Charcot Foot

What is a Charcot foot?

A Charcot foot is a foot problem that can happen when you have diabetes. The foot may get quite deformed. The problem can be very disabling. It may make it hard or impossible for you to walk. It may lead to severe complications, including foot sores and loss of the foot by amputation. Early treatment can help keep the problem from getting severe.

How does it occur?

Charcot foot can happen when you have nerve damage from diabetes (neuropathy). The nerve damage causes a loss of feeling in the foot. You may no longer feel pain, temperature, discomfort, or the position of your foot. It’s easier for the foot to get hurt when you have no feeling in the foot. Because of the loss of feeling, it can be hard for you to know when you are standing or walking abnormally. The muscles and bones in the foot get weak when you don’t use your foot properly. After a while the bones soften and collapse and the foot gets misshapen. You could break a bone in your foot and keep walking on it because you don’t know your foot has been hurt. This damages the foot more and keeps it from healing.

What are the symptoms?

The first symptoms may include:

• redness
• swelling
• warmth in the areas that are red or swollen

If you still have some feeling in your foot, your foot may feel sore.

Over time the foot gets misshapen. It may get bad enough that you cannot wear any kind of shoe or even walk on your foot.

How is it diagnosed?

Charcot foot can be diagnosed early with X-rays or other scans. As it gets worse, it may be diagnosed just from a physical exam.

How is it treated?

The goals of treatment are to prevent fractures, foot and leg sores, and amputation. To protect your foot, you may need to:

• Avoid putting any weight on the foot. You may have a cast or brace on the foot and need to avoid walking on the foot. It may take many months for the bones to heal.
• Wear custom shoes. Shoes specially designed for the problem give support to the weakened bones and help prevent further injury.
• Be less active to keep from hurting the foot more when you walk or do other weight-bearing activities. Your healthcare provider will help you plan an exercise program that protects your foot.

Severe cases may require surgery and sometimes amputation. You may need to have your foot removed (amputated) if:

• You have sores on your foot that are not healing and could cause a life-threatening infection.
• Your foot is so badly deformed that you cannot walk on it. If your foot or lower leg is removed and replaced with an artificial foot or leg (prosthesis), you may be able to walk again.

How long will the effects last?

The nerve damage and loss of feeling will not heal or go away. With treatment you may be able to prevent further damage and stay as mobile as is safely possible.

How can I take care of myself?

• Follow your healthcare provider’s recommendations.
• Keep all follow-up appointments.
• Tell your provider about any new symptoms or concerns right away.

How can I help prevent Charcot foot?

Prevention of nerve damage (neuropathy) is key to preventing Charcot foot. The best way to prevent diabetic nerve damage is to control your diabetes. Try to keep your blood sugar at a normal level.

Also:

• Check both of your feet carefully every day. Tell your healthcare provider right away about any redness, sores, or pain.
• Keep your appointments with all of your healthcare providers.
• See a foot specialist (podiatrist) if your provider recommends it.
• Always wear shoes, even in the house. Make sure that the shoes fit your feet well.
• Be careful to avoid injury. Don’t exercise more than your provider recommends, and don’t wear new shoes too long the first few times.