What's Causing Your Gait Change?

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Don’t take it in stride

A sudden change in gait with no apparent cause is not normal and needs to be evaluated by a doctor. Often, however, gait changes develop gradually as a result of a chronic medical condition.

To determine what’s causing your gait change, your doctor will perform a comprehensive history and a physical exam and review your medications. Here are several possible causes.


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Parkinson’s disease

Quick, short steps or shuffling, with the knees, hips, and spine bent, could suggest Parkinson’s disease or parkinsonism. Parkinsonism is a condition with symptoms similar to Parkinson’s disease that also affects gait.


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Arthritis

Knee or hip arthritis can force you to change your gait, often in an effort to relieve pain as you walk. You may appear stiff; take short, slow steps; or seem unable to bear your body’s weight.


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Back and neck problems

Lumbar spinal stenosis, which is a narrowing of the canal through which the spinal cord travels in the vertebrae of the lower back, can affect gait.

Spinal cord compression in the neck region (cervical spondylotic myelopathy) can interfere with gait and cause loss of balance and coordination and also result in “foot drop,” a weakness in the ankle muscles that causes the toe to drag while walking. Foot drop is sometimes accompanied by a high lifting of the leg to avoid catching the toe on the ground.


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Other orthopedic problems

Lower-extremity surgery or trauma, such as a fracture, can cause a deviation from normal gait.


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Vitamin B12 deficiency

A stagger or an unsteady gait can be a sign of a chronic vitamin B12 deficiency, which can lead to a degeneration of the nerves in the spinal cord and brain. Early detection is crucial: By the time a B12 deficiency gives rise to difficulty walking, the nerve damage may be irreversible.


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Peripheral neuropathy

Damage to sensory nerves in the feet can cause numbness, tingling, or pain in the feet and result in an inability to walk properly. Diabetes is a common cause, but many other medical conditions that are amenable to treatment can also cause neuropathy.


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Other neurologic disorders

Brain tumors, multiple sclerosis, Huntington’s disease, stroke, and normal pressure hydrocephalus (a buildup of cerebrospinal fluid in the fluid-containing sacs of the brain due to an inability of the fluid to flow normally) are examples of the many neurologic disorders that can cause gait disturbances.

These brain and nervous system disorders can trigger a wide range of gait changes, including unsteadiness; slow, small steps; lack of coordination; feeling as if your feet are stuck to the ground; or difficulty initiating leg movement.


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Peripheral artery disease (PAD)

Peripheral artery disease can cause calf, thigh, and foot pain, which occurs when the arteries to the legs can’t deliver sufficient blood flow, resulting in leg pain after walking short distances.


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Mental health disorders

A depressed mood may cause you to walk more slowly and shuffle, and anxiety may cause you to walk more cautiously.


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Drug side effects

Some medications can directly impair walking by causing a Parkinson-like gait disorder. Antipsychotic drugs and metoclopramide are common causes. Drugs that cause blurry vision, confusion, drowsiness, and low blood pressure upon standing—and there are many—can adversely impact gait.


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Footwear

Ill-fitting shoes with no support can cause you to shuffle your feet. High heels and crepe soles can impair gait. Wear sturdy, low-heeled shoes instead.