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 typically the result of nerve damage and can cause the foot to become deformed. This deformity could lead to ulceration, infection, and amputation. Oftentimes, Charcot foot isn’t associated with any pain, so it’s imperative that you stay on top of your foot health.

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.

Symptoms include a red appearance of the foot or ankle, swelling, increased warmth compared to the other foot, soreness, and a foot that feels warm to the touch. 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.

Early diagnosis is crucial to prevent joints from collapsing. Your board-certified podiatrist will examine your foot and ankle and ask about your symptoms. The temperature of your feet may be taken, as a higher temperature in one foot can be a sign of Charcot. X-rays can check for bone damage, and a bone biopsy may be ordered to check for infection. Contact your podiatrist right away if you notice any symptoms so treatment can begin immediately.

Treatment and Long-Term Protection

The only way to stop the progress of Charcot foot is to stay off the foot long enough for it to heal. Decreasing pressure to your feet protects the weakened bones from further damage. During this time, your doctor may have you wear a cast, boot, or brace, and you may need a knee scooter or crutches.

While fractures are healing, it is crucial that you keep your weight off your foot. This is called non-weight-bearing. 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. An elastic bandage wrap or special stocking may also be suggested to reduce swelling and aid healing.

Once your foot has healed, you may be fitted for custom shoes or inserts (orthoses). Custom footwear is made to fit the shape of your foot and can help prevent ulcers caused by rubbing from store-bought shoes. If custom footwear cannot stop ulcers, or if severe deformity or infection has developed, surgery may be needed. A board-certified surgeon will repair the damage and stabilize your foot to prevent further ulcerations.

Protect your feet by always wearing shoes and socks, even indoors. Test bath water with your elbow before stepping in, go to your doctor for nail trimming, and check your feet daily. Managing your blood sugar and attending regular follow-up visits give you the best chance of preventing recurrence.