Those who suffer from peripheral neuropathy—particularly as a consequence of diabetes—are at increased risk for significant foot problems. One of the most serious and debilitating potential complications is a condition known as Charcot foot, also known as Charcot arthropathy.
Charcot foot is a progressive foot deformity that gradually leads to severely fractured, deformed, and misshapen feet. Detecting the early warning signs and intervening before the damage worsens is absolutely critical for the long-term health of your feet. Severe cases may require full amputation of the foot.
How Does Charcot Foot Occur?
It seems strange that such a major problem could develop slowly and relatively undetected, but it’s a natural consequence of what severe diabetic neuropathy can do to feet.
At this state of disease progression, bones in the feet may be very weak and susceptible to fracture due to poor circulation. At the same time, the complete loss of nerve function may prevent you from feeling any pain. If you don’t check your feet regularly, it may be days or even weeks before you realize something is wrong. As you continue to walk on your damaged feet, bones crumble and disintegrate further, buckling under your weight.
Eventually, this leads to severe disfigurement in the shape of the feet which may make walking impossible and create severe ulcers at extreme pressure points.
What Are the Early Warning Signs and How Do I Stop It?
Because extreme neuropathy is normally a prerequisite for advanced Charcot foot, you cannot rely on your senses to alert you to the danger. Likely you will feel no pain at all.
If you have diabetes, you should already be examining your feet carefully for about 5 minutes at least once per day. During these self-exams, check for the early warning signs of Charcot foot:
- Swelling of the feet—even if you can’t see or remember a specific injury or incident that would cause it.
- Redness of skin color.
- The skin feels unusually warm to the touch.
Charcot Foot Treatment
Prompt treatment and strict adherence to your surgeon’s guidelines will be critical if you wish to recover from Charcot foot and return to active, healthy, mobility.
If the deformities are not yet so severe that surgery is required, conservative treatments may be used.
- Immobilization and offloading. In order to protect and allow the fractured bones to heal, the foot must be immobilized, usually in a cast or occasionally a removable boot or brace. Absolutely no weight bearing should occur until your doctor gives you the go ahead, as this will only cause the foot to collapse further. Unfortunately, this process may take several months, but it is necessary.
- Custom shoes. Once the bones have healed and the swelling has been reduced, our team will fit you with custom diabetic shoes and/or orthotics to accommodate your deformity. This will help support your feet and reduce the risk of subsequence injury or ulceration.
If more severe deformities have occurred, surgery will be required. Anything from tendon lengthening to complex bone reconstructions and joint fusions could be on the table, depending on the condition of your feet.
Our goal is always to restore the full function of your feet to the greatest extent possible. However, Charcot foot surgeries are inherently riskier than routine foot surgeries—partly due to their complexity, and partly due to the softer and weaker bones present in people with diabetes. Unfortunately, this means surgery is more likely to be ultimately unsuccessful or result in complications. In extreme cases, amputation may be the best available option.
If you notice any of the early warning signs of Charcot foot, or especially if you notice any other subtle changes in the shape of your foot, please book an appointment immediately for a closer examination. We will do everything we can to keep your feet as healthy as possible, so you can continue to enjoy an active and independent lifestyle. Call us in Princeton at (609) 924-8333, or in Roselle Park at (908) 687-5757