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Family Foot Care & Surgery, LLC

Diabetic Foot Collapse – What to Expect from Treatment

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We won’t sugarcoat it.

Diabetic foot collapse—also known as Charcot foot—is one of the most serious and potentially catastrophic complications associated with diabetes. Without proper attention, Charcot foot can (and often does) lead to significantly impaired mobility, elevated risk of foot ulceration, and ultimately amputation.

But that doesn’t mean the situation is hopeless. Far from it. Understanding the risk factors, recognizing the early warning signs, and seeking out care as early as possible can make a huge difference in your quality of life—now and well into the future.

In short, you need to be prepared. Below, you’ll find more information about just what this condition is, how to recognize the warning signs, and what you can expect from treatment.

What Is Diabetic Foot Collapse / Charcot Foot?

Simply put, this condition happens when the bones, joints, and soft tissues holding them all together in the feet start to crack, crumble, and break down under strain.

Due to poor blood supply in the feet related to diabetes, bones and joints may become extremely brittle and susceptible to injuries.

At the same time, poor nerve function may dull any sensation of pain that you might otherwise feel, causing you to not realize you’ve been injured. As you continue to put weight on your broken foot, the fractures multiply and worsen.

In time, the foot itself may become significantly misshapen, even developing a rocker-bottom appearance.

Not only will this make standing, walking, and moving comfortably much more difficult (if not impossible), the deformed foot is far more likely to develop sores and infected wounds. This results in even greater disability, and quite possibly an amputation of the foot itself.

Who Is at Risk?

Charcot foot is most common in people who have advanced peripheral neuropathy. If nerve damage in your feet has left them feeling completely numb to pain, pressure, temperature, and other sensations, even severe injuries may be completely unfelt. This creates the necessary condition for Charcot foot to develop.

Diabetes is an extremely common contributing factor, given the high rate of diabetes globally and its strong link with peripheral neuropathy. However, those who have neuropathy for other reasons (smoking, alcoholism, etc.) are also susceptible.

How Can I Tell If I Have Charcot Foot?

Obviously, the sooner you notice a problem and seek help, the better your odds of a successful outcome.

The first and most important step is that you perform a thorough self-exam of your feet every single day if you have diabetes—especially if you have any symptoms of peripheral neuropathy. There’s a good breakdown of how you should do this in one of our previous blogs, but in short you should take about five minutes at a consistent time of day and use your eyes and hands to check every part of your foot carefully.

In regard to Charcot foot specifically, though, what should you be looking for?

Of course, if you are already seeing deformities in the feet, your situation has become critical. You need to immediately cease all weight-bearing activities and see a specialist as soon as possible.

But certain signs of Charcot foot can be identified before it reaches this stage. They include:

  • Redness
  • Swelling
  • Skin that is warm to the touch
  • Pain may or may not be present, depending on the severity of your neuropathy.

If you notice these symptoms, it’s not necessarily a guarantee that you have Charcot foot. But at the same time, it’s not worth the risk. Make an appointment with us as soon as you can.

What Can I Expect from Treatment?

Here is the basic breakdown of what you can expect after you make the call:

  • Testing. We will carefully examine your feet and take a few X-ray images to identify the extent of any damage to your bones and joints. We’ll also look for soft tissue damage, wounds, or infections. This is an important step to determine whether or not you truly have Charcot foot, and if so, whether or not surgery is necessary.
  • Surgery. A reconstructive procedure may be necessary if there is already significant damage to your foot structure, and if we think surgery would help improve the situation. However, if you catch Charcot foot early enough, there is a good chance we can skip this step.
  • Casting. Regardless of whether or not we perform a surgical procedure, your affected foot or feet will need to be immobilized so that they can heal, without risk of further damage from weight-bearing and motion. As swelling decreases, you may need periodic adjustment to the cast.
  • Resting. We’ll provide specific instructions to you about when you will be able to return to certain weight-bearing activities. In the meantime, though, it’s important that you take a nice long break from most of your regular tasks and avoid putting any unnecessary pressure on the feet. Crutches, a wheelchair, a walker, or other assistive devices may be prescribed as needed.
  • Wearing the right gear. Moving forward, it will be extremely important that you protect your feet from further damage and a recurrence of the problem. Often this means wearing custom orthotics with special therapeutic shoes. (Charcot foot shoes are usually built with rigid, rocker-bottom soles with an early pivot point and extra shock absorption characteristics.) In some cases, bracing may also be required.

You should expect the whole recovery process to take a minimum of a few months, with casting and resting taking the majority of the time. We’ll be able to provide a more accurate estimate of the time frame once we have an opportunity to examine your feet.

While that doesn’t sound like very much fun (and it isn’t), it’s important to remember that, in the grand scheme of things, it’s a small price to pay for preserving your feet and your mobility. Quick action, proper treatment, and disciplined follow-up care really can make the difference between years of healthy, mobile feet—or losing them for good.

And you don’t have to go in alone. The team at Family Foot Care & Surgery is going to be with you every step of the way. For more information or to schedule an appointment at one of our two convenient locations, give us a call at (203) 876-7736 today. You can also take advantage of our online request form to have a member of our staff reach out to you.

Dr. Sanjay V. Patel
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Dr. Patel has over 20 years of experience in the field of podiatric medicine and podiatric surgery.
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