Charcot foot, also called Charcot arthropathy, is a disease that attacks the bones, joints, and soft tissue in your feet. When it starts, you may not realize something’s wrong. But eventually, it can cause painful sores or change the shape of your foot. But if you know what to look for, your doctor can diagnose and treat the problem before it causes much damage.
What Causes Charcot Foot?
Charcot foot affects people who can’t feel anything in their feet and ankles because of nerve damage. That’s a common problem for people with diabetes. But other things can cause nerve damage, too, including:
There’s no specific cause for Charcot foot. But some things can trigger it:
- A sprain or broken bone that doesn’t get treatment quickly
- A sore on your foot that doesn’t heal
- An infection
- Foot surgery that heals slowly
As these problems begin, you may not know that your foot is hurt since nerve damage keeps you from feeling pain. So the injury or sore gets worse as you walk on it. Then the bones in the foot begin to lose the calcium that makes them strong.
Complications of Charcot Foot
As your bones get weaker, they can break and move out of place. When that happens:
- Your foot may lose its shape. The arch in the middle of your foot may drop until the bones are lower than your heel or toes. Doctors sometimes call this “rocker bottom.”
- Your toes may curl.
- Your ankle might become twisted and unsteady.
- Bones may press against your shoes. This can cause open sores on your skin that can get infected. Poor blood flow, which is a common side effect of diabetes, may make it hard for infections to heal. If that goes on too long, you may need to have your foot removed.
Watch for the First Signs
When Charcot foot begins, your foot will be:
- Feel warm to the touch
It can be hard to know for sure that you have Charcot foot, especially early on. X-rays and lab tests may be normal. Plus, other foot problems can have the same symptoms. If your doctor isn’t a foot specialist (they are called podiatrists) or doesn’t treat diabetes often, they may not know much about Charcot foot. If you’re having foot problems, try to find a doctor who can give you the correct diagnosis.
It can take several months to treat Charcot foot. The key is to ease the stress on your injured foot.
Stay off your foot. Your doctor will put your foot in a cast. This protects it and keeps it from moving. Over the next 2 or 3 months, your doctor will probably change the cast several times as the swelling goes down. You’ll use crutches, a wheelchair, or a knee walker to get around. (A knee walker looks kind of like a mini-bicycle with four wheels. You bend your leg at the knee, then put your knee in the “seat.”)
Prevent new problems. After your doctor takes off the last cast, you’ll wear prescription shoes that fit your feet properly. They’ll relieve the pressure points that can cause injuries or sores. You might need to use a brace, as well. And your doctor may tell you to change some of your day-to-day habits so there’s less wear and tear on your foot.
Repair bones with surgery. Your doctor will only go this route if your injuries make your foot unstable or you can’t wear special shoes or braces. A bad sore also could lead to surgery. During the operation, the surgeon might realign or fuse bones to make your foot more stable. She might also smooth sharp bones that could cut into your skin and cause sores.
Focus on Your Feet
Whether you’ve had Charcot foot or want to prevent it, make sure you care for your feet.
- Get regular checkups with a doctor who treats feet or diabetic foot problems.
- Check your feet carefully every day. Look for swelling, redness, warm spots, or sores. Check between your toes, too.
- Wash your feet every day.
- Always wear socks and shoes.