Antalgic gait refers to the painful condition that is the result of a patient trying to minimize or avoid transferring weight onto one leg due to leg pain. This attempted avoidance creates an unusual gait as the patient tires to put minimal weight on the leg for the shortest duration time possible during the stance phase while walking and/or running. When there is pain in the knee, ankle, leg, or foot, the patient will typically shorten their stride on the injured side, causing alteration in the posture and mobility of the usual walk cycle. Antalgic gait may develop as an immediate response to pain or injury or may develop over the long term as a result of illness, nerve damage, or injury to the musculoskeletal structure. The patient may experience symptoms that range from mild to severe, and while some cases are temporary others may be permanent, depending on the underlying cause. While antalgic gait may occur in any demographic and at any age it typically affects the elderly as well as athletes. Men also have higher rates of affliction than women do.
A familiar example of antalgic gait that develops abruptly and occurs temporarily occurs if one sits on ones foot for an extended period of time or when a limb is positioned awkwardly for a moderate amount of time. The resulting `pins and needles` sensation often results in an antalgic gait as the sufferer `walks it off`.
Antalgic gait may develop over the long term as the result of illness such as Gout, for example. This malady is a painful form of inflammation that affects the joints, and while it may develop in any part of the body it commonly strikes the joints located at the base of the big toe. Uric acid crystals may also form and accumulate over time, making an already painful condition that much more uncomfortable. Patients often describe flare-ups as experiencing the sensation that their toe is on fire, which causes antalgic gait to occur as they try to avoid placing pressure on the effected foot and leg.
The Normal Gait Cycle
A normal gait cycle is comprised of two phases: the stance phase and the swing phase. In a normal gait these two phases flow together smoothly and without interruption, even as body weight is transferred from one leg to the other. The stance phase occurs at the beginning of the cycle when the heel strike occurs, followed by midstance, and ending with the toe-off movement. The swing phase of a normal gait cycle also passes through three distinct motions; it begins with the double stance, when both feet are touching the ground, and progresses to the single limb stance (one foot on the ground), before returning to what is called the terminal double limb stance. The cycle can also be broken into the acceleration, midswing, and deceleration phase. The swing phase works together with the stance phase, beginning at toe-off and ending with the heel strike, to create the walk cycle. In order to establish what is referred to as a normal gait cycle joint movements, pelvic tilt and rotation, balance, and strength must all be able to coordinate smoothly and without impair. Any disruption or injury between the hips and the toes may cause an antalgic gait to occur.
Antalgic Gait: Symptoms
When diagnosing antalgic gait most doctors will look for the following symptoms:
• Unusual or impaired gait cycle
• Favoring one limb over the other to reduce discomfort
• Pain symptoms during normal gait cycle (patient walking without altered gait)
• Markedly short duration of the stance phase
• Uneven/unorthodox strides during the swing phase
Antalgic Gait: Causes
Numerous factors may contribute to the development of an antalgic gait. Common causes include:
• Injury or inflammation of the hip, knee, ankle, leg, or foot
• Diabetic related peripheral neuropathy or foot problems
• Illness such as gout
• Joint or limb deformity
• Stress fractures or broken bones
• Ankle Sprain
• Tumors of the foot, leg, or hip
• Leg Cramps
• Ingrown toenail
• Severe or infected calluses
• Injury to muscles and/or tendons
• Infection of one or more bones
Some of the above factors are due to disease or muscoskeletal development while others are the result of trauma. If you are showing symptoms of antalgic gait it is important to make an appointment with a podiatrist, as the underlying causes may be obscure and/or difficult to diagnosis. Any changes to your normal gait cycle due to pain should also be treated as it can lead to further problems in the future, particularly in the back and hip.
Antalgic Gait: Treatment
Treating an antalgic gait begins with a diagnosis of the underlying cause; only then can treatment be applied. Once the underlying cause has been established and treated symptoms are typically reduced or eliminated and the gait cycle returns to normal. Your doctor may prescribe several treatment methods, including the following:
• Use of a cane, walker, crutches, or any other form of ambulatory device that aids the healing process
• Pain medication to reduce swelling and discomfort
• Reduction, modification, or suspension of physical activity until healing has fully occurred.
The initial focus of most treatment plans is on pain management and restoring overall balance and mobility. Ambulatory devices and modifications to physical activity are usually the primary treatment options though surgical methods may be considered in certain cases. Should a broken bone fail to heal properly surgical treatment could be used to fuse the bone ends back together.
Surgery is also sometimes required for severe ingrown toenails or other forms of trauma or injury. Antalgic gait is in itself usually a symptom of an underlying issue that can be diagnosed by a healthcare professional, such as podiatrist, and the normal gait cycle typically returns after treatment.
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