Diabetic Charcot

Charcot is one of the many diabetes-related foot complications that can eventually lead to amputation. That being said, it’s imperative that you don’t delay treating any Charcot foot symptoms you may be experiencing.

Our foot and ankle surgeons at the Orthopedic Foot & Ankle Center are expertly trained in all forms of podiatry, including diabetic foot problems. Be sure to contact us today to make an appointment! We have multiple convenient locations throughout Greater Columbus, Ohio.

Do I Need Surgery?

Visiting an orthopedic surgeon doesn’t mean that surgery is necessary. Our orthopedic doctors always prefer to use non-surgical procedures to treat injuries.

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What is Charcot?

Charcot (also known as Charcot arthropathy) is a serious condition that affects the structure of your foot and can lead to severe deformity. It occurs when a person is unaware of an injury to their foot or ankle because of nerve damage called neuropathy. Diabetes mellitus is the most common reason for this damage.

Charcot affects the bones, soft tissue, and joints of the foot or ankle. Since many are unaware of the injury, they may continue to walk on the affected foot.

This can weaken structures in the foot and ankle or make fractures worse. This will eventually lead to foot deformity. Patients are susceptible to developing ulcers, which puts them at risk for ulcers, possible infection, and possible amputation. 

Who Does Charcot Foot Affect?

Charcot affects diabetic patients with neuropathy. They are unable to detect injuries to their foot and ankle because of damage to the nerves in their lower legs. The most common reason for this nerve damage is diabetes.

Other risk factors that can contribute towards Charcot foot include the following:

A doctor examining his patient for diabetic charcot.

Signs and Symptoms of Charcot Foot

A man with Charcot in Columbus, Ohio.

If you have Charcot, you will not normally feel much pain. However, you may experience the following symptoms:

  • Burning or tingling sensation: This is a result of nerve damage in the foot.
  • Swelling and redness: These symptoms are due to inflammation of the bones, joints, and surrounding soft tissues.
  • Deformity: The deformity occurs because the weakened bones in the affected area can no longer support the body weight, resulting in misalignment of the bones.
  • Cold feet: Cold feet occur because blood vessels become narrow and constricted due to nerve damage, thus reducing circulation to the feet.
  • Loss of sensation: This symptom is caused by nerve damage in the feet that can lead to partial or complete loss of feeling in the feet.

Causes of Charcot Deformity

As mentioned earlier, Charcot occurs when you injure your foot or ankle without realizing it. Because of the nerve damage, usually caused by diabetes, you lose feeling in your foot and ankle and are therefore unaware of the injury taking place.

The injury may come about in one of the following ways:

  • Traumatic events: You could fracture your foot or sprain your foot or ankle through a fall or other traumatic event.
  • Develop over time: When micro-traumas occur in a normal foot or ankle, you would adjust how you distribute your weight to avoid pressure on an injury. However, a diabetic foot may not feel the damage and continue to apply normal pressure to the injured area. Over time, the pressure can cause the bones to become weak and break.


The loss of sensation in the foot and ankle makes it difficult to identify the injury early on. With continued use, the injury may get worse, eventually leading to deformity.

Diagnosis of Charcot

Your doctor will begin by considering your symptoms and medical history. Then, during a physical exam, they will look for the following signs:

  • If you have warm, red, and swollen feet, the doctor may elevate them to see if it makes an improvement.
  • They will inspect the foot for ulcers or bony prominences, which may lead to ulcers.
  • The shape of the foot will be thoroughly evaluated to identify any evident deformities and to gauge whether they are potentially correctable or rigid.
  • Blood flow and sensation in the foot will be evaluated.


Your doctor may also request the following
image testing to see the bone structure and soft tissue:

  • X-rays: These may not detect fractures during the early onset of the disease. However, as the condition progresses, your doctor will likely see fractures or deformities.
  • MRI scan: An MRI scan can help your doctor to see the soft tissues and rule out inflammation and abscess.

Treatment of Charcot

It’s essential to seek early treatment for Charcot foot. This will help to avoid further damage, deformity, and other complications.

Treatment aims to achieve the following:

  • A stable, painless foot
  • Treat bone disease
  • Prevent new foot fractures/deformity


Your doctor will also want to prevent ulcers and infections from developing. Your treatment may include surgical and non-surgical procedures.

Non-Surgical Treatment for Charcot Foot

While the condition is in its early stages, nonsurgical treatments may be sufficient. The following are some of the no surgical treatments for Charcot foot:

  • Offloading: This treatment basically means to take the weight off your foot. Your doctor may use a protective boot or cast to protect your foot. You may also need to use crutches, a walker, or a wheelchair.
  • Orthopedic footwear: A device called a Charcot Restraint Orthotic Walker (CROW) may be used to relieve pressure and prevent repeat injury. This may be used in the latter stages of recovery.

Surgical Treatment for Charcot Foot

Surgery may be needed if you have serious ankle and/or foot deformities that are unstable and have the potential to develop a foot ulcer.

The following surgical treatments may be used while treating Charcot foot:

  • Debridement of ulcers: This is a surgical cleaning of the ulcer and removal of dead skin.
  • Lengthening the calf muscle or Achilles tendon: This can help relieve pressure points on the sole of your foot, which could cause ulcers.
  • Removal of bony prominences (exostectomy): Removing bony prominences will help avoid the development of ulcers.
  • Charcot deformity correction: Fractures and dislocations may sometimes need fixing with the use of plates, screws, and/or rods. This will help them to heal in the proper position.

Managing the Condition

Don’t delay in treating Charcot. Our foot and ankle surgeons at the Orthopedic Foot & Ankle Center are expertly trained in all pathology related to diabetes. Contact us today to make an appointment! We have convenient locations throughout Greater Columbus, OH. Our doctors look forward to giving you the care you deserve!

Medically reviewed by Terrence M. Philbin, DO

Our Diabetic Foot Care Specialist​s​

JUSTIN R. HUDSON, DPM

Board Certified Podiatric Surgeon and Wound Specialist

LYNETTE R. MEHL, DPM

Board Certified Podiatric Physician, Clinical Podiatrist

SARAH ABSHIER, DPM, CWS

Clinical Podiatrist, Certified Wound Specialist

ROBERTO A. BRANDÃO, DPM

Board Certified, Fellowship Trained Foot & Ankle Surgeon
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