Antalgic Gait: Causes, Symptoms, And Treatment - Healthline

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HealthlineSubscribeAntalgic Gait: Causes, Symptoms, and Treatment

Medically reviewed by Nancy Carteron, M.D., FACR — Written by Scott Frothingham — Updated on December 10, 2021

Causes
Symptoms
Diagnosis
Treatment
Takeaway

An antalgic gait is a disruption in a person’s walking pattern that’s usually caused by pain. In an antalgic gait, the phase when you stand is shorter than when you swing the other leg forward to take the next step. This causes you to walk unevenly.

Antalgic gait is most common in children and older people. In children, antalgic gait is often the result of minor injuries that are often self-healing. Gait disorder among older adults increases with age. It varies from 10 percent in people aged 60–69 years to more than 60 percent of people over 80 years old living in community settings.

How does it feel?

One way to picture an antalgic gait is to imagine you have a sharp stone in your shoe as you’re walking. Trying to avoid the pain results in an uneven gait.

If it hurts to put your weight on your foot, knee, or hip when you walk, you’ll likely avoid putting pressure on the painful area. That often results in limping.

Another common characteristic of an antalgic gait is that a person may keep their ankle fixed in one position as they lift and lower their foot.

Causes of antalgic gait

Antalgic gait is one of the most common walking issues seen in emergency rooms and other clinical settings. Pain is usually reported as the cause.

Antalgic gait may result from relatively minor things like a stubbed toe or twisted ankle. These often heal on their own and are especially common among children. But antalgic gait may also result from more serious causes like a stroke or cancer.

There are many underlying causes of antalgic gait. Causes generally fall into these major categories:

injuries
deformity
infection
inflammation
vascular disorders
neoplasms, or tumors

The most common causes of antalgic gait by category are:

Injury

sports accidents
car collisions
work accidents
stress fractures in the foot

Joint or leg deformity

partial dislocation of a joint
bone malalignment after healing from a fracture
rickets, caused by a vitamin D deficiency

Arthritis

rheumatoid arthritis
osteoarthritis
gout
psoriatic arthritis

Back issues

sciatica
discitis
spondylolysis (spinal fracture)
spondylolisthesis (stress fracture in the thin bone segment between adjacent vertebrae)

Infection

Infectious causes of antalgic gait are most often seen in children, but they also occur in adults. A combination of fever and pain when walking is a warning sign of infection. Infection-related causes of antalgic gait might include:

transient synovitis, which is an inflammation that can follow a viral infection
discitis
epidural abscess
septic arthritis

Tumor

spinal tumor, a possible but uncommon cause of antalgic gait. A tumor, also called a neoplasm, may be either benign or malignant. Though a tumor is rarely the cause of antalgic gait, a missed diagnosis of a cancerous tumor is one of the most serious complications of antalgic gait.

Vascular issues

stroke, which often leads to an antalgic gate in stroke survivors. Research shows that more than 80 percent of stroke survivors experience walking issues post-stroke.
peripheral artery disease (PAD), which research shows can lead to antalgic gait marked by a longer stance period in walking and a reduced swing phase.

Symptoms of antalgic gait

Pain is the main symptom of an antalgic gait. The type of pain may depend on whether the cause is an injury, infection, inflammation, a vascular problem, or a tumor.

The altered gait is an instinctive attempt to minimize the pain of affected muscles, bones, nerve, or joint abnormalities that are causing the pain.

There are many types of gait disorders, but the antalgic gait is distinctive. It’s marked by a shortened “stance phase” and a prolonged “swing phase” when you walk. Doctors can often recognize it simply by having you walk across a room.

Diagnosis of antalgic gait

Since there are different kinds of gait disorders, diagnosing antalgic gait initially depends on the observation of identifiable, visual markers of the condition. The doctor will likely observe you walking in order to see the characteristic gait.

Different disorders may have similar symptoms, so the doctor will also look for things about your gait that do not fit in order to eliminate similar conditions. They may also ask you to describe your pain.

From there, the diagnosis objective then switches to identifying the underlying cause of your antalgic gait. This can be challenging because there are many possible causes. Diagnosis usually starts with the medical professional taking your medical history and conducting a physical examination.

During the physical exam, they’ll be looking for tenderness, swelling, or bruising, especially in the legs or hips. They’ll also look for pain, stiffness, or curvature in the spine. They’ll look for abnormal growths or functional impairment.

Tests may be necessary to pinpoint the exact cause of your antalgic gait. These tests might include:

X-rays. These imaging tests will be essential to see the structures where your pain is. Not all structures are visible in an X-ray, but they provide a good start. The technician will probably take X-rays of both sides of your body for comparison.
MRI (magnetic resonance imaging). To look further, your medical professional may prescribe an MRI scan. It’ll help detect soft tissue injuries or bone fracture, infection, or tumor inside your body.
Computed tomography (CT) scan. This may be necessary in some cases to further assess abnormalities in the bone.
Ultrasound. An ultrasound test uses high-frequency sound waves to create images within your body. In the case of antalgic gait, it’s often used to detect fluid in a joint that may be causing your pain.
Laboratory tests. Lab tests, like blood or urine samples, may be taken to help diagnose viral or bacterial infections. In children, lab tests may help identify juvenile rheumatoid arthritis.

Treatments for antalgic gait

The treatment of antalgic gait starts with identifying the underlying cause and the treatment of the underlying pain.

Once the cause has been pinpointed, your doctor may prescribe specific treatment for that condition, which often includes:

medications
mobility devices
physical therapy or an exercise program
surgery

Read on to learn about specific treatments often recommended for antalgic gaits resulting from various causes.

Arthritis

Depending on the type of arthritis you have, your doctor may prescribe or recommend:

nonsteroidal anti-inflammatory drugs (NSAIDS)
disease-modifying antirheumatic drugs
Janus kinase inhibitors
corticosteroids

Leg or joint deformity

Joint dislocation. Your doctor will move your joint into place and then immobilize it while the injury heals. They may also prescribe pain medication. In some cases, surgery may be necessary.
Bone malalignment. Your doctor might perform an osteotomy. This involves cutting or rebreaking the bone, realigning it, and repairing it with a rod down the middle or with a plate and screws.
Rickets. The doctor will recommend increasing intake of calcium and vitamin D. But this condition, which primarily affects children, is rare in the United States.

Back issues

Sciatica. Although most cases resolve themselves without treatment in about 6 weeks, your doctor might prescribe anti-inflammatory pain medication. They might also recommend hot or cold packs and a directed exercise program.
Vertebral osteomyelitis. Your doctor will typically treat this condition with 6 weeks of intravenous antibiotics. Surgery to remove the infection is required in about half of these cases.
Discitis. Along with pain control, your doctor might prescribe a 4-6 week course of antibiotics if you have bacterial infection. Your doctor might consider surgery as well.

While the cause of your pain is being determined and addressed, your doctor may prescribe treatment to normalize your gait as much as possible, including:

Cane, crutches, or a walker. Especially in cases of trauma, these devices help take the weight off the painful area to help the healing process.
Rest. If your gait is caused by a sprain or muscle issue, rest — often combined with the application of heat or cold — can help the healing process.
Physical therapy. Physical therapy can help you improve muscle tone, coordination, and joint mobility.
Exercise. Low-impact exercise like swimming and biking are often recommended for strength, endurance, and balance training that can affect your gait.

Takeaway

Antalgic gait can be caused by minor injuries, but also by serious conditions like arthritis or vascular disease. In most cases, these conditions can improve with treatment.

As you age, gait disorders can cause falls and injuries, which may affect your quality of life. See your doctor and get a full diagnosis. Once the cause of your pain has been addressed, your gait may return to normal.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Auerbach N. et al. (2021). Antalgic gait in adults.https://www.ncbi.nlm.nih.gov/books/NBK559243/
Bullock, J. et al. (2019). Rheumatoid arthritis: a brief overview of the treatment.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422329/
Graeber, A. et al. (2021). Vertebral osteomyelitis.https://www.ncbi.nlm.nih.gov/books/NBK532256/
Davis, D. et al. (2021). Sciatica.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422329/
Li S, et al. (2018) Post-stroke hemiplegic gait: New perspective and insights.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6088193/
Muskara, JD, et al. (2021). Diskitis.https://www.ncbi.nlm.nih.gov/books/NBK541047/
Nonnekes, J. et al. (2020). Functional gait disorders. A sign-based approach.https://n.neurology.org/content/94/24/1093
Osteotomy. (n.d.).https://cartilage.org/patient/about-cartilage/cartilage-repair/osteotomy/
Pirker W, et al. (2016). Gait disorders in adults and the elderly: A clinical guide.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5318488/
Rickets. (n.d.).https://rarediseases.info.nih.gov/diseases/5700/rickets
Smith, T. et al. (2021). Foot dislocation.https://www.ncbi.nlm.nih.gov/books/NBK554613/
Szymczak M, et al. (2018). Gait pattern in patients with peripheral artery disease.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819174/

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Medically reviewed by Nancy Carteron, M.D., FACR — Written by Scott Frothingham — Updated on December 10, 2021

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How does it feel?

Causes of antalgic gait

Injury

Joint or leg deformity

Arthritis

Back issues

Infection

Tumor

Vascular issues

Symptoms of antalgic gait

Diagnosis of antalgic gait

Treatments for antalgic gait

Arthritis

Leg or joint deformity

Back issues

Takeaway

How we reviewed this article:

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