Charcot Foot: What It Is, Who’s at Risk, and How to Protect Your Feet

“Pain is a gift. Without it, your body doesn’t know to pull back—and you keep walking on damage.”

Welcome to The Diabetes Podcast blog. Today we’re talking about Charcot foot. If you’ve never heard of it, you are not alone. Charcot foot can quietly damage and deform your foot—even without pain. That’s why awareness matters. We sat down with Wayne Walker, host of The Trouble aFoot Podcast, to learn what every person with diabetes should know. Wayne blends lived experience, advocacy, and hope. This blog is here to help you spot signs early, make good choices, and feel supported.

What Is Charcot Foot?

• Medical name: neuropathic arthropathy

• Plain words: a bone and joint problem in the foot (and sometimes ankle) that happens when nerves don’t work well

• What happens: the bones get weak and can collapse. The midfoot often drops, and the arch can bulge down. This is called a “rocker bottom” foot.

Why It’s So Tricky

• It often doesn’t hurt because of neuropathy (nerve damage). Pain is the body’s alarm, and neuropathy turns the alarm off.

• People keep walking on it because it doesn’t hurt. That makes the damage worse.

• Bones shift downward. The midfoot can press into the skin, forming a lump. Walking on that lump can create an ulcer.

• Ulcers can get infected fast. Infection can spread to the bone (osteomyelitis). This can threaten your limb and your life.

Who Is Most at Risk?

Studies and lived experience suggest higher risk if:

• You have diabetes and peripheral neuropathy

• You have extra body weight (often obesity)

• You’ve been on your feet for years on hard surfaces (work or sports)
  Important: You do not have to be older. Charcot foot can show up in younger people with neuropathy and good circulation. Good blood flow can increase swelling and heat, which can speed up damage in the acute phase.

How Common Is Charcot Foot?

• Estimates vary. Roughly 1–4 out of 1,000 people with diabetes may develop Charcot foot.

• Among people with neuropathy, risk is much higher—some estimates suggest around 13%.

• You can also develop Charcot foot without diabetes if you have neuropathy from other causes.

Real-Life Warning Stories

Wayne shared this: years before diagnosis, he pulled a power cord out of his foot. The metal prongs were stuck in his sole. He didn’t feel it. Another story: a man worked all day with a nail through his boot into his foot. He only found out when he saw blood. This is how severe neuropathy can be—no pain, even with major injury.

Early Signs of Charcot Foot (Don’t Ignore These)

• Swelling in one foot (often sudden)

• Warmth and redness in that foot

• A feeling like you “twisted your ankle” but it doesn’t hurt

• A change in how your foot looks or how you walk

• A new bump on the bottom of your arch (rocker bottom)

• Fever with foot swelling or an open sore

What To Do Right Away

• Take your temperature if your foot is swollen, hot, or red.

• If you have a fever or the foot looks “wrong,” go to the ER or urgent care.

• Ask directly: “Could this be acute Charcot foot?”

• Stop putting weight on that foot until you see a specialist (podiatrist or foot/ankle orthopedic surgeon). Offloading matters.

Diagnosis

Your care team may use:

• Physical exam (checking temperature difference and swelling)

• X-ray (may look normal very early)

• MRI or other imaging to see bone and joint changes

Treatment Options (What Doctors Often Discuss)

• Offloading and orthotics: Special boots, casts, or custom orthotics to stop the pounding and let the bones settle. Some people stay with this long-term to protect the foot.

• Reconstructive surgery: To realign and stabilize bones. This can help create a “feasible” foot for daily life.

• Amputation (often below the knee): Removes the problem and infection risk. Many people choose this and do well with modern prosthetics.

There is no single “right” choice. It’s personal. A great doctor will explain pros and cons for your life, your other foot, your goals, and your support system.

Why “No Pain” Is Not “No Problem”

Pain protects us. With severe neuropathy, you can keep walking on a broken or collapsing foot because you don’t feel it. This is why early action is vital. Offload as soon as you suspect Charcot foot.

Daily Foot Care: Small Habits, Big Impact

• Check your feet every day. Look for redness, swelling, cuts, blisters, or new bumps. If you can’t see the bottom, use a mirror or ask someone to help.

• Wear protective, well-fitting shoes. Avoid thin, worn-out, or tight shoes. Get diabetic-friendly footwear if recommended.

• Keep skin clean and dry. Moisturize tops and bottoms, not between toes.

• Trim nails carefully or have them trimmed professionally.

• Never walk barefoot, even at home.

• Call your doctor fast for any sore, blister, cut, or swelling—especially if you have a fever.

Support, Hope, and Real Talk

Charcot foot can feel scary. But you are not alone. Wayne’s message:

• It’s okay to feel shocked at first. Many people have never heard of Charcot foot until it hits.

• You still have a life to live. You can adapt, protect your other foot, and find a new normal.

• A foot can be “feasible” even if it’s not perfect. You may not run marathons, but you can still walk your dog around the block. That hope matters.

What Wayne Wishes He Knew Earlier

• Footwear matters. Supportive shoes may help reduce long-term pounding on your feet.

• Early action matters. Don’t wait on swelling, warmth, or redness.

• Education is key. Learn the signs, check your feet, and see specialists sooner.

• Ask direct questions. “Could this be Charcot foot?” “How do I offload right now?”

How to Talk With Your Doctor

• “I have diabetes and neuropathy. My foot is warm, red, and swollen.”

• “I read about Charcot foot. Can we check for that?”

• “Do I need an offloading boot or cast?”

• “What are my treatment options—orthotics, reconstruction, or amputation? What fits my life best?”

• “How do I protect my other foot?”

If You’re Newly Diagnosed

• Take a breath. You have options.

• Offload now. Follow the plan to protect bone and skin.

• Build your team. Podiatrist, foot/ankle surgeon, diabetes clinician, wound care, physical therapist, and a supportive community.

• Join support spaces. Hearing from people who “get it” helps a lot.

Discover the Trouble aFoot Podcast

If Charcot foot is part of your life—or your doctor even mentioned it—check out Wayne Walker’s Trouble aFoot Podcast. It’s a safe place to hear real stories, learn, and feel supported. You’ll find community, practical tips, and hope.

Key Takeaways

• Charcot foot can deform your foot without pain.

• Swelling, warmth, and redness in one foot are red flags.

• Offload early. Don’t “walk it off.”

• Treatment choices include orthotics, reconstructive surgery, and amputation. There is no one-size-fits-all.

• Daily foot checks and good shoes are powerful.

• You are not alone. Support is here.

You Can Do This

Take care of your feet, your body, and your mind. Share this with someone who needs it. Knowledge, support, and connection make a real difference. We’re here to help. You can reach us at [email protected].

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