All About Charcot Foot

Charcot foot is a syndrome that arises from neuropathy (nerve damage) in the foot and/or ankle. With the loss of sensation caused by the nerve damage, the patient may experience injuries that they are not immediately aware of. They may experience redness and swelling, of the feeling of warmth in the affected area.

As the injuries worsen or accumulate, foot bones can break or joints can dislocate within the foot. These fractures and dislocations can lead to foot deformity. As the condition deteriorates, the deformed foot can cause foot sores to develop. If left untreated, these sores can become infected possibly leading to amputation of the foot. Charcot foot is most common among patients with diabetes.

Symptoms of Charcot foot

Because sensation is reduced, a person experiencing Charcot foot condition will typically first notice swelling or redness of the foot. The skin will feel warm at the spot. As it advances, there may be a deep aching feeling and visible foot deformity.

Causes of Charcot foot

Charcot foot develops over a period of time. It is triggered by a number of factors. As mentioned above, Charcot foot is highly associated with neuropathy (damaged nerves). Neuropathy can be caused by diabetes, alcohol or drug use, infection, spinal cord and nerve root disease or trauma, HIV, Sarcoidosis, rheumatoid disease and psoriasis. People with neuropathy experiences diminished muscle control and reduced feeling in their foot.

It can also be triggered by a sprain or twisted ankle. If the person continues to walk on the foot, it can worsen and lead to bone fractures in the foot. This can lead to the development of Charcot foot.

Treatment of Charcot foot

Early detection of Charcot foot can prevent further damage and deformity of the foot. The treatment is aimed to reduce weight-bearing, heal the bones and prevent new bones from breaking.

  1. Non-surgical treatment

    • Reduce the weight on the foot – The first phase of the treatment is to lessen the weight on the foot. This is because the foot will be fragile and must be protected so that bones can heal naturally. You will be advised to avoid placing weight on the foot for several weeks. Treatment may involve use of a splint, cast, a removable boot or brace, crutches, or a wheelchair.
    • Custom shoes – There are specially designed shoes with inserts that you can wear to help you carry out your normal daily activities as your foot heals. Using custom shoes can also prevent the recurrence of Charcot foot, reducing the likelihood of amputation.
    • Modifying your activities – It may be necessary for you to adjust your activities in order to prevent trauma to your foot. If care is not taken, you can develop Charcot foot in both feet, so you need to protect them and allow proper healing to take place.
  2. Surgical treatment

    If Charcot foot leads to deformity, and it becomes severe to the extent that you cannot use braces and orthotics, surgery may be your only option. Charcot foot surgery may involve open reduction and internal fixation and fusion. In severe cases, bony prominences may need to be removed as well. Immediately after surgery, you will have to avoid weight bearing. Recovery may take a few months, especially among diabetic patients with a slower healing response. Periodic checkups with your podiatrist will be required.

If you’ve been diagnosed with peripheral neuropathy in the past, due to diabetes or another condition, you should be aware of the danger of developing Charcot foot. If the symptoms of redness, inflammation or deformity are present, you should consult a foot care specialist for checkup and routine care. Call Houston Foot and Ankle Care at (713) 541-3199 to make an appointment with Dr. Maislos – a leading Houston foot doctor who treats patients with Charcot foot and related disorders.

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