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Charcot foot is a rare, debilitating condition that affects the structure of the foot. It’s characterised by bone, joint and muscle weakness, as well as foot deformities. Named after the 19th-century French neurologist Jean‐Martin Charcot, whose research laid the groundwork for modern medical professionals’ understanding of this foot problem, Charcot foot occurs as a result of neuropathy.

If your nerves are damaged, they can’t carry messages effectively between your brain and feet. As a result, your brain struggles to control and co-ordinate your feet. Because their normal pattern of movement is disrupted and they’re not being exercised properly, your foot muscles lose their strength. This has a knock-on effect on your joints and bones, which also get weaker and can easily fall out of alignment, creating abnormal pressure points on your soles. In a nutshell, key parts of your feet no longer work in harmony. As feet are the foundation of movement, your gait and balance may suffer too.

The Perfect Storm for Foot Health

The combination of neuropathy, weakness, unsteadiness, an abnormal distribution of pressure, and gait problems creates the perfect storm for foot health. Charcot foot puts you at greater risk of suffering from strains, fractures, ulcers and other foot complaints. To make matters worse, the nerve damage means it’s harder for your feet to alert your brain to pain and other issues. You might continue with your typical routine unaware there’s something wrong. Your feet might therefore be exposed to excessive stress, trauma or infection day in, day out, compounding the problem. Ultimately, your joints and bones could collapse, as could your shock-absorbing arches, dramatically altering the shape of your feet.

When your body tries to heal the damage wrought by injuries and other problems, it creates areas of inflammation in your feet and may make them look redder and feel warmer than usual. Many people with Charcot foot find their feet swell considerably and, if the arches have collapsed, look bowed when seen from the inner side (rather like a shelf forced to support too many books). This deformity, known as rocker-bottom foot, is clearly visible in Foot Health Facts’ illustration of Charcot foot. In addition, your toes may curl and droop due to your feet’s weakness.

Associated with Diabetes-Related Nerve Damage

Charcot foot is among the foot ailments associated with diabetes. Not everyone with Charcot foot is diabetic, and having diabetes doesn’t mean you’ll definitely develop the condition. However, it’s still important to be aware of the link.

The reason people with diabetes are particularly prone to developing Charcot foot is because they often suffer from the foot condition’s cause: neuropathy. Diabetes can result in high blood sugar levels. The body either produces too little insulin to regulate the amount of glucose in the blood (the cause of Type 1 diabetes) or is resistant to the hormone’s effects (Type 2 diabetes). Excessive amounts of glucose have a detrimental effect on the small vessels tasked with supplying your nerves with nutrient-rich blood, so the nerve endings suffer.

Diabetic Foot Assessments Are Essential

If you have diabetes and are worried about Charcot foot, what can you do? Firstly, attend a diabetic foot assessment at least annually. At our modern foot clinics, our skilled London podiatrist team performs thorough neurological, vascular and skin checks with the aim of detecting conditions such as Charcot foot – and treating them – as early as possible. Secondly, do your best to manage your blood sugar levels, check your feet daily and see your podiatrist or GP urgently if you notice any Charcot foot symptoms (i.e. swelling, redness, unusual warmth or changes in foot shape). Thirdly, consider calling the Diabetes UK helpline to talk about how you feel.

If you’re diagnosed with Charcot foot, treatment may involve rest and wearing a cast for several months. This will prevent further damage and deformity while allowing the muscles, joints and bones to heal. You may then need protective footwear, plus prescription orthotics to support your foot. As Diabetes UK points out, ‘in the majority of cases Charcot foot doesn’t have to result in surgery or an amputation’. Operations are only required in severe cases. The specific approach differs between patients, but tends to involve realigning the bones and joints and reshaping the foot.

It’s important to bear in mind that the sooner Charcot foot is diagnosed, the more successful – and straightforward – treatment is likely to be.

For expert help with Charcot foot and other diabetes-related foot problems, contact Feet By Pody today.