, it is possible to wait with the visit. However, curative treatment is also necessary in this case if there is no independent improvement.

Treatment and therapy

The therapy of a gait disorder naturally depends on the causes that have caused the gait disorder. Since the causes can be as varied as in hardly any other disease, treatment is not only different if an orthopedic, an internal or a neurological cause is the trigger for the gait disorder. Instead, treatment methods can also vary widely within any of these three groups. Some causes such as circulatory problems, high blood pressure, low blood pressure are usually treated with medication. Strokes and thrombosis, however, may require surgical intervention beyond medication. If alcohol, smoking or other toxins are the cause of the gait disorders, in many cases simply giving up these substances can help. For many orthopedic causes, immobilization of the affected bones or muscles is sufficient to ensure a successful healing process. In some cases, however, medications are prescribed instead or physical therapies and other measures are ordered. In some cases, the gait disorder can only be treated with surgery. Neurological causes are often particularly difficult to treat, because here often only the symptoms can be reduced, but not the cause.

Outlook and prognosis

It is not possible to give an accurate prognosis for gait disorder in general, as it is highly individualized and depends on numerous factors. If the gait disorder is due to a nutrient deficiency and the deficiency is corrected, the gait disorder improves rapidly in many cases and often disappears completely. There is as yet no causative treatment for Parkinson’s disease. However, the gait disorder in Parkinson’s can be improved by taking medication. Particularly in the early stages of the disease, drug therapy often brings a significant improvement in symptoms. In the later course of the disease, however, the gait disorder may no longer be avoidable. If treatment is started in time, a normal life span is possible despite Parkinson’s. In multiple sclerosis, the prognosis is worse for men than for women. However, other factors play an important role in the outlook, such as age at onset of the disease, the number of inflammatory lesions, and which areas of the central nervous system are affected by multiple sclerosis. Problematic alcohol consumption can also cause gait disorders. It often begins in adolescence. However, the majority of adolescents discontinue harmful use of alcohol even without intervention. Alcohol dependence can progress in phases or deteriorate continuously. About 20% of those affected recover without help – with treatment, that number ranges from 40% to 75%, depending on the study.

Prevention

Gait disorders with neurologic causes often cannot be prevented. However, the risk of developing a gait disorder that has an internal or orthopedic cause can be minimized, at least in part, by a healthy lifestyle. Abstaining from alcohol and nicotine, getting enough exercise, refraining from particularly dangerous sports, observing safety precautions in everyday life, such as warming up properly before and using leg protectors during sports or the like, are helpful methods to prevent gait disorders, but can never completely eliminate them.

Here’s what you can do yourself

Gait disorders can usually only very rarely be treated by self-help. In most cases, a doctor must be consulted. Often, surgical treatment is also necessary, and treatment with medication takes place only in a few cases. Gait disorders often occur in older age and can strongly influence and limit the patient’s everyday life. Various walking aids can be used for gait disorders. These include, for example, the walking stick, a rollator or a wheelchair. With these devices, the locomotion of the affected person is facilitated, so that an ordinary everyday life is possible again. Gait disorders can be prevented by sporting activities. Even at an older age, sporting activities have a positive effect on gait disorders and can prevent and limit them. Rehabilitation sports and gymnastics can help strengthen muscles and minimize deficits in posture, and then also alleviate the symptoms of gait disorders. However, gait disorders can also be triggered by psychological problems. Again, there are no self-help methods available. In any case, the patient should seek medical treatment. If there is also a lot of pain with the gait disorders, a doctor must also be consulted. Without treatment, the pain may intensify and lead to the former medical complications.