Charcot foot is a crippling condition of the foot bones related to diabetes and poor blood flow to the extremities. The condition is caused by a lack of feeling in the foot, often related to neuropathy. When neuropathy is present, the bones of the foot become weakened and can fracture easily. Due to the lack of feeling that neuropathy causes, the patient continues to walk on the foot, causing complications that can lead to deformities.
The symptoms of Charcot foot initially include redness, swelling, warmth in the affected area of the foot, pain, soreness, insensitivity, a strong pulse in the foot and misalignment of the joints, also called subluxation. According to FamilyDoctor.org, the warning signs of nerve damage, which leads to Charcot foot, are numbness, tingling, sharp pain, muscle weakness and difficulty walking. Additional symptoms of calluses and diabetic foot ulcers may occur as a result of bone protrusions due to the deformity that develops.
If the symptoms go undetected and untreated, the muscles become unable to support the foot properly, causing minor trauma such as sprains and fractures. As the condition worsens, the joints become dislocated and collapse, causing deformity. It is important to regularly check your feet and discuss any symptoms with your doctor, especially if you have diabetes.
Early detection of the condition is imperative to avoid a deformity, disability or possible amputation. Charcot foot can be diagnosed by looking at the patient’s medical history (especially diabetes), discussing symptoms and conducting tests such as xrays and MRIs. The imaging test allows the doctor to detect problems such as fractures, joint subluxation and osteophytes. Additional laboratory tests can be conducted to draw fluid to detect bone and cartilage fragments and blood, which can be present in some cases. Once treatment has begun, xrays will continue to be taken to evaluate the status of the condition.
Patients with Charcot foot have many options for treatment, depending upon how progressed the condition is. Non-surgical treatments consist of:
- Immobilization of the foot and ankle to protect the weakened bones so they can repair themselves.
- Custom shoes and braces to be used after the bones have healed. Custom shoes and inserts help prevent the recurrence of the condition and development of ulcers. Braces are used in cases of severe deformity.
- Activity modification may be needed to avoid continued trauma to the feet.
In severe cases of deformity, surgery may be necessary to reshape the foot and remove bony protrusions. Doctors determine what option is best based on the severity of the deformity.
Patients can play a vital role in preventing Charcot foot. A few preventative measures are:
- Maintaining blood sugar levels to reduce the progression of nerve damage.
- Visiting a foot and ankle specialist regularly for check-ups.
- Checking both feet daily for symptoms. Have someone assist you if you are unable to thoroughly examine your feet.
- Trying to avoid injury, such as bumping the foot or while doing extensive exercise programs.
- Following doctor’s instructions for long-term treatment to prevent recurrences, ulcers and amputation.
- Wearing good, supportive shoes.
- Wearing seam-free socks that won’t irritate diabetic feet.
Charcot foot is a serious condition that if left untreated, could lead to severe deformities of the feet and possible amputation. If you are experiencing any of the symptoms or feel you may be at risk for Charcot foot, please contact Orthopaedic Associates of Michigan at 616-459-7101.
Sources: ePodiatry.com, FootSmart.com, FamilyDoctor.org, Foot Health Facts – Charcot Foot
