People with diabetes are prone to health complications, including those of the lower limbs and feet.
However, few people understand what diabetic Charcot foot is, what causes it, and how to help prevent this diabetes complication.
This article will explain everything you need to know about diabetic Charcot foot and what to do if you’re experiencing this diabetes complication.
What is Charcot foot?
Charcot arthropathy, also known as Charcot neuroarthropathy or Charcot foot, is a rare complication of diabetes, affecting between 0.1-7.5% of all people with diabetes.
When people have diabetes for a long time and struggle with high blood sugar levels over many years, the excess glucose in the bloodstream causes blood vessel damage.
This can result in neuropathy of the lower limbs and feet, which is a relatively common complication of diabetes.
Charcot foot is one of the most serious foot problems that can result from neuropathy.
It develops as a result of undetected damage, infection, or injuries to the bones of the foot, leading to significant deformity and disability.
It occurs because most people lose feeling in their feet and ankles when they have neuropathy and cannot detect when their feet have been injured or if they’re infected.
Charcot foot can make the joints in your foot collapse, and it also makes infection more likely, which can lead to permanent immobility, disability, and even amputation.
What are the risk factors for Charcot foot?
Anyone who has diabetes (any form of diabetes) is at risk for Charcot foot. Charcot mainly affects those who have diabetes.
However, the main risk factors for developing this complication include:
- If you are over age 40 years old
- If you have had diabetes for more than seven years
- If you regularly smoke tobacco
- If you are sedentary
- If you regularly drink alcohol
- If you also have hypertension (high blood pressure)
- If you are overweight or obese
- If you have high cholesterol
- If you have kidney disease or chronic kidney disease (CKD)
What are the symptoms of Charcot foot?
If you have diabetic neuropathy, it can be tough to tell when you’ve injured or damaged your foot because you’ll lose feeling and sensation in your lower legs and feet.
This is why it is crucial to see your doctor regularly for checkups so they can examine your legs and lower extremities for any infection or damage.
However, the following symptoms may be an indication that you have Charcot foot:
- Foot pain
- Foot discoloration or redness
- Swelling (difficulty fitting shoes on your feet)
- A feeling of heat or warmth (usually just the affected foot)
Advanced Charcot has the following symptoms:
- Rocker-bottom feet, where the entire arch of your foot has collapsed into a bulge
- Toe shape changes, where your toes curve under or curl
- Ankle shape changes, with the ankle on your affected foot curving in or out
- Foot ulcers and open sores
- Open wounds and infections
How is Charcot foot diagnosed?
If you regularly see your doctor for diabetes treatment, they should always do a physical foot exam.
They will take a look at the well-being of your feet, including feeling sensation, bone structure, toenail, and skin health, and look for any injuries, damage, or infections.
If your doctor suspects that you have Charcot foot, they will order imaging and bloodwork to assess.
The following tests can diagnose Charcot foot:
- Foot X-rays
- Magnetic resonance imaging (MRI)
- Blood tests to measure white blood cell count (WBC) to check for infection
Alert your doctor if you’ve noticed changes to your feet and have diabetes.
They can help rule out diabetes complications such as neuropathy and Charcot foot before you develop a damaging diagnosis.
What are the treatment options?
Charcot foot is a serious diabetes complication that needs immediate attention.
Preventing the condition from getting worse is the best treatment for Charcot foot.
Your doctor will most likely treat Charcot foot by doing the following:
- Make sure you take the weight off the affected foot by prescribing a brace, crutches, a walker, or a wheelchair while the foot heals.
- Prescribe orthotics to help cushion your feet better in shoe wear. You may also need a supportive foot or ankle brace. Ask your doctor for recommendations if your socks and shoes aren’t fitting correctly.
- Physical therapy to help aid in pain and improve mobility. You can work with a physical therapist to create an exercise plan that will improve your foot and overall health.
- Surgery for extreme cases of Charcot foot. This may occur when the damage to your foot is extensive (including collapsed bones and joints or ulcers and infections. In rare cases, you may need a foot amputation.)
Learn more about footwear for diabetic neuropathy:
- Guide to diabetic neuropathy socks (with a review of the best options)
- The best shoes for diabetic neuropathy
- Review of diabetic neuropathy insoles
What is the prognosis of Charcot foot?
If you’ve been diagnosed with Charcot foot and address it early, you should be able to avoid serious complications and permanent disability.
However, you’ll need regular checkups with your doctor, who will want to do follow-up imaging and additional exams of your feet (after treatment) to check the progress.
If you’ve been diagnosed with later-stage Charcot foot, you might need to learn to walk differently or with the help of a walking or mobility aid. You may also need a wheelchair.
Having Charcot foot may impede your ability to stay active, which is crucial if you have diabetes.
Talk with your doctor about strategies for staying active with Charcot foot, including activities that have less impact on your feet, like bicycling or swimming.
Very rarely will someone need a foot amputation as a result of Charcot foot, but it does happen.
How can you prevent Charcot foot?
If you have diabetes, prevention is key. Make sure your blood sugar levels stay within a healthy range and that you eat a healthy diet and continue to stay physically active as you age.
Work with your doctor to set realistic blood sugar goals for your lifestyle, and contact a registered dietitian (RD) who can create a meal plan that will work for you and help you meet your health goals.
It is also important to stay active.
The Centers for Disease Control and Prevention (CDC) recommends that most adults exercise for 30 minutes or more most days of the week. Plus, a few days of strength training every week that keep you healthy as you age.
See your doctor regularly for diabetes checkups and foot exams.
They can monitor the progression of any existing diabetes complications and address foot injuries and infections before they turn into more severe health conditions like Charcot foot.
Finally, you can reduce the risk of diabetes-related foot problems by doing the following:
- Check your feet daily for changes
- Keep your feet clean and dry, and wash them daily
- Regularly cut your toenails and keep them short
- Do not walk outside barefoot
- Wear clean socks and appropriate shoes daily, making sure they’re not too tight
- Maintain blood flow to the feet by elevating them when you sit, wiggle your toes often, and stay active throughout the day