Diabetes and Charcot Foot

By Gary N. Friedlander DPM, FACFAS and Jay C. Larson DPM
December 31, 2015
Category: Diabetic Foot Care

Tis the season for being on our feet. When your feet hurt, it throws your whole day off. What if your feet don’t hurt or feel anything at all? Does that mean they are healthy? Not necessarily. Neuropathy, or nerve damage in your feet can cause some serious damage that may lead to infection, surgery and potentially an amputation. Charcot foot or medically known as Charcot neuroarthropathy is becoming increasingly popular due to neuropathy associated with diabetes mellitus. This subtle nerve damage can causes serious damage in a foot without causing any pain at all.

Charcot’s foot occurs due to a deformity of bones in the foot. Because of the decreased pain sensation with neuropathy, you may not be able to feel when there is a fracture or repetitive damage of the foot and continue to walk on it. This micro trauma leads to remodeling of the bones in the foot. The remodeling of the foot causes bones to become prominent and more prone to ulceration, most commonly found in the mid foot of Charcot foot patients. These ulcerations increase the potential to not only infect the skin and soft tissue but the bones of the foot as well. Without proper treatment the foot may ultimately have to be amputated.

Symptoms of Charcot foot

  • Redness and swelling

  • The foot is warm to touch

  • Pain associated with the deformity

  • Midfoot appears to be collapsed

Treatment options include surgical and non-surgical. Depending on the stage of the Charcot whether it is acute or chronic, will determine the treatment. Diagnostic imaging such as x ray and MRI may be used by the clinician. Immobilizing the foot is the preferred treatment for acute Charcot. It is important to get the foot to calm down before any major correctional surgery can be done. A walking boot maybe prescribed by your podiatrists to immobilize and offload the foot to calm down the acute Charcot. In chronic Charcot, correctional surgery may be indicated to correct the foot deformity providing the patient with a foot structure less prone to ulceration and correctly fit in a shoe. Custom shoes may be needed to fit the foot in order to help prevent the formation of ulcers. There are plenty of complications associated with Charcot, but the best way to treat Charcot’s foot is prevention. Ensuring good glycemic control, daily foot checkups, and avoiding injury are all excellent ways to prevent Charcot foot from affecting your life.

It is important to remember that the absence of pain does not always imply healthy feet. If you notice a red, hot, swollen foot or any changes in your foot health, please consider making an appointment with Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona.

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