Is Charcot Foot Hereditary?

Charcot Foot Hereditary
If you have diabetes and peripheral neuropathy, you face the possibility of developing Charcot Foot. The condition attacks the joints and soft tissues of your feet, weakening your bones. But, what you might not know is Charcot Foot is also hereditary.

While there are many genetic mutations associated with Charcot Foot, treatment options are available. Talk with your doctor to determine if and what type of Charcot Foot you might have.

How common is Charcot Foot?

According to Foundation for Peripheral Neuropathy, Charcot Foot affects approximately 1 in every 2,500 Americans, totaling roughly 125,000 people. Over time, it can cause painful sores and change the shape of your foot.

What causes it?

Mutations in the genes that control the structure and function of the nerves outside your brain and spinal cord, called your peripheral nerves, cause Charcot Foot. As it progresses, the nerves degenerate and lose the ability to communicate, leading to muscle weakness and atrophy, as well as a reduced ability to feel cold, heat, and pain.

What’s the impact?

There are five main types of hereditary Charcot Foot. Some affect the fatty covering over your nerves, called myelin, that protects and helps cells transmit impulses. Others directly affect your nerves, causing muscle weakness and atrophy.

Ultimately, they all result is the same types of outcomes. Charcot Foot can be prompted by an injury that isn’t treated in a timely fashion, leading your arch to drop below your toes to create a “rocker bottom.” Your foot can become reddish, warm to the touch, or swollen. Additionally, your toes can curl, and your ankle can twist. The misshapen bones can press against your shoes to create sores and ulcers that can get infected and potentially lead to amputation.

Be sure to work with an orthopedist, podiatrist, or foot center that specializes in diabetes care to manage your Charcot Foot.

How can you treat it?

Even though you may not be able to stop all symptoms associated with Charcot Foot, you can treat it. Follow these steps to minimize the impact.

  1. Get regular check-ups with a foot doctor who has experience treating diabetic foot problems.
  2. Check your feet daily for swelling, redness, warm spots, and sores. Check between your toes, too.
  3. Wash your feet daily, and dry them thoroughly.
  4. Always wear socks and shoes.
  5. Keep your blood sugar levels under control — between 80-130 mg/dL before eating, under 180 mg/dL after.
  6. Take extra care to avoid injury, particularly while exercising.
  7. Strictly immobilize your foot or ankle with a cast if recommended by your doctor.
  8. Practice non-weight bearing measure to alleviate stress on your foot.

For more information about hereditary Charcot Foot, contact the Amputation Prevention Centers of America.

Treating Charcot Foot: Surgery or Not?

Treating Charcot Foot
If you have peripheral neuropathy, there’s a chance you could also develop Charcot foot. This condition weakens the bones of your foot, as well as your joints and soft tissues, while causing painful sores or changing the shape of your foot.

As many as 2.5 percent of patients with diabetes can develop Charcot foot, and it can recur in as many as five percent of cases.

Fortunately, your doctor can help you in treating Charcot foot, largely reversing the damage it causes. Depending upon the severity of your case, you could receive medical or surgical therapy. Any treatment option you receive will have similar goals: take weight off the injured foot, address bone disease, and prevent future foot fractures.

Charcot Foot Diagnosis 

Imaging scans can help your doctor determine what treatment type you need. X-rays offer detailed pictures of dense structures, such as bones. MRI and ultrasound provide good imaging of foot and ankle soft tissues, potentially identifying any bone infections. Bone scans are nuclear tests that can also identify bone infections. A specific test — an indium scan — tags your white blood cells and follows them to the infection site.

Treating Charcot Foot

Whether your doctor recommends surgical or non-surgical treatment, you will get the best long-term results if you closely follow your physician’s instructions. Most specifically, wait until he or she tells you it’s safe to put weight on your foot again.

Also, be sure to check your feet daily for any problems, including scrapes or lingering sores. If any exist, immediately contact your doctor. The sooner you get treatment, the more likely you are to have a good outcome.

Non-surgical treatment: Offloading — keeping your weight off your affected foot — is the most important part of treating Charcot foot without surgery. For anywhere from 8-to-12 weeks, you’ll wear a protective walking boot or cast. The protective footwear should stay in place until any redness, swelling, or heat disappears. The Charcot Restraint Orthotic Walker (CROW) is a commonly used device.

The second step is prescription orthotic shoes. These shoes must fit appropriately, providing enough room for your toes and enough cushioning for the heel, arch, and ball of your foot. The right shoes won’t have any pressure points, reducing the risk of injury or ulcers.

You’ll also need to change your activities to avoid repetitive trauma to both feet.

Surgical treatment: Surgery is recommended for individuals with severe ankle and foot deformities that could make using a brace or other orthotics difficult. These patients are also at a higher risk for developing foot ulcers.

Surgery could involve re-aligning the bones of your foot or removing some that could cause ulcers. According to recent research, most patients with diabetes are able to resume normal walking after surgery.

Because infection risk is high post-surgery, you’ll be instructed not to put your full weight on your foot until your doctor gives you the green light. You’ll also need to commit to wearing protective footwear for life.

Remember, it is possible for Charcot foot to return, so stay vigilant with your foot hygiene.

For more information on treating Charcot foot, contact the Amputation Prevention Centers of America.