Diabetic Foot Neuropathy or Charcot Foot & Podiatry

A complex condition with many far reaching consequences, diabetes is a condition which is a growing concern in the Western world, where factors like diet and lifestyle are causing an increase in the incidence of this metabolic disorder. At its roots caused by a disruption in the regulation of blood sugar levels, diabetes can cause a number of serious complications affecting the heart, kidneys, and lower limb.

Diabetic foot is one such complication, and one which has many individual pathologies leading to the overall condition. One of these is neuropathy, and in this article we look at diabetic foot neuropathy and the role podiatry plays in its treatment and management.


What is diabetic neuropathy/Charcot foot?

Known as Charcot joint/foot or neuropathic osteoarthropathy, this progressive damage to a vital joint plays a key role in the injuries, deformities, and infections that can lead to the need for an amputation. Charcot foot can have a number of underlying causes, of which diabetes mellitus is the major cause.

The condition is progressive and most sufferers won’t notice any sign of it until it has advanced past a certain point. Charcot foot involves a gradual wearing down of a weight bearing component of the foot. Over time the bone is slowly broken down, eventually resulting in a painful deformity which usually presents alongside a serious infection or ulceration. One of the foot’s primary functions is to bear our weight as we walk and run, as such, when this ability is compromised by Charcot foot, a person’s mobility and quality of life are badly affected.

The condition progresses through two key mechanisms. The first is a loss of feeling in the foot which has a number of side effects, including more frequent injury to the foot and subsequent inflammation. These and other consequences of this loss of sensation traumatise joints and contribute to the condition. The second is a change in the vasculature of the foot which can often trigger a sequence of events culminating in the resorption of bone, a process which essentially involves the body breaking down bits of bone for other uses.

Charcot foot can be hard to detect because the early symptoms, mild inflammation and swelling, can pass unnoticed for some time. As the condition progresses, pain and elevated temperature becoming prominent, as well as severe swelling and often visible deformities.

Charcot foot is considered quite serious not only because of the pain and level of debilitation involved, but because if left untended, infections in a Charcot foot can necessitate amputation. These infections can pose a serious threat to a person’s life, and in these instances sometimes removing the limb is the only way to stop its spread into the rest of the body.

Podiatry and Charcot foot

As a specialty focussing on the foot and its and care and treatment, podiatry is important in treating and maintaining diabetic foot, including Charcot joint should it occur.

The first step in the podiatric care of this condition is prevention. Diabetics are advised to attend regular appointments with podiatrists who will be able to provide useful advice as to what can be done to prevent the onset of this condition. This usually involves general foot care advice like what kind of footwear a patient should use to prevent undue stress on the joints of the foot.

Another role is information. A podiatrist will indicate what signs and symptoms a patient should watch out for if suffering from diabetes, allowing for an earlier detection of the condition, and hence more rapid treatment. The earlier Charcot foot and its underlying causes are detected, the more quickly action can be taken.

Podiatrists are also key in the detection of Charcot foot. As mentioned above, the early signs of Charcot foot can be quite subtle, and by attending regular appointments with a podiatrist, a diabetic can ensure that any tell-tale signs that the condition is developing are picked up on quickly, again allowing for more rapid treatment.

Finally podiatrists are closely involved in the treatment of Charcot foot. Depending on their qualifications and experience, podiatrists can prescribe medication and perform treatments, including certain foot surgeries, to address Charcot foot and alleviate the condition.

Because of the nature of Charcot foot, podiatry is closely involved in all areas of its prevention, diagnosis, and treatment. It is important to remember that diabetes is best managed by following doctors’ orders, including making the lifestyle changes known to effectively contribute to managing the disease. If the disease as a whole is managed effectively then the risk of diabetic foot is massively reduced.

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