Overview

Your stride can unveil not only your personality, but also your physical and mental health. On seeing a limping man, can you guess what made him limp? An unusual walk will leave a plethora of stories to tell. Our topic of discussion is also about one such kind of walking- the antalgic gait.

We must first grasp what an antalgic gait is to further comprehend it. An antalgic gait is a limp caused by our body’s response to pain while we move around. Many patients in hospitals and clinics exhibit this type of limping if they’re in pain. Before delving into the causes and symptoms of antalgic gait, it is important to understand that there are different types of non-antalgic gait abnormalities too.

Types of Gait Abnormalities

What is a non-antalgic gait? The gait abnormality caused by reasons other than pain is a non-antalgic gait. There are many other reasons for gait abnormalities. Let’s see the different types of gait disturbances in short.

  • Propulsive gait (Parkinsonian): A forward bending posture similar to that seen in Parkinson’s disease patients. To avoid falling, people with this gait may need to use walkers or canes. While walking, they will take smaller steps.
  • Scissors gait (Diplegic): Children with cerebral palsy will walk with this scissoring gait, in which their knees cross each other.
  • Spastic gait (hemiplegic): People with muscle sclerosis will drag their stiff leg in a semi-circular motion to make each step.
  • Waddling gait (myopathic): Waddling or myopathic gait is seen in people with hip and thigh muscle weakness. Their body will swing from side to side, causing their hips to drop with each step.
  • Steppage gait (Neuropathic): Some people find it difficult to lift their foot while walking due to a loss of dorsiflexion at the ankle. Each step requires them to drag and drop their foot. They stamp their foot with each step.
  • Ataxic (Cerebellar): People with ataxic gaits have difficulty walking in a straight line. They will walk with a shaky balance and incoherent arm movements as if they were drunk.
  • Choreiform (Hyperkinetic Gait): Choreiform gait refers to walking with hyperkinetic jerking movements. Involuntary movements are common in people with neurological disorders (dyskinesias).
  • Sensory gait: People with sensory gait will raise their legs to a higher position as if climbing a step. They walk easily during the day when they can see their legs. They will, however, lift their leg high in the dark or with their eyes closed.
  • Trendelenburg gait: It is also known as Gluteus medius lurch. As the name implies, the gluteus medius and gluteus minimus muscles in the buttocks are involved in this gait. With each step, the sides of the hip will droop on the opposite side due to a weakness in these muscles.

In contrast to the other gaits, antalgic gait is caused by pain in the lower extremities or lower back. People will adjust their posture and movements to adapt to the pain while walking.

What Causes an Antalgic Gait?

Antalgic gait can be traumatic or non-traumatic. The trauma-induced gait abnormality can be the result of lower extremity injuries that happened in

The non-traumatic antalgic gait can be the result of the following.

Causes-of-antalgic-gait

  • Osteoarthritis and rheumatoid arthritis
  • Infections
  • Inflammations and Blisters
  • Cramps and Sprains
  • Deformities in joints or legs
  • Overuse or stress fracture/injury
  • Neoplasms or tumor
  • Sciatica
  • Spinal Osteomyelitis and Discitis
  • Pelvic girdle pain

Symptoms of Antalgic Gait

The leg’s weight distribution, pace, movements, stance, and swing will all be equal and smooth in a normal gait. As a result, observing a person walk can give us a hint that he or she has an abnormal gait.

The individual’s steps will be altered to avoid aggravating the knee, foot, or hip pain. People who are in pain in their feet may apply pressure to the heel, toes, or to the side. Because of the knee pain, they will shift more weight and pressure to the unaffected knee in order to relieve pressure on the painful side. While watching the hip move, pain in the lower spine, hip, or buttock can be identified.

Following are the symptoms of people with antalgic or painful gaits.

  • Short steps
  • Uneven steps during the leg swing
  • Atypical or altered gait
  • Walking with difficulty to ease the pain
  • Unusual swaying during the stride
  • Change in the position of the legs with each step

Diagnosis of Antalgic Gait

As previously stated, antalgic gait is not a disease but a physical condition caused by various diseases and injuries in the lower extremities. As a result, the primary goal of the diagnosis is to determine the root cause of the limp. The physical examination is the first and most important diagnostic tool. The physician will collect the patient’s pain symptoms and palpate the area of pain to determine the source of the limping. Swelling, tenderness, numbness, tingling, bruising, pain, stiffness- any of these symptoms can point to the source of the discomfort.

Once the source of the pain or discomfort has been determined, an X-ray of the suspected area of pain will be taken. This can detect fractures or other abnormalities in the skeletal system. CT or MRI scans will be performed for a more comprehensive evaluation. Bone scans can detect infections, inflammations, and tumors. Ultrasound scans and laboratory tests will also provide a clear picture of the source of pain.

Antalgic Gait in Children

Adults will provide a detailed medical history as well as symptoms of pain or discomfort. However, as the younger children are unable to express their discomfort clearly, their limping should be taken seriously. The limping could be caused by pain from an injury or a muscular deformity. Imaging studies of the hip, leg, ankle and foot would be required to understand antalgic gait in children.

Because toddlers and infants can fall from their cribs or while walking often, parents may fail to take the fall seriously. However, if you notice them limping, do not ignore it. Childhood arthritis, Transient Synovitis, and Osteomyelitis to the femur, tibia/fibula, or humerus can all affect even neonates. Antalgic gait in children can also be caused by Legg-Calve-Perthes disease, Slipped Capital Femoral Epiphysis (SCFE), Juvenile Idiopathic Arthritis (JIA), Lyme disease, or tumors such as Osteochondromas, Osteoid Osteoma, or Leukemia. As a result, thorough testing would be required for a complete diagnosis.

Antalgic Gait Management

Most causes of antalgic gait improve in a few days, and the individual will soon resume normal gait. Only in extreme cases, the underlying causes will necessitate treatment. Treatment for antalgic gait will be determined based on the type of root cause. Some cases will be resolved in 1 to 2 months.

The non-invasive treatment options include

  • Heat or cold therapy
  • Physical therapy
  • Weight loss therapies
  • Pain medications and antibiotics to reduce inflammation, infection, and pain
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Use of cane, crutches, or walker
  • Braces and casts to the leg or hip

In cases of bone fractures, such as a broken fibula or an ankle fracture, casts or invasive surgeries are used to fuse the broken bone. It may take more than six months to regain the normal gait in such cases. Chronic illnesses, such as tumors, would necessitate extensive treatment, surgeries, and therapies. Antalgic gait can result in falls in children and the elderly.

Long-Term Effects of Antalgic Gait

In the elderly with osteoarthritis in the knee, we can find abnormalities in the knee and the hip and ankle joints. They would change their stride to alleviate the pain in their knee joints. This would limit the range of motion and cause pathology in the hips and ankles. Because arthritis in old age cannot be completely cured, most people will have this altered gait for the rest of their lives.

We need to understand how applying pressure to the normal leg/hip/ankle to relieve pain in the other leg causes problems in the normal leg/hip/ankle. When the normal leg is forced to bear more weight than usual, it may experience wear and tear, resulting in the same or related symptoms in the normal leg. Depending on the location of the stress, it may include pathology in the hip, leg, or ankle.

If the pain persists for an extended period of time, people will become accustomed to the antalgic gait, which may become their default gait, resulting in a slew of new symptoms and pathology on the other normal parts of the lower extremities. The affected part also will lose its muscle strength and further deteriorating the condition.

How Can We Fix Antalgic Gait through exercises?

Antalgic gait exercises would help to regain balance and prevent falls. Exercises to regain muscle strength will aid in the maintenance of stability. More focus on the heel or toe raise exercises will ensure the range of motion in the ankle and help reduce pain. Simple exercises such as raising the knee to the chest while lying down, standing one leg while holding something stable, walking on the treadmill at a slow pace, or attempting to walk on objects will also help improve hip and knee stability. After consulting with your doctor, you can perform these exercises at home.

Final Thoughts

Antalgic gait is the most common type of altered gait seen in people suffering from lower extremity pain. Though the majority of the causes of antalgic gait will go away without causing us too much trouble, some should be taken seriously. Because antalgic gait can alter the normal pathology of an otherwise healthy body part, we must exercise caution to avoid further harm.

Using appropriate ambulatory devices such as canes, crutches, and walkers can help the patients suffering from antalgic gait to manage the pain and discomfort while walking. It would also reduce risk of falls which is very common in individuals having antalgic gait. It is advisable to seek the guidance of a physical therapist to learn how to use such devices correctly.

“Prevention is better than cure.” We must remember to keep ourselves away from destroying our health through negligence. Never ignore your antalgic gait, or you will get into trouble.