Diabetic peripheral neuropathy can make the feet numb and reduce sensitivity to pain. Without the ability to feel pain, a person may not know when and how to protect an injured area. Therefore, they just keep walking on the injured foot.
Walking on an injured foot can cause some bones to break. This can crack, splinter and erode bones in the feet. The affected foot can then take on a deformed appearance as joints shift, changing their position and shape. Sometimes the deformity is so severe that instead of having a normal arch on the sole, it may actually become convex and take on a rocker-bottom appearance. This is referred to as a Charcot foot. The acute changes in a Charcot foot may cause the foot to swell and become red and warm to the touch. Bone infections like Charcot foot require antibiotics, sometimes for months.
Treatment of a Charcot foot begins with immobilization. During the acute stage, the foot is fragile, susceptible to further damage, and must be protected. This is often done by casting, splinting and the use of crutches or even a wheelchair. Once the foot changes shape and heals in the abnormal position, however, surgery may be needed to remodel the bones.
Sometimes molded shoes, or shoe inserts (orthoses), can remove enough pressure from these bones to adequately protect them.
Solutions and Prevention
What can you do to prevent these devastating changes? First of all, tight control of your diabetes may delay or prevent the onset of the neuropathy that is the underlying cause of Charcot foot deformity. If you already have neuropathy, speak with your podiatrist about preventative diabetic foot care. Also, examine your feet daily. If you notice any changes in shape, color or temperature, call your podiatrist for advice immediately.