Dr. Thomajan Explains How Charcot Foot Is Treated and How it Can Be Prevented

Charcot foot is a rare and serious complication of neuropathy (nerve damage). This condition develops due to the loss of sensation in the feet, often in those who have diabetes. Because patients with diabetes often develop neuropathy that interferes with their ability to feel wounds, infections, or pain in their feet, damage and injuries can happen to their feet, and they don’t know it. Injuries can include bone softening and broken bones that may go unnoticed until they create a foot deformity. How to prevent Charcot foot

The skilled and experienced podiatrists at Austin Foot and Ankle Specialists understand the complex nature of diabetes-related neuropathy and the very serious foot conditions that can develop because of it. Dr. Thomajan discusses Charcot foot and strategies that can help prevent this foot condition.

Causes of Charcot Foot

Charcot foot develops due to neuropathy in the feet and most frequently occurs in patients with diabetes. Other conditions that can lead to neuropathy and increase a patient’s chance of developing Charcot foot include:

  • Heavy use of alcohol or other drugs
  • Infections
  • Spinal cord injuries
  • Parkinson’s disease
  • Syphilis

Triggering Events

Charcot foot often develops after some type of trauma happens to the foot, and the damage from the trauma is not immediately recognized. When the damage goes unnoticed, a patient may use the foot when they shouldn’t, making the damage worse. Some examples of initial trauma that could result in Charcot foot include:

  • A sprain or broken bone that isn’t treated quickly
  • A sore on the foot or ankle that does not heal
  • An infection
  • A dislocation within the foot
  • A foot surgery that does not heal properly

It’s possible you can’t remember the trauma that caused the wound, infection, or damage. Only 25-50 percent of patients with Charcot foot can remember a specific injury that led to the condition. This may be because patients who develop this condition are typically less able to feel pain or other sensations in their feet.

How to Help Prevent Charcot Foot

As with many medical issues, the best way to address Charcot foot is by using prevention strategies. Because Charcot foot most often occurs in patients with diabetes, the podiatrists at Austin Foot and Ankle Specialists recommend patients take the following measures, which include many of the same steps as good diabetes management:

  • Manage blood sugar levels
  • Make regular diabetes check-ups
  • Perform daily foot exams at home to monitor for injuries
  • Make regular foot exams with a podiatrist to monitor your ability to sense pain and pressure in your feet
  • Perform proper toenail maintenance
  • Elevate feet when in a seated position
  • Manage blood pressure
  • Maintain a healthy weight—obesity is a significant factor in developing Charcot foot
  • Wear socks and shoes all day to protect your feet from injuries
  • Wash and moisturize feet every day
  • Keep cholesterol low
  • Prevent/manage kidney disease


Patients who are experiencing Charcot foot may have some of the following symptoms:

  • Foot pain (this may not occur in patients with severe nerve damage)
  • Redness
  • Discoloration
  • Swelling
  • Excessive warmth in one foot compared to the other


A doctor can diagnose Charcot foot by obtaining a medical history and completing a physical exam of the patient’s feet and ankles; through imaging tests like X-rays, CT scans, and MRIs; and through blood tests to look for signs of infection.


If you think you might have Charcot foot or have been diagnosed with this condition, you need to stay off your foot to prevent injuries and to avoid making existing injuries worse. Although you may be able to walk, if your ability to feel pain in your foot is compromised, you may not realize if you are making your foot condition worse. Your doctor might assist you in keeping weight off of your foot with:

  • A cast or brace that you wear for 2-3 months
  • Crutches
  • A walker
  • A wheelchair
  • Orthotics
  • Custom shoes to prevent future issues

Additionally, your doctor may recommend physical therapy to help with pain, stiffness, and discomfort. Surgery may also be necessary in the most severe cases, to repair, replace, or realign the bones of the foot. Surgery may be recommended if the foot has become deformed in a way that prevents normal walking, places the patient at a high risk of ulcers, or there are unstable fractures or dislocations and cannot heal without surgery.

Consequences of Ignoring Charcot Foot

If Charcot foot is diagnosed and treated quickly, it is generally possible to avoid serious, life-altering complications. If it is not treated promptly, it can lead to the following:

  • Collapse of joints and deformity in the impacted foot
    • Rocker-bottom foot. The bones in the middle of the foot collapse, causing the arch to round outward instead of upward. There may be a visible bulge in the middle of the underside of the foot.
    • Toe shape changes. Toes may start to curl under the foot as the bones and tissue in the foot break and the toes compensate to keep the person stable.
    • Ankle shape changes. The ankle may bend to one side, becoming less straight and stable than the ankle on the other foot.
    • Foot ulcers. As the foot or ankle changes shape, there could be pressure on certain areas of the foot, leading to sores and infections.
  • Permanent issues with using your foot that require you to learn different ways to walk and move or use mobility aids.
  • Difficulty wearing shoes
  • Increased likelihood that infections in the foot will get worse and spread to other parts of the body. Sepsis is a condition that results when infection moves to the bloodstream.
  • Amputation
  • Life-threatening complications

When to Seek Treatment for Charcot Foot

If you have a condition that has caused nerve damage and you lack sensation in your feet, you should be aware of the following and seek out immediate medical attention:

  • Changes to the shape of your foot
  • Changes to the skin on your feet, such as discoloration, warmth, or a funny smell
  • Loss of hair on your feet or toes
  • Decreased sensation in your
    • Legs
    • Ankles
    • Feet
    • Toes
  • Pain, tingling, cramping, or burning in your legs or feet, especially at night
Craig Thomajan
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Austin Podiatrist