"Charcot foot" is a debilitating condition that is named for a French neurologist and professor of anatomical pathology in the 1800's. It arises in patients who develop a peripheral neuropathy, often from diabetes, that produces progressively worsening numbness and loss of sensation in the feet. Patients with this disorder sustain repeated trauma to their foot, that includes various fractures and dislocations of bones, that they do not feel. They continue to walk on a foot that's being progressively damaged, which gradually becomes increasingly more deformed as the joints and bones of the foot collapse, often taking on a "rocker-bottom" appearance, .
Charcot foot may cause severe deformity of the foot (or sometimes the ankle) and be associated with considerable disability, including impairment of standing or walking. Amputation may be required in extreme cases.
Charcot foot is frequently a complication of diabetic neuropathy, or some other type of peripheral neuropathy, that impairs sensation in the lower extremities to the extent that the patient is unable to feel temperature, pain, injury, or even fractures to the bones of the feet. In the ordinary course of their daily routine, patients sustain repeated trauma to their foot, while failing to notice that the foot is becoming deformed. They continue to walk on it and increase the damage to the foot.
There are two sets of symptoms. There are symptoms from neuropathy that include pain, numbness, tingling, and loss of sensation, and there are symptoms related to Charcot joint that include increased redness (erythema), increased warmth, swelling, and pain in the affected foot.
The diagnosis of Charcot foot is usually made on the basis of a medical history and physical examination in a patient who has diabetes and neuropathy, and confirming the diagnosis by performing x-rays and imaging studies. It is important to have a high index of suspicion for this condition in any diabetic patient who has neuropathy in the lower extremities.
Early diagnosis can lead to early treatment, which may help prevent the serious deformities that occur to the foot when treatment is delayed and the bones of the foot collapse.
Monitor your blood sugar and A1C with your doctor and try to keep the diabetes under good control. Good diabetic control will help decrease the likelihood that the neuropathy will progress, and that will help to prevent the development of Charcot foot.
Try to avoid injuries to the lower extremities.
Have regular check-ups with your doctor.
See the doctor promptly, if you notice any persistent color or temperature changes in your foot or if your foot becomes swollen or develops deformities.
Your doctor may require you to become completely non-weight bearing for a period of time, which may be weeks or months. That's to allow the bones to heal themselves and to stop the foot from collapsing. When some walking is allowed, your foot may be put in a cast, boot, or brace, and you may be instructed to use crutches or a wheelchair. Some patients, whose foot deformities have progressed, may rquire surgery, such as realignment of bones, fusion of the bones, or removal of part of the bone.
Getting Disability Benefits for Charcot Foot
With Charcot foot, walking and standing may be markedly impaired by pain and deformity, which your doctor must document with specificity in your medcial record. It's not enough for the doctor to simply document that you are disabled from being able to work, without specifying what elements of your job you are no longer able to do. In order to successfully obtain disailibty benefits from either the Social Security Administration (SSDI) or an employer-provided plan (ERISA), your medical records must make clear the specific functional limitations and restrictions you have that disable you from working.
Your disablity lawyer must work closely with your treating physician to get the proper documentation of your specific findings and impairments into the medical records. At Law Med that's what we do.