What it is
Charcot foot, also called Charcot neuroarthropathy, is a condition in which the bones and joints of the foot become weakened and may shift or collapse. It is most often associated with nerve damage (neuropathy) that reduces feeling in the foot, including in people living with diabetes.
Because the foot may not feel pain normally, small injuries, pressure or stress on the bones can go unnoticed. Over time the shape of the foot can change, sometimes creating new pressure points where skin can break down and ulcers can form.
Early signs people sometimes describe include a foot that looks swollen, feels warmer than the other foot, or looks red, often with little pain. These signs can overlap with infection and other problems, so only a licensed clinician can tell what is going on after an evaluation.
How it’s traditionally been approached
Care for Charcot foot has traditionally centered on reducing stress and pressure on the affected foot. Clinicians have commonly used offloading approaches such as casts, boots, or other protective devices, with the specific choice made by a provider after an evaluation.
When an ulcer is present, wound care specialists have commonly assessed the wound, cleaned and removed unhealthy tissue when appropriate, selected dressings, checked for infection, and looked at blood flow and overall health. Imaging such as X-rays or other scans is often part of how clinicians evaluate the bones.
Over time, some people also work with providers on custom footwear, bracing, or monitoring for changes in foot shape. In some situations clinicians have considered surgery. Other therapies, such as negative pressure wound therapy, are also used in certain wounds. Whether any of these fit a given person is a decision for a licensed clinician.
How the right wound care specialist may help
The right wound care specialist may help by looking at the whole picture: the wound itself, the shape and stability of the foot, circulation, nerve sensation, blood sugar management, and footwear. A visit generally includes a history, a careful foot and wound exam, and sometimes imaging or other tests.
The specialist may coordinate with other professionals, such as podiatrists, orthopedic or vascular specialists, endocrinologists, orthotists, and primary care clinicians. This team approach is common because Charcot foot and foot ulcers often involve several systems at once.
Questions worth asking a licensed provider include: What is causing my wound? How is it staged or classified? What are my treatment and offloading options? How long might healing take, and what could slow it? What signs should prompt me to call you? What is covered by my insurance? Ask also about any products, such as skin substitutes or amniotic grafts, since their FDA status varies and coverage differs by product and payer. For further reading on amniotic products specifically, amnioticdoctors.com is an independent resource.
The whole-person view
Living with a foot condition can affect the whole person. Reduced mobility, time spent offloading, worry about wounds, and changes to daily routines can raise stress, and stress and sleep can in turn influence how the body feels and how people manage their health. Body, mind and stress affect each other.
Some people find body-based support helpful for reconnecting with their physical sense of safety and comfort, and Somatic Experiences lists practitioners who offer this. Others prefer to talk through the emotional load of a long recovery with a licensed counselor, and Therapists.plus can help people find talk therapy. These are complements to, not replacements for, medical care.
Somatic Experiences: trauma and emotional healing →Somatic Experiences: embodiment and movement →Therapists.plus: mind body connection →
Keep in mind
- Seek medical care promptly for any sign of infection: spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills, or a wound that is rapidly worsening.
- Call 911 or go to the ER for heavy bleeding, exposed bone or tendon, signs of sepsis, or a deep or severely contaminated wound, such as from a serious accident.
- Only a licensed clinician can diagnose Charcot foot and decide what care is appropriate after an evaluation. This page does not replace professional guidance.
- If you are in crisis or feeling overwhelmed, call or text 988 to reach the Suicide & Crisis Lifeline.
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Frequently asked questions
What is charcot foot wound care?
Charcot foot wound care is the professional management of skin breakdown or ulcers on a foot affected by Charcot neuroarthropathy, along with protecting the weakened bones and joints. It commonly involves wound assessment, offloading, infection checks and coordination among providers. A licensed clinician decides the specific approach.
What causes Charcot foot?
Charcot foot is most often linked to nerve damage that reduces feeling in the foot, including neuropathy related to diabetes. Without normal pain signals, repeated stress or minor injury may go unnoticed and bones can weaken. A provider can evaluate the cause in your case.
Can a Charcot foot ulcer heal?
Many foot ulcers can heal with appropriate professional care, but results vary and are never guaranteed. Healing can depend on offloading, blood flow, infection, blood sugar management and overall health. Ask your provider about expected healing time for your wound.
What are the warning signs of a Charcot foot problem?
Common signs include swelling, warmth and redness in one foot, often with little pain, and sometimes a change in the foot's shape. These signs can resemble infection, so see a licensed clinician promptly rather than waiting.
What kind of specialist treats Charcot foot wounds?
Wound care specialists, podiatrists, orthopedic and vascular specialists, and endocrinologists may all be involved. Many people see a team, depending on the wound and foot condition. Your primary care clinician can help point you toward an evaluation.
Is hyperbaric oxygen or a skin substitute used for Charcot foot wounds?
Some providers use hyperbaric oxygen therapy for certain diabetic foot ulcers within FDA-cleared indications, and skin substitutes or grafts are sometimes considered for some wounds. Their FDA status varies, coverage differs by product and payer, and results are not promised. Ask a licensed provider whether any option is appropriate for you.
Educational resource. WoundKare shares general information and connects people with independent wound care specialists. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.