Charcot Foot is a serious condition that causes the bones and joints in the foot to weaken and break down. It happens in people who have nerve damage and have lost feeling in their feet — a condition called peripheral neuropathy.
People with certain medical conditions like diabetes are more likely to develop peripheral neuropathy, which puts them at risk for Charcot Foot.
A foot affected by Charcot may:
Look red
Feel hot
Be swollen
You might also have:
Pain (though not always, due to numbness)
Foot deformities (changes in the shape of the foot)
Ulcers (open sores on the foot)
When someone has lost feeling in their foot, they may not notice an injury like a small break or fracture. Because they can’t feel the pain, they may keep walking on the injured foot, which causes more damage.
Over time:
The bones can break or collapse
The foot can become deformed
Ulcers can form from pressure points created by the new foot shape
Charcot Foot can get worse quickly, so it’s important to get medical attention early if you notice signs like redness, swelling, or warmth in your foot.
The exact cause of Charcot Joint (also known as Charcot Foot when it affects the foot) isn’t fully understood, but two main factors are believed to work together:
Changes in blood flow can affect bone health. In some people, increased blood flow to the foot (a condition called hyperemia) may lead to bone loss over time. This makes the bones weaker and more likely to fracture.
Conditions like diabetes can damage the nerves in the feet — this is called peripheral neuropathy. When this happens:
You may not feel pain, pressure, or injuries.
Minor injuries like sprains or small bone fractures can go unnoticed.
Because there’s no pain, the person keeps walking on the injured foot, causing more damage over time.
This ongoing damage, without the body’s usual warning signs (like pain), can lead to severe bone and joint breakdown, deformity, and even ulcers.
Charcot Joint develops when nerve damage and changes in blood flow make the bones weaker, and the person doesn’t feel injuries that happen. As a result, the foot continues to be used instead of rested, leading to more serious damage.
This stage happens before the bones start to break or the foot changes shape.
The person has lost feeling in their foot (called loss of protective sensation).
There may have been a small injury, like a twist or sprain, but they didn’t feel it.
The body may start to react with inflammation (redness, heat, swelling), even though the bones still look normal on an X-ray.
Why it matters:
This is an early warning sign. Catching it now can help stop Charcot Foot before it starts.
This is the beginning of Charcot Foot.
The foot becomes red, warm, and swollen.
The bones inside may break or move out of place, but you might not feel it because of nerve damage.
You may still be walking on it without realizing there’s a problem.
Why it matters:
This is the most important stage to catch early. If treated now, more damage can be prevented.
This is when the body starts to repair the damage.
Swelling and redness begin to go down.
The bones start to heal, but they may heal in the wrong position.
The shape of your foot may start to look different or become deformed.
Why it matters:
Proper care and support (like special boots or braces) can help prevent your foot from getting worse.
The foot has healed, but not in the normal shape.
The foot is no longer hot or swollen.
The bones are now hard again, but the foot is often permanently deformed.
Because of the new shape, you’re at a higher risk for ulcers or sores.
Why it matters:
You’ll need long-term care, such as custom shoes or braces, to protect your foot and keep it healthy.
When someone has Charcot Foot, the bones in the foot or ankle are fragile and broken. To help them heal properly, the foot needs to be protected and kept still (this is called immobilization).
If the foot is not protected, the bones can shift and the whole shape of the foot can collapse.
Treatment for Charcot Foot is different for each person. The healthcare team looks at many things to decide the best plan, such as:
Medical history
Any other health problems
Balance and feeling in the feet
Support from family or caregivers
How much damage there is to the foot
Once the foot has healed and become stable, some people may be able to switch to orthopaedic shoes with a custom foot insert (orthosis) to help protect the foot and prevent further problems.
Non-weight bearing means you do not put any weight on your foot — not even to stand or walk.
This is one of the best ways to protect a Charcot foot and give it time to heal.
But it can be very hard to do all the time, especially in daily life.
To help, there are tools like:
Wheelchairs
Crutches
Knee scooters (a wheeled device you rest your knee on while moving)
These can make it easier to stay off your foot and protect it from more damage.
A Removable Cast Walker (RCW) is a special boot that works like a cast to protect and support the foot.
It can be taken off to change bandages or sometimes while sleeping.
It’s often used by people with a regular-shaped foot and ankle.
It only works well if it is worn all the time when standing or walking.
Sometimes, the RCW is adjusted or customized to better fit a person’s foot for more comfort and support.
A Total Contact Cast (TCC) is a special cast made from fiberglass or plaster. It is put on by a Certified Orthotist or trained technician.
The cast covers your foot and lower leg to keep the bones and joints still while they heal.
It gives great protection for a Charcot Foot.
However, because the cast can’t be removed, it’s hard to check the skin underneath.
This means there is a risk of getting a sore (ulcer) if there’s too much pressure in one spot.
A CROW walker is a custom-made brace that fits the foot and ankle.
It is made by creating a mold of the person’s foot and ankle.
The CROW walker is used to keep the foot and ankle still (immobilized) and help with healing.
It’s especially helpful for people who have severe foot deformities or ulcers.
