What is Charcot's Foot?

Charcot’s foot is one of the many complications that can occur in those with diabetes mellitus. The higher blood glucose levels that occur in diabetes affect many body systems such as the eye, kidneys and nerves. In long standing cases, especially if there has been a poor control of the blood glucose levels, there is damage to the nerves that supply the feet. This makes the feet vulnerable to problems as if something goes wrong, you do not know it has gone wrong as you can not feel it due to the damage of the nerves. This could be something as simple as standing on a nail and that getting infected and you do not know that you have stood on the nail. It could be a blister or corn that gets infected and you do not know that it is there on the foot unless you have a look. This is why foot care is so important for those with diabetes and why it is given so much emphasis. A Charcot foot is the damage that occurs to the bones and joints if there is an injury and you do not know that the injury has occurred.

Another way of looking at it is to consider this way: imagine that you sprain your ankle badly and you do not know that you have because you do not feel the pain from it. You then continue to walk around on it. Imagine all the additional damage that you do by walking around on it. The first you may notice that there is something wrong is when you sit down and look at your feet and you notice that one is much more swollen than the other. This is what happens in those with diabetes who develop a Charcot’s foot. There is some damage, like a sprained ankle or a progressive collapse of the arch of the foot and as no pain is felt they continue to walk around on it. It should be obvious just how much more damage that gets done to the initial injury before the problem is finally noticed due to the swelling. Sometimes there is not much swelling, but the Charcot’s foot is picked up by the difference in temperature between the two feet due to the inflammatory process in the damaged foot that generates more warmth.

The development of a Charcot foot has to be treated as somewhat of an emergency as the further it progresses the much worse it is going to be and the more difficult it is to manage. The person really needs to cease all weightbearing immediately or at the very least get a walking brace so that the injury is supported. For the not so serious cases and those cases that were serious and have improved a very supportive insole in the shoe is needed to support the foot and the injury. Often surgery is needed to realign the dislocated and subluxed joint. The most serious cases can end up with the foot and/or leg needing to be amputated as the injury has done too much damage.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.