Charcot foot, also known as diabetic neuroarthropathy or Charcot joint disease, is one of the most devastating and life-changing potential complications for those with severe diabetic neuropathy.
After years of high blood sugar-related damage, the bones of the feet may become brittle enough to crack and fracture—and your senses have dulled to the point where you don’t even feel the pain.
Over time, the fractures compound and the foot itself changes shape and can become severely deformed. This can affect your ability to stand and walk normally and can lead to severe ulcerations (and ultimately an amputation) of your foot.
What Are the Symptoms of Charcot Foot?
It’s important to remember that pain is usually not a symptom of Charcot foot. At this point, peripheral neuropathy has damaged sensation in the feet and ankles so severely that you can’t even feel a broken bone.
In the earliest stages, the most common signs of Charcot foot include:
- Unexplained swelling in the feet
- Redness on the top of the foot
- Skin is warm to the touch
Because these symptoms are relatively common and can be associated with many different conditions, Charcot foot is often disregarded or misdiagnosed.
If you have severe neuropathy and notice these symptoms, please make sure you insist on a full checkup for Charcot foot, which often requires an X-ray to confirm. Failure to identify and manage in the earliest stages can have devastating consequences as your feet slowly become deformed.
What Causes Charcot Foot?
Most cases of Charcot foot emerge as a result of two essential underlying factors:
- Severe peripheral neuropathy. Significant damage to sensory nerves in the feet leave you unable to feel pain, temperature, trauma or other sensations. By far the most common cause of peripheral neuropathy today is diabetes.
- A preceding foot injury. Usually there is a singular foot injury that first causes one or more bones in the feet to crack or fracture. As you continue to walk on that foot, the injury becomes more severe, and more bones and joints begin to crack or crumble.
Remember that, because of the severe neuropathy, you might not even notice if or when this initial injury occurs. This is a major reason that it is critical to examine your feet every day if you have diabetes or neuropathy.
Treating Charcot Foot
Once the deformity becomes severe, it can create pressure spots that interfere with walking and trigger recurring wounds. At this stage, amputation may be the only possible recourse. Therefore, it is extremely important to identify and address Charcot foot early, before significant deformities have occurred.
Conservative treatment protocols may include:
- A period of total non-weight bearing and immobilization (casting) to allow the injured bones to heal. The duration of this period varies depending on the severity of the condition. If subsequent X-rays show improvement, weight bearing may be gradually increased until healing is complete.
- Customized shoes, orthotics, and/or bracing after the primary injury has healed. These will give proper support to the feet and ankles and cushion pressure spots. They are critically important if you want to prevent a recurrence of Charcot foot.
- Activity modifications to reduce the risk of further damage.
If the Charcot deformity is severe enough, it may be necessary to perform a reconstructive surgery. If successful, reconstructive surgery can restore alignment of the feet and joints, preserve the foot and prevent amputation. However, there are always risks, which is why it’s so important to counteract Charcot foot before it reaches this stage.
If you have diabetes or severe neuropathy, whether or not you’ve had Charcot foot in the past, following these steps can help save your foot—or even your life.
- Manage your blood sugar levels carefully
- Examine both feet carefully every day for injuries
- Always wear good shoes that protect your feet, even at home
- Schedule regular diabetic foot care checkups with your podiatrist—at least once a year for most individuals, although your doctor may recommend more frequent appointments in some cases.
To schedule an appointment with Dr. Bruce Scudday—an expert in Charcot foot treatment and diabetic foot care management—please call the office closest to you today:
- Curie Drive: (915) 533-5151
- George Dieter Drive: (915) 856-3331