Charcot foot (Charcot neuroarthropathy) happens when the bones of a foot with nerve damage weaken and begin to collapse. Because sensation is reduced, people often keep walking on it — which is exactly what causes the damage.
The early signs
- A foot that is red, warm and swollen
- Often little or no pain, despite dramatic swelling
- Usually one foot only
- No obvious wound or injury to explain it
- Sometimes mistaken for infection, gout or a sprain
Why early diagnosis matters
In the early, active phase the bones are soft. If the foot is protected and offloaded at this stage — usually with a total contact cast or removable walker — the architecture of the foot can often be preserved. If walking continues, the arch collapses into a "rocker bottom" shape that is very difficult to fit into footwear and prone to ulcers for life.
Treatment
Treatment is largely about immobilisation and time: casting, strict offloading, regular review and, once the bone activity settles, custom footwear or bracing. Surgery is reserved for severe deformity or instability.
The rule to remember
If you have diabetes and one foot becomes warm and swollen — with or without pain — stop weight-bearing on it and get it assessed the same day.
This article is for general information and does not replace an individual consultation. If you are worried about your child or yourself, please book an appointment.