Gait Disorder

Overview

A gait disorder is an abnormal way of walking. Normal walking depends on many systems working together, including the muscles, joints, nerves, inner ear, eyes, and brain. When any of these is affected, the pattern, speed, or steadiness of walking can change.

Gait disorders range from a mild limp to severe unsteadiness that makes walking unsafe. They are especially common in older adults and are an important cause of falls. Because so many conditions can affect walking, finding the underlying cause is the key to effective treatment.

A gait disorder is not a disease in itself but a sign that something is affecting one of the systems involved in walking. Sometimes the cause is obvious, such as pain from an injured knee, and sometimes it is subtle, building up gradually over months or years. In older adults especially, several small problems can combine to affect walking, which is why a careful, thorough evaluation is so valuable.

Symptoms

Gait disorders can look different depending on the cause. Features people or their families may notice include:

• Limping or favoring one leg
• Unsteadiness, swaying, or a wide-based walk for balance
• Shuffling steps or difficulty starting to walk
• Dragging a foot or frequent tripping
• Slow walking or needing support such as a wall or furniture
• Frequent falls or a fear of falling

These changes may come on suddenly, as after a stroke, or develop gradually with conditions that affect the nerves, joints, or brain.

Common Causes

Many conditions can cause a gait disorder, including:

• Nerve and brain conditions: Stroke, Parkinson's disease, multiple sclerosis, peripheral neuropathy, and normal pressure hydrocephalus
• Muscle and joint problems: Arthritis, hip or knee pain, muscle weakness, and old injuries
• Balance and inner ear disorders: Problems that cause dizziness and unsteadiness
• Other factors: Vision problems, certain medicines, alcohol, and general weakness from illness

Sometimes more than one cause is present at the same time, especially in older adults.

Associated Symptoms

Depending on the cause, a gait disorder may occur alongside:

• Dizziness or vertigo
• Numbness, tingling, or weakness in the legs
• Tremor or stiffness
• Joint pain or swelling
• Memory or thinking changes
• Loss of bladder control in some conditions

These accompanying symptoms can offer important clues about what is affecting the way a person walks. For example, numbness and tingling point toward a nerve problem, while joint pain and swelling suggest an issue with the bones or joints. Sharing all symptoms with a doctor helps narrow down the cause more quickly.

Diagnosis & Evaluation

Evaluation focuses on identifying the cause:

• History and examination: A doctor reviews when the problem began, watches the person walk, and tests strength, sensation, reflexes, balance, and joints.
• Imaging: X-rays, CT, or MRI may be used to look at the joints, spine, or brain.
• Nerve and other tests: Nerve studies, blood tests, or balance testing help pinpoint the cause.

A careful evaluation often reveals one or more treatable contributors. Because improving even one of several contributing problems can make walking noticeably safer, this step-by-step approach is often very rewarding, especially in older adults whose mobility may be affected by a combination of small issues.

Treatment & Management

Treatment depends on the underlying cause and aims to improve walking and prevent falls.

• Treating the cause: Managing arthritis, Parkinson's disease, neuropathy, or other conditions can improve gait.
• Physical therapy: Exercises to build strength, flexibility, and balance, along with gait training, are central to recovery.
• Assistive devices: A cane, walker, or proper footwear can improve safety and confidence.
• Medication review: Adjusting medicines that cause dizziness or drowsiness can help.
• Home safety: Removing trip hazards such as loose rugs, adding grab bars and handrails, and improving lighting all help reduce the risk of falls.

When to See a Doctor

See a doctor for a new or worsening problem with walking, repeated falls, or new unsteadiness. Seek emergency care or call emergency services right away if walking trouble comes on suddenly with:

• Weakness or numbness on one side of the body
• Slurred speech, facial drooping, or confusion
• Sudden severe headache or loss of balance
• A fall causing a serious injury or head injury

Sudden gait changes can be a sign of a stroke and need immediate attention.

Related Topics

Frequently Asked Questions

References

1. MedlinePlus, U.S. National Library of Medicine. Walking abnormalities.
2. National Institute on Aging (NIA). Prevent Falls and Fractures.
3. Centers for Disease Control and Prevention (CDC). Older Adult Falls.
4. Merck Manual Consumer Version. Gait Disorders in Older Adults.