A guide for patients with Charcot foot

What is a Charcot foot?

Charcot (pronounced sharko) is a serious condition that can lead to severe deformity of the foot. It may occur as a complication of several chronic (long-term) diseases that cause neuropathy (nerve damage). Diabetes is the most common cause in the western world.

Why is it called Charcot?

It is named after the 19th century French doctor, Jean-Marie Charcot, who first described the condition.

Why is it serious? 

The deformity may severely affect your mobility. The bony prominences also make it more likely that you will get ulcers on your foot.

Who gets a Charcot foot?

It affects less than three per cent of people with diabetes, and only those who have neuropathy.

It is most likely to occur if you:
• have high sugar levels
• are aged 50 to 60
• have had diabetes for longer than 12 years.

How do you get a Charcot foot?

The exact cause is unknown but is most likely the result of trauma. If your foot is numb because of the neuropathy, you may not notice if you are damaging it and small fractures may occur. As it is painless, you will continue walking on it and further damage the bone and cartilage. Ultimately, the structure of your foot will collapse.

What part of the foot is involved?

The most common area is the midfoot (60 per cent). It can also occur at the ball of the foot (30 per cent) and the ankle joint (10 per cent).

What are the symptoms of a Charcot foot?

It can occur suddenly. The area is usually hot, red and swollen. It may not hurt at first but, if untreated, it can become quite painful.

How do you treat a Charcot foot?

It is vital you do not walk on the foot until the condition calms down. This may take many months. Your foot will need to be immobilised with either a rigid boot, plaster cast, or total contact cast. The cast is changed from time-to-time. You will need to wear it until the temperature of your foot is back to normal.

You may also need crutches, a walking frame, or a wheelchair until the foot has stabilised.

Your foot will be carefully monitored and x-rayed periodically to check on the changes to the bones and joints.

Can I do anything to prevent a Charcot foot?

It will help if you:

• keep your blood sugar under control
• be careful to avoid injury
• check your feet every day and contact your podiatrist if you notice any changes.

Can I still drive and go on holiday?

Your podiatrist will be able to advise you about this.

What happens after it gets better?

You will probably need special shoes and an insole to support the foot. This will be discussed with you at the appropriate time.

Could I get a Charcot foot again?

It is not usual for Charcot to occur in the same place, but it may occur on the other foot or another part of the same foot.