What Is Charcot Foot?  

Charcot foot is a condition causing weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking, the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, creating a rocker-bottom foot shape.

Charcot foot is a serious condition that can lead to severe deformity, disability, and even amputation. Because of its seriousness, it is important that patients living with diabetes—a disease often associated with neuropathy—take preventive measures and seek immediate care if signs or symptoms appear.

Causes

Charcot foot develops as a result of neuropathy, which decreases sensation and the ability to feel temperature, pain, or trauma. Because of diminished sensation, the patient may continue to walk, which makes the injury worse. People with neuropathy are at risk for developing Charcot foot. In addition, neuropathic patients with a tight Achilles tendon have been shown to have a tendency to develop Charcot foot due to increased forces upon the ball of the foot.

Symptoms

The symptoms of Charcot foot may include:

• Warmth to the touch (the affected foot feels warmer than the other)
• Redness in the foot (foot looks infected)
• Swelling
• Pain or soreness 

Diagnosis

Early diagnosis of Charcot foot is extremely important for successful treatment. To arrive at a diagnosis, the doctor will examine the foot and ankle and ask about events that may have occurred prior to the symptoms. X-rays and other imaging studies such as MRI are performed.  Blood tests may be ordered as well. Once treatment begins, x-rays are taken periodically to aid in evaluation of the status of the condition.

Nonsurgical Treatment

• Immobilization. Because the foot and ankle are so fragile during the early stage of Charcot, they must be protected so the weakened bones can regain integrity. Complete non-weightbearing is necessary to keep the foot from further collapse. The patient will not be able to walk on the affected foot until the doctor determines it is safe to do so. During this period, the patient may be fitted with a cast, removable boot or brace, and may be required to use crutches, knee scooter, or a wheelchair. It may take the bones several months ore longer to heal.
• Custom shoes and bracing. Shoes with extra depth and special inserts may be needed after the bones have healed to enable the patient to return to daily activities.  These custom shoes and inserts also help prevent recurrence of Charcot foot, development of foot ulcers, and possibly amputation. In cases with significant deformity, special bracing is also required.
• Activity modification. A modification in activity level may be needed to avoid repetitive trauma to both feet. A patient with Charcot in one foot is more likely to develop it in the other foot, so measures must be taken to protect both sides. 

Surgery 

In some cases, the Charcot deformity may become severe enough that it requires surgery. The doctor will determine the proper timing and appropriate procedure for each individual case.

Preventive Care

The well-informed patient can play a vital role in preventing Charcot foot and its complications by following these measures:

• Keeping blood sugar levels under control can help reduce the progression of nerve damage in the feet.
• Get regular checkups from a foot and ankle specialist.
• Check both feet every day—and see a doctor immediately if you notice signs of Charcot foot.
• Be careful to avoid injury of the foot and ankle – for example: hitting the foot, sprains, overuse from exercise.
• Follow the doctor’s instructions for long-term treatment to prevent recurrences, ulcers, and amputation.

If you are suffering from symptoms similar to Charcot Foot, do not hesitate to call us (949) 833-3406 or request an appointment online.  Our doctors are well-versed in this condition and can develop an effective treatment course to get you back in action as soon as possible.