When you have diabetes, preventative care is the only way to prevent complications such as Charcot foot neuropathy. As the name suggests, this condition develops as a result of neuropathy, a common side effect of diabetes. Charcot foot is a very serious complication that can result in limb loss. Thankfully, it develops in stages. So, with regular checkups and early intervention, we can prevent progression, surgery or, worst of all, amputation.
Charcot Foot Neuropathy: What Causes this Complication?
When you have diabetes, especially if your disease is not well controlled, high levels of sugar in your blood can damage small vessels throughout your body. If this happens, blood flow to your nerve decreases. In turn, you may develop neuropathy.
If you develop neuropathy, you can lose sensation in your extremities. You may also experience, burning, tingling or numbness in your feet and toes. However, the loss of sensation in your feet presents the biggest health risk. Because, with reduced feeling in your feet, you could cut or injure your skin without noticing the problem. In turn, a wound could form, and, because of reduced blood flow, that wound won't heal well.
Soon, more complications can develop. First, you may form an ulcer. This hard-to-close wound can threaten your limb. But it's not the only threat to your limb health.
Let's say you don't cut or scrape your foot. Instead, you break or dislocate a bone. Now, if this injury goes undetected, you may develop charcot foot due to neuropathy.
Other Risk Factors for Charcot Foot
In addition to Charcot foot neuropathy, you could develop this condition sue to gait changes that come from reduced sensation in your feet. Additionally, these factors increase your risk for this complication:
- Your age
- The density of your bones
- Arterial disease
- Past foot injuries
Charcot Foot with Neuropathy: What are the Symptoms
Fortunately, Charcot foot is a relatively rare complication, affecting about 13% of individuals with diabetes. Worse, this condition often goes undetected until it progresses to the point where you're at risk for limb loss. As such, recognizing the stages of Charcot foot can help you detect problems in their early stages. This can help you seek early intervention, and prevent serious complications.
When Charcot foot is first developing, your foot will be mildly red, warm or swollen. (Because temperature changes in your foot can indicate many problems, our podiatrist in Houston uses advanced technology to look for hot spots in your extremities.) If you come in at this stage, we may detect tiny cracks in your foot bones via our in-house x-ray. Or, we may need an MRI to find swelling or bruising on your bones.
Unfortunately, if we don't intervene, Charcot foot symptoms will continue progressing. Next, foot inflammation will worsen. Now, we'll be able to see fractures on an X-ray, along with dislocated joints and swollen bones on an MRI. At this stage, your foot will begin to deform.
What happens if you don't seek intervention at this point? Those damaged bones will start to break down or dissolve. Some of the fractures will start healing, but damaged bones can fuse together. If that happens, your deformities will be permanent.
Still haven't sought Charcot foot treatment? Now, your bones will rebuild, but in positions that deform your foot. At this point, ulcers are very common, though not necessarily painful, since Charcot foot with neuropathy comes with reduced sensation in your feet.
Early Intervention for Diabetic Foot Complications
If we catch Charcot foot in its early stages, we may be able to prevent deformities and avoid surgery. At first, we'll start by immobilizing your foot, allowing the damaged bones to heal. Depending on your specific condition, we can accomplish this with either a cast or a walking boot. Either way, you'll have to keep weight off your foot (called offloading, as described in this scientific study) while it's immobilized. And be prepared for a long haul: healing can take several months, if not longer.
if immobilization is effective, and your bones do heal, you'll need follow-up care to protect your feet. This stage of treatment may include wearing custom orthotics, or more advanced options such as an ankle-foot orthosis (AFO). Finally, you may need special footwear to stabilize your joints, or to make room for any deformities that we haven't corrected.
Surgery for Charcot Foot: When is it Necessary?
You'll need to surgically treat Charcot foot if we can't manage your symptoms with casting, prescription footwear, or other assistive devices. Some of the procedures you may require include wound debridement for any ulcers that have formed. If Charcot foot has caused bone deformities, we may need to remove those pointed bones surgically. At the same time, we may need to stabilize other damaged bones in order to correct the foot deformity. Finally, since Charcot foot can cause problems with your Achilles tendon, we may also need to surgically address your tendon, giving you extra length in order to reduce pressure and help you walk comfortably.
Houston Podiatrist Prevents Diabetic Foot Complications
As we've just illustrated, Charcot foot neuropathy develops in stages. This condition sets in after nerve damage due to diabetes makes you lose sensation in your feet, allowing damage to your foot bones to go unnoticed. In the early stages of this condition, you'll notice symptoms that include warmth, redness, and swelling in your feet. But, without early intervention, symptoms will progress and get worse, causing damage to your bones and deformities in your foot.
If we start to treat Charcot foot in its early stages, we can use non-invasive treatments such as immobilization. Afterward, non-invasive devices such as orthotics or AFOs can keep the condition from returning. However, if we don't detect Charcot foot in its early stages, surgical treatment may be your only option. And, if we don't detect foot deformities at the stage where surgical correction is still possible, you may end up losing your limb altogether.
Now, we know that this sounds scary, but that's actually a good thing. We want you to be scared of diabetic foot complications. Because they are actually avoidable, as long as you engage in preventative foot care for diabetics. What does that involve? At home, you need to conduct daily foot checks, reporting any changes to our office right away. Already, this daily home care will go a long way toward preventing problems. But, alone, it's not enough. For that reason, we suggest that every diabetic schedules quarterly office visits for more comprehensive exams. So, if you're overdue for your next visit? Now's the time to reach out to the office and get an appointment on the books. We'll get you in as soon as possible. Because that's the best way to prevent any complications that could threaten your foot health!