Description: Charcot Foot is a pattern of bone and joint destruction that can lead to severe foot deformities. This disease begins with peripheral neuropathy (decreased feeling in the feet), most commonly seen in diabetics. People with decreased nerve sensation may injure their feet, producing small fractures in the bones; and because they have decreased feeling, they may have minimal or no pain, and they continue walking on the foot. This causes the bones to heal unevenly, causing the foot to become deformed.
Symptoms & Treatments: The acute, or early symptoms of Charcot Foot are: small fractures of the bones of the foot, swelling over these areas, and later the entire foot may become swollen and inflammed. There is little, if any pain during this stage. Treatment during this stage is imperative, and includes: complete rest of the foot by using a non-weightbearing cast, crutches, and bed rest. If treatment is not initiated, this disease progresses to its chronic stage. During this stage the following symptoms may be present: a foot which is deformed, and noticebly different then the other foot; a collapsed arch; bones which abnormally protrude against the skin, possibly causing the skin to breakdown and ulcerate; swelling and inflammation of the foot; and there may be no pain present, or in some patients the pain is intense, due to the amount of bone and joint destruction present. Treatment during this stage involves non-weightbearing casts until the swelling subsides, physical therapy, and custom-made shoes and orthotics.
Prevention of Charcot Foot:
- Anyone who has peripheral neuropathy, especially diabetics, should be treated with custom-made orthotics to help guard the feet against injuries; to support the bones and joints of the feet, thus preventing deformities from occurring; and to protect the bottom of the feet from friction, calluses, and ulcers of the skin. The special custom-made orthotics we make are designed to accomplish the above, and they are made out of comfortable, long-lasting, space-age materials.
- Examine your feet dailyincluding the tops, bottoms, and between your toes. Look for inflammed areas, cuts, peeling and breaks in the skin, rashes, and swelling. Press on your nail to see if they are painful or ingrown. Touch your feet and make sure the temperature is the same in both, and that they are not cooler then the rest of your body. Test to see that you have good feeling in the bottom of both feet, by gently moving your finger from heel to toes. If any of the above is abnormal, see a podiatrist immeditely.
- Wear properly fitted shoes, with uppers made of soft materials, the toe box (the area where the toes lie in the shoe) should be deep and wide to reduce pressure on the toes, and the heels should be no higher than 3/4 inch. Seamless socks and shoes cause less problems then those with seams. Always wear shoes and socks; they protect the feet from injury. Do not walk barefoot.
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We recommend that you discuss all foot changes with your doctor as soon as they occur. Frequent foot exams by your doctor are also recommended.
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