If you suffer from diabetes, you may very well experience a number of foot problems such as neuropathy and/or charcot foot. This condition is often caused by vascular complications and worsened by nerve damage. It is a progressive, degenerative disease that is difficult to address. It can cause many complications in foot care because it weakens foot bones and makes them more likely to fracture.
In this article you will learn:
- Can charcot foot be cured?
- What is charcot neuroarthropathy?
- Is charcot foot a disability?
- Is charcot foot painful?
Read on to learn more.
Is charcot foot painful?
Because charcot foot is a progressive disease, it naturally worsens over time. As time goes by, joints begin to collapse and the feet may take on abnormal configurations. Additionally, because nerve damage is involved, sufferers may experience symptoms such as tingling and lack of feeling in the feet, and it may become difficult to control the movement of the feet.
Very often people suffering from charcot foot do not feel pain because of neuropathy. For this reason, they may be likely to simply ignore the condition and continue with activities of daily living without taking any special care. Unfortunately, untreated charcot foot becomes much worse very rapidly as the bones, cartilage and ligaments of the foot become more and more damaged.
The joints of the foot are especially at risk of damage and injury caused by daily wear and tear. Joints most commonly affected are:
These joints are located in the midfoot and the forefoot. If symptoms are ignored over a lengthy period of time, the feet may become deformed. Disability may result, and eventually amputation may be needed.
Who is at risk of developing charcot foot?
The American Diabetes Association says that people who have suffered from diabetes for 15 years or more and are over age 50 are at greatest risk. It is unusual for charcot foot to affect both feet. In fact only about 20 percent of sufferers experience symptoms in both feet.
How do you know if you have charcot foot?
The condition is relatively fast to develop. In fact, it can make its first appearance and become full-blown in a matter of weeks or months. By comparison, peripheral neuropathy takes decades to develop. Charcot foot may begin as a result of minor trauma. Symptoms you should watch for include:
- Warmth and/or a strong pulse in the foot
- Discoloured and/or unstable foot joints
- Misaligned bones at the joint
- Soreness, pain and swelling
- Redness and inflammation
- Possible nerve damage
- Loss of foot sensation
- Foot deformity
How does charcot foot begin?
More often than not, neuropathy is the cause of charcot foot. Patients suffering from neuropathy are less able to feel pain, injury and/or extremes of temperature. This puts them at greater risk for damage, wear and tear on the already compromised joints of the foot. Those who have tight Achilles tendons are even more likely to develop charcot foot.
Symptoms can begin due to a trauma to the foot. People who have high blood sugar levels (hyperglycemia) or diabetes are also very likely to develop charcot foot. This is because these two conditions are often precursors to peripheral neuropathy.
Complications to watch for with charcot foot
Here are some things to watch for that may give you a clue if you are beginning to develop charcot foot:
- Compression of the nerves or blood vessels
- Numbness in the feet
- Loss of foot function
- Joint inflammation
- Bony protrusions
- Foot deformity
- Bone infection
- Foot calluses
- Foot ulcers
One symptom that fairly guarantees a definite diagnosis of charcot foot is a charcot fracture. This is a symptom that will not occur until later in the progression of the disease after changes of the bone have occurred. If you present to your doctor or podiatrist with an unexplained bone fracture in your foot, diagnosis will be easy; however, successful treatment will be difficult.
It’s important that you not wait until you experience extreme symptoms. Catching the symptoms early is most helpful in developing a successful treatment plan. For this reason, if you suspect that you may be developing charcot foot you should see your podiatrist right away. This is the only way to be sure of your diagnosis.
Naturally, your podiatrist or your doctor will look at your feet and examine them. He or she will perform a medical history and ask you some questions about your activities and any symptoms you may have been having.
Your doctor or podiatrist will perform a series of tests to determine whether or not you are suffering from charcot foot. This can be a somewhat tricky process because some other conditions present similar symptoms. For example, deep venous thrombosis and cellulitis may exhibit similar symptoms.
For early detection, your doctor or podiatrist will use some traditional diagnostic tools, such as:
- Nuclear bone scan
- CT scan
By combining your test results and information gained from your interview, your doctor will be able to determine a proper diagnosis. If your doctor does diagnose charcot foot, be sure to discuss these important topics with him or her:
- Activities that may cause or worsen charcot foot
- Environmental changes that may help
- Dietary instructions and requirements
- Best and newest treatment methods
- Proper footwear & foot care
- Nutrients that may help
Your doctor will work with you to design a treatment plan. You will need to return for regular exams to document the progress of your condition. At these exams, your doctor may take samples of joint fluid to send off to the lab for testing. These tests are designed to check for bone and cartilage fragments.
What are the treatment options for charcot foot?
Stabilising the joints is the main goal of charcot foot treatment. Your doctor will give you instructions to help you attain this goal. You must be sure to follow them closely. Instructions and treatment may include:
- Use of medical equipment such as a cast and crutches or even a wheelchair
- Limiting of activities that cause or worsen your condition
- Customise braces and shoes
- Immobilisation of the feet
You must understand that it is of the utmost importance that you protect your feet if you are suffering from charcot foot. Failure to care for your feet may result in severe deformity. Surgery may become necessary. If this is the case, your doctor will discuss surgical procedures with you and provide sound advice to help you make wise decisions.
Ostectomy & arthrodesis are surgical procedures for charcot foot
The most common surgical procedure associated with charcot foot is ostectomy. This procedure involves incising the sole of the foot in order to remove fragments of bone and/or cartilage and any abnormal bone growth. Following this procedure, you must wear a cast or brace as instructed until your foot has recovered completely. This is generally an outpatient procedure.
Arthrodesis is also a frequently prescribed surgical procedure for charcot foot. This procedure involves realignment of the ankle with the hind foot or the midfoot. During the midfoot realignment process, collapsed arches will be repaired and bony growths will be removed. This is a fairly complex procedure that involves the insertion of plates and screws into the foot to help stabilise bones and joints. Arthrodesis patients usually spend at least one night hospitalised.
Following the procedure, the patient wears a non-weight-bearing cast for a period of three months. After removal of the initial cast, a weight-bearing cast is necessary for one more month. Once all casts are removed, orthotics are prescribed. These are to be used for a period of time to be determined by the doctor.
For hind foot and ankle realignment, the process is the same; however, recovery time and procedure is somewhat different. Following the three month use of a non-weight-bearing cast, hind foot arthrodesis patients must use a special brace for a period of two or three months these braces protect the arch of the foot and make it possible for the patient to continue walking during the recovery.
Following your surgery, your doctor will keep in close touch with you. You should report promptly for all of your checkups to be certain that you are making satisfactory progress.
Is there anything you can do to prevent charcot foot?
To prevent charcot foot, you would do many of the same things that you do to prevent or control diabetes. Keep your blood sugar levels under control by eating a healthy, whole foods diet. This will help minimise your risk of developing neuropathy, which leads to charcot foot.
Take good care of your feet by checking them every day for any signs of foot problems. Wear comfortable, well fitted shoes and avoid injuring your feet. See your podiatrist as needed.
Disclaimer: Pedi Reviews does not provide medical advice, treatment or diagnosis.