(Note that Charcots disease is not the same as CMT or Charcot Marie Tooth Disease. Use the search box again to find the FAQ on that condition.)
There is a kind of joint disease found almost exclusively in sufferers of diabetes called Charcots disease. It occurs when the sensory nerves that supply a joint lose their ability to report the joint’s position back to the brain effectively. The brain is then unable to sense when the joint is being used incorrectly, for example moving too fast through its range of motion without the muscles being called in to put the brakes on, as would usually occur. This can result in the joints being put under unmanageable pressure and destroyed. This is particularly common in the joint just below the ankle called the subtalar joint.
There is quite a long process to build up to developing Charcots disease in that nerve damage will usually take many years to progress. Unfortunately, there are very few signs that are obvious to the sufferer and when the disease process starts, the damage escalates very quickly. The joint can go from being disordered but working fairly normally, to being ruined in one day as one step becomes the straw that broke the camel’s back. If you suffer from neuropathy in your feet, you must see your podiatrist and have your foot function assessed. If you don’t know if you have neuropathy or not, make an appointment today to see a podiatrist and find out. If no damage has occurred within your foot joints as yet, a shoe insert called an orthotic can dramatically reduce future damage to the joints and make a Charcots breakdown far less likely. Even if you are found to have no symptoms, within our podiatry clinic, if you are assessed to have lack of sensation in the joint, a support will be crafted for you to protect the joint in the future. If you already have developed Charcot foot, an orthotic may help to make the position in which the foot will soon become permanently frozen, a better one. If your foot is already fused in a bad position, parts of the foot will be bearing a lot of pressure which is a precursor for developing pressure ulcers. Overloaded areas can be managed with a pressure deflecting insert.
To read this Q&A session on charcots disease as a single handbook, or to access the downloadable / printable version, please browse to our Diabetes Info Sheet. Alternatively, use this link to return to the Podiatry FAQs Blog.