she has right limp for 25 years. she got an injury in her right toe while skipping, she had pain in the toe for 1 month, then she got second toe injury, her right toe kicked to the wall, then made her limp to now. while she walks with heels, it is normal, but it is bad while she walks with toes, pushing the right toe, and her right foot tremors. no pain, no weakness, no numbness on the right foot. I have no idea which body’s party problem, toe？ nerve? lower back? or brain? or a mental problem? but I give acupuncture on my lower back, feeling much better after one session. keeping treatment.

Case Study | A 25-Year Limp with an Unclear Cause

This patient had been limping on the right side for approximately 25 years.

The problem began after two separate injuries to the right toes. The first occurred while skipping and caused toe pain for about one month. Later, she injured the toes again after kicking them against a wall. Since then, the abnormal gait has persisted.

An interesting feature was that she could walk relatively normally on her heels, but the limp became much more obvious when walking on the forefoot and pushing off through the right toes. During this movement, the right foot also developed a noticeable tremor.

She did not report pain, weakness or numbness in the right foot.

At the first assessment, the exact source of the problem was still unclear. Possible contributing areas included the foot itself, the peripheral nerves, the lower back or a more central neurological mechanism.

Rather than assuming that the old toe injury was still the whole explanation, I treated the lower back with acupuncture and continued to observe her gait response.

After the first session, she reported that walking felt noticeably better.

Clinical Reflection

A symptom that has lasted for 25 years should not automatically be explained by the event that happened at the beginning.

The original toe injuries may have started the problem, but persistent abnormal gait and foot tremor suggest that other neurological or biomechanical factors may also need to be considered.

The improvement after treating the lower back was clinically interesting, but one treatment response is not enough to establish the diagnosis.

Further examination and follow-up are still needed to understand where the main problem is coming from.