Charcot Foot (Charcot Neuroarthropathy)

Bone and joint collapse due to neuropathy

Burning, tingling, or numbness in the feet caused by nerve damage. MLS laser helps regenerate nerve tissue and improve circulation, restoring feeling and reducing the discomfort that makes sleep and walking difficult.

• What causes it?

  Charcot foot is a serious — and often misdiagnosed — condition in which the bones of the foot progressively weaken, fracture, and collapse, leading to a severely deformed foot. It occurs in people with peripheral neuropathy, most commonly from diabetes.

  Because sensation is lost, small fractures that normally cause pain go undetected. The person continues walking on the injured foot, causing more fractures and joint destruction. Blood flow to the bones is also abnormally increased in neuropathic patients, which accelerates bone resorption. The result can be a collapsed, rocker-bottom foot deformity that dramatically increases ulcer risk.

• How do I know if I have it?

  Charcot is frequently mistaken for infection, gout, or a simple sprain in its early (acute) phase. The foot is swollen, red, and warm — but not painful, which is a key distinguishing feature in a neuropathic patient.

  X-rays may appear normal early in the process. MRI detects bone marrow edema (early Charcot) before collapse is visible on X-ray. Bone scan and CT scan are additional tools. Ruling out osteomyelitis (bone infection) is critical since treatment differs significantly — MRI with contrast is the most accurate test for this distinction.

  Temperature comparison between both feet can be used to monitor active vs. quiescent (healed) Charcot — active Charcot shows more than 2°C temperature difference.

• How is it treated?

  Early, aggressive offloading is the cornerstone of treatment. Total contact casting immobilizes the foot and prevents further collapse. The patient must be strictly non-weight-bearing until the acute phase resolves — this can take 3–6 months or longer.

  Once the Charcot is quiescent (bones have stabilized and temperature normalizes), custom Charcot restraint orthotic walkers (CROWs) or custom diabetic shoes with accommodative orthotics protect the deformed foot and prevent ulceration.

  Surgery is considered for patients with unstable deformity, recurrent ulceration, or infection that cannot be managed with orthotic accommodation. Charcot reconstruction surgery (realignment and fusion) is complex and high-risk but can be limb-saving in selected patients.

• Does more insurance cover treatment?

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