The field of medicine is constantly changing as new discoveries are made about how our bodies function. Neurology is the branch of medicine that deals with the nervous system, and much of its basic knowledge was established in the 19th Century by a French physician named Jean-Martin Charcot. He recognized the relationship between peripheral neuropathy and a breakdown in the structure of the foot, for example. The condition Charcot foot has carried his name ever since, but more is being discovered about it every year.
Diabetes and Breakdown of the Foot Structure
These days, Charcot foot is more likely to be a complication of diabetes rather than a result of other possible causes, such as polio or leprosy. If you have diabetes, uncontrolled glucose levels can damage the nerves in your extremities (peripheral neuropathy) and affect your blood vessels, and that can cause problems with the bones and joints in your feet.
Researchers are still discovering more about why this should be, but the combination of loss of sensation (which means you may not notice an injury) and compromised circulation (which prevents nutrients and oxygen from reaching your cells) can lead to weak bones, fractures that you can’t see or feel, and poor healing.
Keep an Eye Out for These Signs of Charcot Foot
Unlike many other foot problems, pain is not the first symptom of this condition. In fact, the lack of pain is a problem, because you may not realize anything is wrong. If your feet don’t hurt, you keep walking on your damaged bones, and they continue to disintegrate and move out of position, until the entire structure of your foot can collapse. You need to check your feet every day to look for other symptoms of this problem.
Two early indicators are swelling and redness. Your body’s response to injury is to rush blood to the area, so swelling, or edema, is a sign that something is going wrong. The skin may look red from the increased pooling of blood as well. These symptoms are sometimes mistaken for an infection in the bone, but that rarely happens if there is no break in the skin.
If you notice either of these symptoms but have no recollection of a recent injury, you should come into our office for imaging tests. X-rays can show evidence of small fractures and bones that are starting to move out of alignment. MRIs can show soft tissue damage or presence of an infection. If we catch the problem early, there is a much better chance that conservative treatment will head off more serious issues.
Helping Bones Heal
The two most important treatments are keeping weight off your foot and keeping it immobile so the bones can heal. A cast is often used, which not only holds bones in position, but also helps control swelling. The cast will be changed every week or two until the foot and ankle are normal size again. Casting is accompanied by use of crutches, a knee walker, or a wheelchair, so you don’t put any weight on the foot. Healing can take three months or more.
If the collapse has deformed your foot, you may not be able to wear normal shoes even after the bones have healed. Prescription diabetic shoes are designed to keep pressure off sensitive areas and avoid the development of ulcers.
There are times when conservative treatment does not adequately deal with Charcot foot. In that case, you will be referred to a specialist for possible surgery. The best thing you can do to prevent this possibility is to keep your blood sugar levels under strict control, so the nerve damage doesn’t occur in the first place.
Chiropodist Tony Abbott has the expertise and training to help you identify and treat diabetic foot complications. Give Abbott Foot & Ankle Clinic in Collingwood a call at (705) 444-9929 to set up an appointment. We want to help your feet stay healthy to support you throughout life!