Charcot Foot Care for Diabetic Patients

What You Need To Know

Understanding Charcot foot, its warning signs, and why early care matters.

Understanding Charcot Foot

Charcot foot is a rare but serious complication that impacts the bones, joints, and soft tissue in your foot or ankle. It is a pattern of bone and joint damage that can lead to foot deformity. This deformity could lead to ulceration, infection, and amputation. Those with diabetes mellitus are particularly prone to the condition.

Charcot foot begins with peripheral neuropathy, a disease of the nerves in the feet. Because your nerves do not function well, you may not sense pain when you injure your foot. You may break bones or damage joints without knowing it. If you keep walking on your injured foot, fractures can heal unevenly, causing foot deformity. When the midfoot is impacted, the arch collapses and the bottom of the foot rounds, called a rocker-bottom foot deformity.

Symptoms of Charcot foot include a red appearance of the foot or ankle, swelling, increased warmth compared to the other foot, soreness, and skin that feels warm to the touch. Oftentimes, Charcot foot isn’t associated with any pain, so it’s imperative that you stay on top of your foot health and check your feet daily for changes.

Diabetics are most at risk, especially those who have had diabetes for several years. Other risk factors include smoking, regular alcohol use, high blood pressure, high cholesterol, kidney disease, and being overweight. Contact your board-certified podiatrist immediately if you notice any symptoms, as early diagnosis is crucial to prevent joints from collapsing and to protect your ability to walk.

Treatment and Prevention of Charcot Foot

Early diagnosis and treatment can prevent or lessen potential damage and the need for limb salvage. By catching Charcot early and staying off your feet during healing, you may be able to halt its progress. Treatment may be nonsurgical or surgical, depending on the severity of the condition.

Decreasing pressure to your feet is one of the most important ways to heal Charcot foot. Your doctor may have you wear a cast, boot, or brace, and you may need a knee scooter or crutches. Remember, you often don’t feel pain with Charcot foot, so even if you feel fine, stay off your foot until your doctor says it’s OK. Once your foot has healed, you may be fitted for custom shoes or orthotic inserts to help prevent ulcers caused by rubbing from store-bought shoes.

If Charcot foot has caused a severe deformity or if an infection has spread, surgery may be necessary. A board-certified surgeon will repair the damage and stabilize your foot. The goal of surgery is to provide a stable foot that will not develop further ulcerations. In high-risk cases, limb salvage surgery may be considered to prevent amputation.

To help prevent Charcot foot, manage your blood sugar levels to slow nerve damage, wear shoes and socks even when indoors, get fit for custom orthotics, and stop any activity causing foot or ankle pain. Check the top and bottom of your feet, your heels, and between your toes daily. If you have neuropathy or diabetes, see your podiatrist at least once per year to catch problems before they progress.