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Limping is often caused by pain, and pain is frequently the result of limping. When limping due to pain, individuals will shorten the stance phase—the period in which the foot on the affected side remains in contact with the ground—to minimize the time spent bearing weight on the injured leg or foot. This asymmetric abnormality of the gait can be caused by physical trauma, such as sports injuries, motor vehicle accidents, or accidental or deliberate blunt force trauma. It can also be caused by conditions affecting the nervous system, such as cerebral palsy, stroke, Parkinson's disease, or multiple sclerosis, leading to muscle weakness, spasticity, or coordination problems.
| Characteristics | Values |
|---|---|
| Cause of limp | Pain, weakness, neuromuscular imbalance, skeletal deformity, physical trauma, medication side effects, arthritis, bone fractures, muscle strain, injury, infection, or genetic disorders |
| Treatment | Pain management, rest, ice, crutches, physical therapy, steroid injections, joint replacement surgery, medication (NSAIDs), exercise, healthy body weight |
| Diagnosis | X-ray, blood tests, joint aspiration, magnetic resonance imaging (MRI), electromyography (EMG), history, physical exam findings, laboratory tests, radiological examination |
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What You'll Learn
Limping caused by physical trauma
Limping is an asymmetric abnormality of gait and can be caused by pain, weakness, neuromuscular imbalance, or a skeletal deformity. Physical trauma is the most common cause of limping in children and younger people. It can be caused by accidental or deliberate physical trauma, which may result in a fracture, muscle bruising, or a contusion. Deliberate abuse is an important consideration here.
Slipped capital femoral epiphysis (SCFE) is a condition where the growth plate of the head of the femur slips over the underlying bone. It usually presents with hip pain in males during puberty and is associated with obesity. Most people with SCFE experience a painful limp, and in half of the cases, both hips are affected. Nearly a quarter of people only experience knee pain. Treatment for SCFE involves non-weight-bearing movement and surgery. If not treated early, osteonecrosis or death of the head of the femur may occur.
Other causes of limping in children include infectious arthritis, osteomyelitis, transient synovitis, and Legg-Calvé-Perthes syndrome. Transient synovitis is a reactive arthritis of unknown cause that affects the hip. It can be difficult to distinguish from septic arthritis, a bacterial infection in the joint. Lyme disease, a bacterial infection spread by deer ticks, and osteomyelitis, an infection that affects the long bones, can also cause limping.
In younger people, physical trauma such as sports injuries or motor vehicle accidents are common causes of limping. In older people, arthritis is the most common cause of pain and limping. Osteoarthritis (OA) occurs when the articular cartilage that lines the endings of bones begins to thin and deteriorate, altering the normal movement of a joint and causing 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 50, and are worse after periods of inactivity. Treatment for OA includes non-steroidal anti-inflammatory drugs (NSAIDs), regular exercise, maintaining a healthy body weight, and physical therapy. In more severe cases, corticosteroid injections or joint replacement surgery may be necessary.
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Limping caused by bone fractures
Limping is often caused by pain, weakness, neuromuscular imbalance, or a skeletal deformity. The most common cause of a painful limp is physical trauma, which can result in a fracture, muscle bruising, or a contusion. Limping can also be caused by pain or injury to the foot, leg, or hip.
Fractures can cause limping due to the pain associated with putting weight or pressure on the injured area. A fracture can also lead to weakness and decreased flexibility in the injured leg, further hindering normal walking. In severe cases, a fracture may cause the bone to shift out of place, resulting in joint misalignment and even more difficulty walking.
Bone fractures are typically diagnosed through imaging tests such as X-rays, CT scans, and MRI scans. X-rays are particularly useful in visualising bones and joints and detecting osteoarthritis or bone spurring. MRI scans provide detailed views of soft tissues and can reveal inflammation associated with infections near broken bones.
Treatment for limping caused by bone fractures may include pain management through over-the-counter medications, icing the injury, and resting the affected area. Crutches can also be used to reduce weight bearing on the injured limb. In more severe cases, surgery may be required to realign the bone fragments and stabilise them in place. Physical therapy plays a crucial role in restoring a person's walking pattern and encouraging the healing process.
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Limping caused by arthritis
Limping can be caused by many factors, including pain, weakness, neuromuscular imbalance, or a skeletal deformity. The most common underlying cause of a painful limp is physical trauma. However, in the absence of trauma, other serious causes, such as arthritis, may be present.
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.
Septic arthritis is a bacterial infection in a joint. In most cases, bacteria from the bloodstream spread to the joint, causing septic arthritis. It is also possible to introduce bacteria into the joint from trauma or bites, during surgery to a joint, or from infections elsewhere in the body (e.g. bone, soft tissue) that spread into a joint. Septic arthritis is a serious condition and should be evaluated urgently by a physician.
Juvenile rheumatoid arthritis presents gradually with early morning stiffness, fatigue, and weight loss. Legg-Calvé-Perthes syndrome is a degenerative disease of the head of the femur, which results in bone loss and deformity. It usually presents as a chronic condition.
Infectious arthritis, osteomyelitis, and slipped capital femoral epiphysis in children can also cause limping. Transient synovitis is a reactive arthritis of the hip of unknown cause.
If limping is due to injury or pain, it can likely be treated with rest, ice, crutches, or physical therapy. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, regular exercise, and maintaining a healthy body weight are also good first steps for managing antalgic gait caused by osteoarthritis.
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Limping caused by muscle strain
Limping is an asymmetric abnormality of gait and can be caused by pain, weakness, neuromuscular imbalance, or skeletal deformity. The most common cause of a painful limp is physical trauma, which may result in a fracture, muscle bruising, or a contusion. Strains impact muscle tendons and 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. A strained calf muscle, for example, can make it difficult to walk without limping.
Following a strain, initial symptoms can be controlled by icing, elevating the leg, and resting from any irritating activities. Depending on the severity of the issue, over-the-counter pain medications, bracing for stability, or physical therapy may be recommended to restore your range of motion and strengthen the affected area. Physical therapy can help build strength in the muscles that support the arthritic joint and alleviate symptoms.
If limping is due to injury or pain, it can likely be treated with rest, ice, crutches, or physical therapy. Limping can also be caused by many complex neurological conditions, which will likely require evaluation by a doctor to determine the cause and appropriate treatment or therapy.
In children, there are multiple reasons for limping, including injury, infection, or genetic disorders. If a child has a limp, they should be evaluated by a doctor. In adults, a limp may be indicative of underlying conditions such as cancers, acute lymphocytic leukaemia, osteosarcoma, or Ewing's sarcoma.
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Limping caused by neurological conditions
Limping can be caused by several factors, including pain, weakness, neuromuscular imbalance, or a skeletal deformity. While it can sometimes be the result of an injury or pain to the foot, leg, or hip, it can also indicate more complex neurological conditions. Limping caused by neurological conditions will likely require evaluation by a doctor to determine the appropriate treatment or therapy.
Neurological conditions are a common cause of limping in elderly individuals. A new limp in an older person could be a sign of injury to the brain, spinal cord, or peripheral nerves. As people age, it is more common to develop a limp due to a neurological disorder. Neurological conditions that can cause limping include cerebral palsy, muscular dystrophy, and mild brain palsy.
In children, limping is a common complaint in pediatric, pediatric orthopedic offices, and emergency rooms. Limping in children can be caused by various factors, including injury, infection, or genetic disorders. Several neurological disorders can cause limping in children, such as cerebral palsy, muscular dystrophy, and mild brain palsy. A child with a limp should be evaluated by a doctor to determine the underlying cause.
Diagnostic tests for limping can include X-rays, blood tests, joint aspiration, magnetic resonance imaging (MRI), and electromyography (EMG). These tests help evaluate the bones, joints, muscles, ligaments, and nerves to determine the cause of the limp. If the cause is suspected to be neurological, further neurological testing and imaging of the head and spinal cord may be recommended.
Treatment for limping caused by neurological conditions will depend on the specific diagnosis and can vary from lifestyle modifications, physical therapy, and medication to more invasive procedures such as surgery. In some cases, assistive devices like crutches or canes can help correct a limp by reducing weight on the affected limb.
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Frequently asked questions
Limping can be caused by pain, weakness, neuromuscular imbalance, physical trauma, skeletal deformity, or injury to the foot, leg, or hip.
Treatments for limping include rest, ice, pain medication, crutches, physical therapy, and in some cases, surgery.
Yes, limping can cause muscle pain due to the abnormal gait and increased stress on the affected limb.
Common causes of muscle pain in the legs include strains, sprains, tears, bruises, and inflammation.
To prevent muscle pain when limping, it is important to wear supportive and comfortable shoes, use assistive devices like crutches, and perform stretching and flexibility exercises to maintain joint health and prevent stiffness.
