Drop Foot and Fibromyalgia: Exploring the Connection

Drop foot (inability to dorsiflex the foot) results from weakness/paralysis of the tibialis anterior (L4‑L5, deep peroneal nerve). Fibromyalgia is a central sensitization syndrome causing widespread pain, fatigue, and cognitive symptoms.

Direct Causation? No evidence that fibromyalgia directly causes drop foot. However, indirect links exist:

• Muscle Weakness/Deconditioning: Chronic pain and inactivity lead to disuse atrophy.
• Comorbid Neuropathy: Fibromyalgia patients may have concurrent small‑fiber neuropathy or lumbar radiculopathy.
• Medication Side Effects: Certain drugs (e.g., statins, chemotherapy) can cause myopathy/neuropathy.

If a fibromyalgia patient develops drop foot, thorough neurologic workup (EMG/NCS, MRI spine) is essential to identify treatable causes (radiculopathy, peroneal neuropathy, ALS, MS). Treatment targets the underlying etiology: physical therapy, ankle‑foot orthosis (AFO), nerve decompression, or disease‑modifying therapy.