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Family Foot & Ankle

Charcot Foot

If you have diabetes, you’ve probably heard over and over that taking care good care of your feet is mandatory. Given that the disease affects both sensation (by damaging nerves) and circulation, you’re much more susceptible to injury and infection—and with damaged nerves, you may not feel anything is wrong until it’s too late.

One of the worst possible consequences of diabetes is Charcot foot. This condition can cause significant damage and deformity to the bones and soft tissues of the foot in those with severe neuropathy. Failure to seek treatment early enough may necessitate complicated (and potentially risky) surgical procedures, or even amputation.

How and Why Charcot Foot DevelopsRecovery from Charcot Foot

Usually a number of key factors must be present for Charcot foot to develop:

  • An initial bone injury … This doesn’t have to mean something so dramatic, like an injury from an auto accident or bad fall. It could simply be that bones, weakened from poor circulation, crack and break due to ordinary stressing of walking and working.
  • … that goes undetected due to severe neuropathy … When nerve damage is severe, you can’t rely on a pain response to alert you when something’s wrong—even broken bones. Most cases of Charcot foot are painless for this very reason.
  • … and is further damaged by continued walking and stress. When bones in the foot are broken, continuing to put weight on them as if nothing is wrong can cause disastrous damage, both to the bones and the surrounding tissues. In time, many fractures can develop, bones and joints literally disintegrate, the foot becomes severely disfigured or misshapen, and sores and wounds (or other problems) develop and become chronic.

Your Early Detection Guide: Symptoms of Charcot Foot

To successfully treat Charcot foot without surgery (or with a less invasive or complicated one), early detection is absolutely critical. If you have diabetes, especially with significant nerve damage in the legs, always be on the lookout for:

  • Swelling of the foot. This is usually the first symptom, and may be present even without an obvious initial injury.
  • Skin that is reddened or warm to the touch.

Pain may also be present, but again, a lack of pain doesn’t necessarily mean a lack of a problem. Your nerves may simply be too damaged to send those signals to your brain.

Medical Treatment for Charcot Foot

Immobilization is the first step. Your foot will be protected in a cast or boot, and you will be permitted absolutely no weight bearing for a period of time necessary to allow weakened bones to heal.

After the bones have healed, we will likely set you up with custom shoes, orthotics, and/or bracing to provide the extra support and cushioning you will need to decrease your risk of future damage. You may also need to consider some modifications to your daily activities or lifestyle in order to avoid repetitive damage or trauma to your feet, and make sure you are always checking your feet regularly for issues or complications.

A severely disfigured foot will generally require surgery. The appropriate procedure may vary significantly depending on the location, severity of damage, and relative stability of the affected bones and joints. Each procedure comes with its own set of outcomes and risks. Your surgeon will inform you of your options, and what you can expect, based on the physical examination and a discussion of your personal goals.

The Best Treatment Is Prevention

By being disciplined about maintaining healthy blood sugar levels, personally inspecting your feet at least once per day, scheduling regular diabetic foot checkups, and seeking help at the first sign of trouble, you can significantly mitigate the potential damage of Charcot foot or even avoid it entirely.

To schedule a diabetic checkup, or if you have any concerns about the health of your feet, we urge you to call Family Foot and Ankle Center or contact us through our website. Being proactive won’t just lead to better outcomes—it could save your foot, or even your life. To schedule an appointment at one of our six Greater Cincinnati locations, please dial 888-689-3317.

Dr. Cynthia Miller
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Dr. Cynthia Miller is a board certified podiatrist who has been established in the Cincinnati area since 2004.