When you have diabetes and peripheral neuropathy (nerve damage), you’re more at risk of developing Charcot foot.
Charcot foot is one of the serious foot complications you should be aware of. It can be difficult to deal with, but having treatment as early as possible can reduce your risk of further problems, like developing a foot ulcer or needing an amputation.
Coping with Charcot foot can be really hard, and the changes to our daily lives caused by the coronavirus pandemic and its restrictions may leave you feeling even more overwhelmed. Some of you may be worried about having hospital treatment during this time, or just need someone to talk to. We want you to know we are here to help.
What is Charcot foot?
Before we can answer this, we need to explain peripheral neuropathy as it plays an important part in the development of Charcot foot.
Neuropathy affects your nerves, which carry messages from your brain to different parts of your body. When you have diabetes, high blood sugar, high blood fats and high blood pressure can damage the small blood vessels that supply your nerves, preventing them from receiving the essential nutrients they need.
Because of this, the nerves throughout your body can become damaged or, over time, disappear. This means you may start to lose the sense of feeling in your hands, feet or legs.
If you have neuropathy in your feet, you may not notice any damage to your foot, such as injuries or broken bones. This means you won’t realise that you need to see a doctor.
Because of neuropathy, you’ll be able to continue walking on your affected foot without noticing any changes or feeling pain. But as you put pressure on your foot, the bone and joints can start to change shape. This can alter the shape of your entire foot and put other joints at risk.
Once you have a misshapen foot, you may also be at a greater risk of developing a foot ulcer. In serious cases of Charcot foot, you may need to have an amputation.
We know amputations can be difficult to come to terms with, but the more you know about Charcot foot and the symptoms to look out for, the earlier you can get the treatment you need to prevent these serious complications from developing.
The signs and symptoms of Charcot foot may include:
- warmth – the affected foot feels warmer than the other
- change in foot colour
- change in foot shape.
If you notice any of these symptoms in your feet, take the weight off that foot immediately and talk to your doctor, footcare team or local health service for more information and advice.
"If you notice your foot has suddenly become red, hot and swollen, maybe with or without pain, please immediately take the weight of your foot and seek help from your doctor or local footcare team."
- Daina Walton, Podiatrist at King's College Hospital
If you have lived with diabetes for a long time, or if you have nerve damage in your feet, you are at an increased risk of developing Charcot foot. But the good news is there are things you can do to reduce this risk.
Checking your feet every day can help you spot the symptoms or any unusual changes to your foot. You may also be able to get support from your foot specialist if you have neuropathy.
Stopping smoking and keeping your blood sugar levels, blood fats and blood pressure within your target range can also prevent Charcot foot from developing. And it’s important to avoid big changes to the amount of day to day physical activity you do.
For more advice on how to manage your condition and lower your risk of complications, head over to our Learning Zone and join 60,000 other people discovering more about their diabetes.
If you are diagnosed with Charcot foot, there are two treatment types available to you.
Non-surgical treatment involves keeping the foot as still as possible. This means you will not be able to put any weight on your affected foot.
To help you with this, your foot will be put in plaster cast or you will be given a protective boot. Your footcare team may also give you a wheelchair or crutches, as you’ll need them to move around.
The process can take several months, or longer depending on your individual diagnosis. You may also be given custom shoes after your treatment to keep your foot protected and prevent a foot ulcer from developing.
We know that this type of treatment may mean you have to completely change your way of life. But keeping your foot still is really important as it will give the bone time to heal.
If non-surgical treatment is not an option for you, you may need to have surgery. Your footcare team will discuss this with you.
The type of the surgery you will need depends on your individual diagnosis, and you may need to have more than one operation. Your doctor will be able to talk you through this, along with the risks and benefits involved in the surgery.
Depending on the damage to your foot, you may need to have it reshaped so that you can start to bear weight on it again over time. This type of surgery may mean you need to have the bones and joints in your foot all moved into their original place.
If reshaping the foot and constant rest doesn’t help, you may need an amputation. Your diabetes team will support you through this. And we’re here for you too.
We know that this type of treatment can be worrying, but in the majority of cases Charcot foot doesn’t have to result in surgery or an amputation. Regularly checking your feet for the symptoms and getting treatment as soon as possible can help to prevent these complications from developing.
"The podiatrist tested the sensitivity in my feet using a blunt pin. I couldn’t feel much, and in 2010 I was diagnosed with Charcot foot in both feet. I wore protective boots to support my feet, but my left foot had started to change shape and I needed surgery."
- Jayne's been having treatment for Charcot foot. Read her story.
If you are having treatment
We understand that you may be worried about going into hospital because of the coronavirus pandemic. But you should continue to go to your appointments if you are having treatment for Charcot foot. Your specialist diabetes foot services are running as usual, and the NHS is open if you need urgent care.
Please do not attempt to remove your cast at home yourself, or stop going to your appointments. Without the right treatment, Charcot foot can get worse and lead to further problems.
If you have any concerns before your appointment, or if you need to reschedule ones that you have missed, contact your healthcare team. They will be able to help.
We're funding scientists at King's College Hospital to research new and better ways of preventing foot complications in people with diabetes.
Read more about research we've funded into how materials called bioceramics can help to heal fractures in Charcot foot and reduce the need for amputations.
Coping with Charcot foot
Charcot foot can be very difficult to deal with. You may need to go through lots of treatment, and you may find yourself needing extra support.
Some people can feel like a burden on their family, and it can be quite a lonely road back to recovery. But it’s important that you know that you’re not alone, and that help is out there for you.
Whether you’ve got a specific question about your treatment, or you just want to have a chat with someone who knows about diabetes and Charcot foot, give our confidential helpline a call. You’ll be able to speak to a highly trained advisor who can take the time to talk you through your concerns or how you’re feeling.
There are other people with diabetes who have had Charcot foot, and reaching out to them can be a great help. You can read their experiences in our online forum, or sign up to take part in the conversations yourself.
It can be tough to go through the treatment for Charcot foot alone, but joining a community can really help you feel supported throughout the process.