Florida Foot Specialists

Can Diabetic Foot Charcot Be Reversed? A Podiatrist’s Insight

While DFC is irreversible, prompt detection and intervention can halt its progression and avert additional complications. Common treatments include minimizing foot pressure through the use of casts, boots, or even wheelchairs.

In more severe instances, surgical procedures might be required to mend the foot and ankle. After the inflammation diminishes, individuals with DFC must consistently wear custom footwear to safeguard their feet and ward off subsequent harm.

About Diabetic Foot Charcot

Charcot foot, also known as Charcot arthropathy or charcot joint disease, is a severe complication that can develop in diabetic patients, especially those with high blood sugar levels.

This condition is closely linked to peripheral neuropathy, a type of nerve damage common in diabetic patients.

Patients with Charcot feet typically experience loss of sensation in their feet, making them vulnerable to injuries and trauma.

Without proper treatment, these injuries can go unnoticed and get worse over time, leading to severe deformities in the bones and joints of the foot.

Charcot foot can actually make the joints in your foot collapse, resulting in permanent damage to your entire foot.

As a result, patients with Charcot feet may have difficulty walking and completing daily activities.

Even a small injury can become worse over time, leading to severe deformities and mobility issues for patients.

This is why prompt detection and intervention are crucial in managing this condition. Early treatment can prevent further injury and halt the progression of Charcot foot.

So while Charcot foot is irreversible, its effects can be minimized with proper care and treatment.

Only a small percent of people with diabetes  develop Charcot foot, but those who do are at risk for recurrent episodes.

Charcot neuroarthropathy is characterised by bone and joint destruction on the background of a neuropathy. Its prevalence in diabetes varies from 0.1% to 8%. Infection develops in 50%–60% of ulcers and is the principal pathology that damages diabetic feet.

National Library of Medicine

The Role of Blood Sugar Levels

Blood sugar plays a significant role in diabetic Charcot foot. High blood sugar levels over time can damage the nerves and blood vessels in the feet, leading to a condition called diabetic neuropathy.

Diabetic neuropathy can cause a loss of sensation and feeling in the feet, making it difficult to notice injuries or changes to the skin or bones.

When a person with diabetic neuropathy injures their foot, they may not be able to feel the pain or discomfort, which can lead to repeated injuries and further damage.

This damage can eventually lead to Charcot foot, a condition that causes the bones and joints in the foot to break down and collapse.

In addition to causing nerve damage, high blood sugar levels can also weaken the bones and make them more susceptible to fractures.

This can make Charcot foot worse and lead to more severe deformities.

Keeping blood sugar levels under control is essential for maintaining healthy feet in diabetic patients.

People with diabetes should work with their healthcare provider to develop a diabetes management plan that includes regular blood sugar monitoring, medication, and lifestyle changes.

Here are some tips for managing blood sugar levels and preventing diabetic Charcot foot:

  • Eat a healthy diet that is low in processed foods and high in fruits, vegetables, and whole grains.
  • Get regular exercise.
  • Take your diabetes medication as prescribed.
  • Check your blood sugar levels regularly.
  • Inspect your feet daily for any cuts, sores, or changes in skin color or temperature.
  • Wear comfortable shoes that fit well.
  • See your healthcare provider for regular foot exams.

If you have diabetic neuropathy, it is important to be especially careful to protect your feet from injury.

You should avoid walking barefoot and wear supportive shoes at all times. You should also inspect your feet daily for any signs of injury or infection.

If you think you may have diabetic Charcot foot, it is important to see your healthcare provider right away.

Early diagnosis and treatment can help to prevent further damage and improve your prognosis.

Risk Factors That Can Contribute To DFC

Two common risk factors that can contribute to Charcot are obesity and age.

Obesity can put extra pressure on the bones and joints in the feet, making them more susceptible to fractures and damage.

Age also plays a role, as older individuals may have weaker bones and decreased sensation in their feet due to nerve damage.

Other risk factors for Charcot foot include:

  • Long-standing diabetes
  • Poor blood sugar control
  • Peripheral neuropathy
  • History of foot trauma or injury
  • Previous episodes of Charcot foot

If you have any of these risk factors, it is essential to take extra precautions to protect your feet and regularly monitor for signs of Charcot foot.

Early Detection is Key

The key to treating Charcot foot lies in early detection.

The perils of procrastination and dismissal in addressing Charcot foot symptoms can be devastating.

Delaying treatment or ignoring the signs of Charcot foot can result in irreversible damage, leading to permanent deformities and even amputation.

In the early stages, the damage to the bones and joints may not be as severe, making it easier to manage and reverse.

Regular check-ups with a healthcare provider and self-monitoring of blood sugar levels and foot health can help to detect any issues early on.

If you notice any changes in your feet, such as redness, warmth, swelling or pain, it is important to seek medical attention right away.

Your healthcare provider may order imaging tests, such as X-rays or MRI scans, to assess the extent of the damage and determine the best course of treatment.

Let’s delve deeper into this topic and explore the various treatment options available. 

Diagnosis and Treatment Options

Accurate diagnosis by a foot specialist or an orthopaedic surgeon is essential to determine the best treatment options, be it non-surgical treatment or surgical treatment.

Non-Surgical Treatment

When it comes to non-surgical treatment, the most common treatment for Charcot foot will most likely require some activity modification in your lifestyle. is offloading, which involves keeping weight off the injured foot.

Following are some of the most common non-surgical treatments:

  • This might require the patient to wear special shoes, such as diabetic shoes or custom shoes, to prevent further injury.
  • Non-weight bearing (keeping weight off the injured foot). For some, immobilization may be required.
  • Another non-surgical treatment option is the use of a walking cast or an external fixator to stabilize the foot.

Surgical Treatment

In cases where there’s a severe deformity or a risk of foot ulcers, foot surgery might be recommended by an ankle surgeon.

This could involve realigning the foot bones or even using an external frame to correct the deformity.

Post-surgery, it’s essential to maintain blood flow to the area and prevent bone infection and avoid other foot complications.

Healing times will vary depending on the severity of foot deformity and the amount of compliance by the patient.

Long Term Outcome and Quality Of Life

The long-term outcome and quality of life for patients with Charcot feet due to diabetes are not explicitly detailed in the provided Wikipedia article on “Peripheral neuropathy.”

However, based on the general information about peripheral neuropathy, which is closely related to Charcot foot, we can infer some potential outcomes:

  1. Loss of Sensation: Diabetic neuropathy can result in a loss of sensation in the feet, which means that minor injuries or pressure points might go unnoticed. This can lead to complications like ulcers or infections.
  2. Motor Symptoms: Patients may experience muscle weakness, impaired balance, and coordination due to neuropathy.
  3. Sensory Symptoms: There might be unusual or unpleasant sensations such as tingling or burning, reduced ability to feel sensations like texture or temperature, and impaired balance when standing or walking.
  4. Autonomic Symptoms: Symptoms related to the autonomic nervous system can also occur, such as dizziness upon standing, erectile dysfunction, and difficulty controlling urination.
  5. Progression: Most types of polyneuropathy, including Charcot foot, progress slowly over months or years. However, there are cases where the progression is rapid.
  6. Quality of Life: The quality of life for patients with Charcot foot can be affected due to pain, impaired mobility, and the need for special footwear or interventions. Regular check-ups, early detection, and appropriate management can help improve the quality of life.

For a more comprehensive understanding of the long-term outcomes and quality of life for patients with Charcot feet specifically, further research or consultation with medical professionals specializing in this area would be beneficial.

Other Diabetic Foot Infections

Charcot foot is not the only infection that diabetic patients are at risk of.

Other common diabetic foot infections include:

  • Cellulitis: a skin infection that can spread to deeper tissues and become life-threatening if left untreated.
  • Diabetic foot ulcers: open sores on the feet that heal slowly and can lead to serious complications if not properly treated.
  • Osteomyelitis: a bone infection that is often caused by an open wound or deep tissue infection.

It’s crucial to seek prompt treatment for any diabetic foot infections to prevent them from becoming more severe and causing long-term damage.

Prevention is the best approach, so it’s important to manage diabetes and take good care of your feet through regular self-examinations, proper foot hygiene, and wearing appropriate footwear.

Why Are Diabetics More Prone To Foot Problems?

Diabetics are more prone to foot problems due to several reasons:

  1. Neuropathy: Diabetes can cause nerve damage, known as diabetic neuropathy, which results in a loss of sensation in the feet. This means that minor cuts, sores, or blisters might go unnoticed, leading to the development of ulcers or infections.
  2. Excess Weight: If a diabetic person is greatly overweight, because of neuropathy, they probably will not feel  the pressure of excess weight on their feet.
  3. Weak Bones: Diabetes can also weaken bones and make them more susceptible to fractures. This makes diabetic patients more prone to Charcot foot and other foot complications.
  4. Poor Blood Circulation: Diabetes can lead to poor blood circulation in the feet, making it harder for wounds or infections to heal. Reduced blood flow can also increase the risk of various foot complications.
  5. Foot Deformities: Certain foot deformities, such as hammertoes, bunions, or Charcot foot, can develop due to neuropathy. These deformities can create pressure points in the foot, leading to ulcers.
  6. Dry Skin: Diabetic neuropathy can cause the skin on the feet to become dry and cracked, which can lead to infections.
  7. Calluses: Diabetics often develop calluses on their feet, which can thicken over time and break down, leading to ulcers.
  8. Foot Ulcers: If untreated, minor wounds can develop into ulcers. These ulcers can become infected and, in severe cases, lead to gangrene, which might require amputation.
  9. Poor Immune Response: Diabetes can affect the immune system, making it harder for the body to fight off infections. This means that even minor foot injuries can become serious if they become infected.
  10. Peripheral Arterial Disease (PAD): Diabetes increases the risk of PAD, which reduces blood flow to the feet. This can lead to pain, infections, and slow healing of wounds.

It’s essential for diabetics to take special care of their feet, including regular check-ups, wearing appropriate footwear, and maintaining good foot hygiene to prevent complications.

Frequently Asked Questions

  • What is Charcot arthropathy?
    Charcot arthropathy, commonly known as Charcot foot, is a condition resulting from nerve damage, leading to foot deformities.
  • How can diabetic patients prevent Charcot foot?
    Regular checkups, maintaining stable blood sugar levels, and wearing diabetic or special shoes can help prevent the onset of this condition.
  • What are the signs of foot ulcers?
    Foot ulcers often manifest as open sores on the foot, especially in areas with bony prominence. If you notice any, consult a foot specialist immediately.
  • Is foot surgery always necessary for Charcot foot?
    Not always. While foot surgery is a successful treatment for severe cases, non-surgical treatment options like custom shoes or walking casts can be effective.
  • How can I find a foot specialist near me?
    Institutions like Loyola Medicine have a team of ankle specialists and orthopaedic surgeons who can provide expert care.
  • What is an external fixator?
    An external fixator is a device, like an external frame, used to stabilize the foot and prevent further injury.
  • How can I manage foot pain associated with Charcot foot?
    Regular check-ups with a foot specialist, wearing appropriate footwear, and following prescribed treatment options can help manage foot pain.