Charcot Foot

Charcot foot (pronounced “shar-KO”) is a problem that can happen in people who have nerve damage from diabetes. In rare cases, it is caused by other health problems.

Nerve damage in the foot or ankle leads to numbness, pain, redness, and swelling. The sore foot may feel hotter than the other foot. This increases the chance that you could break bones in your foot or have another injury and not feel it. If your foot gets injured a lot, the joints can break down, and the foot can become deformed. If you have severe Charcot foot, you may not be able to walk normally. The problem also increases the risk of foot ulcers and infections.

You can protect your feet as much as possible to keep them from being injured. If you already have Charcot foot, you may wear a cast—or a series of casts—for several months to help your foot heal.

Symptoms

Charcot foot

Foot bones, showing fractured bone and skin sore over broken bone.

Charcot foot is a deformity that results from nerve damage (neuropathy) in the foot or ankle. The nerve damage causes a loss of sensation that increases the risk of injury to the feet. When the foot is repeatedly injured, the weight-bearing joints start breaking down. Early signs of Charcot foot include redness, swelling, and increased temperature of the foot.

Charcot foot: When to call

Call your doctor now or seek immediate medical care if:

  • You have symptoms of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the area.
    • Pus draining from the area.
    • A fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have a new problem with your feet, such as:
    • A new sore or ulcer.
    • A break in the skin that is not healing after several days.
    • Bleeding corns or calluses.
    • An ingrown toenail.
  • You do not get better as expected.

Treatment

How can you care for Charcot foot?

  • Follow your doctor's directions if you are told to wear a plaster or fiberglass cast. The cast can help ease pressure and prevent further damage to your foot.
  • Keep your blood sugar in your target range by eating healthy foods, getting regular exercise, and taking insulin or other medicine as prescribed. Check your blood sugar as often as your doctor recommends.

Taking care of your feet

  • Inspect your feet daily for blisters, cuts, cracks, or sores. If you cannot see well, use a mirror or have someone help you.
  • Take care of your feet:
    • Wash your feet every day. Use warm (not hot) water. Check the water temperature with your wrists, not your feet.
    • Dry your feet well. Pat them dry; do not rub the skin on your feet too hard. Dry well between your toes. If the skin on your feet stays moist, bacteria or a fungus can grow, which can lead to infection.
    • Keep your skin soft. Use skin cream to prevent calluses and cracks. However, do not put the cream between your toes, and stop using any cream that causes a rash.
    • Clean underneath your toenails carefully. Do not use a sharp object to clean underneath your toenails. Use the blunt end of a nail file or other rounded tool.
    • Trim and file your toenails straight across to prevent ingrown toenails. Use a nail clipper, not scissors. Use an emery board to smooth the edges.
  • Change socks daily. Socks should be thick and cushioned and fit loosely around your feet. Socks without seams are best because seams often rub the feet. Do not wear stockings, socks, or garters that come up to the thigh or knee unless your doctor tells you to. These can decrease blood flow. You can find socks from specialty catalogs for people with diabetes who have problem feet.
  • Look inside your shoes every day for things such as gravel or torn linings, which could cause blisters or sores.
  • Buy shoes that fit well. Shop for shoes in the evening when your feet are more likely to be swollen. Look for shoes that have plenty of space around the toes. This helps prevent bunions and blisters. Try on shoes with the kind of socks you will usually wear with those shoes. Break in new shoes slowly by wearing them for no more than an hour a day for several days. Avoid plastic shoes. They may rub your feet and cause blisters. Good shoes should be made of materials that are flexible and breathable, such as leather or cloth.
  • Do not go barefoot. Do not wear sandals, and do not wear shoes with very thin soles. Thin soles are easy to puncture. They also do not protect your feet from hot pavement or cold weather.
  • Have your doctor check your feet during each visit. If you have a foot problem, see your doctor. Do not try to treat an early foot problem at home. Home remedies or treatments that you can buy without a prescription (such as corn removers) can be harmful.
  • Always get early treatment for foot problems. A minor irritation can lead to a major problem if not properly cared for early.
  • Do not smoke. Smoking affects blood flow and can make foot problems worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.

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