Diabetic Foot Conditions

Damage and deterioration of the joint is known as arthropathy. Arthritis, for example, is a common cause of ankle arthropathy and also includes inflammation of the joint. When the ankle joint is affected, ankle sprains, fractures, and dislocations may become more likely and your movement may become limited due to pain and deformity.

Treatment involves addressing the cause of the joint damage and treating symptoms. Depending on the severity of your symptoms, this may include medication, physical therapy, and surgery.

This particular foot deformity is a serious complication of diabetes that can cause disability or even lead to the need for amputation. It stems from nerve and blood vessel damage that weakens the bones enough to change the shape of your foot.

A telltale sign of Charcot foot is what is called “rocker bottom,” in which a bony bulge develops on the sole of the foot. This occurs after bones in the foot weaken, fracture, and become repositioned due to continued walking on the fractured foot. Nerve damage due to diabetic neuropathy, for example, is what allows a person to continue to walk on a fractured foot without feeling pain. Doing so permits the condition to progress to the point of deformity.

Early diagnosis of Charcot foot is critical for successful treatment. Symptoms include a foot that is red, warm, inflamed, or tender to the touch. X-rays can evaluate the extent of the damage.

Reconstructive surgery may be required if the damage is severe. If not, immobilization (as with casts, boots, or braces) and custom orthotics may help weakened bones repair themselves. Keeping weight off the foot while it heals can have a significant impact on your recovery as well.

Neuropathy is a type of nerve damage or loss of nerve function that can cause pain as well as reduced ability to feel sensations, especially in the extremities. For example, a person with uncontrolled diabetes may fail to notice if the shoes they are wearing are too tight or feel blisters or sores that subsequently develop. Foot ulcers that become infected can result in tissue death (gangrene).

The nerve damage caused by diabetic neuropathy cannot be reversed, but its progression can be halted by managing your diabetes. By keeping your blood sugar levels within a normal range, patients with diabetic neuropathy can prevent additional nerve damage.

Typical symptoms of diabetic neuropathy include pain, tingling, numbness, weakness, and a loss of feeling or sensation, especially in the limbs.

Your doctor may recommend medications to address neuropathy symptoms such as painkillers and certain anti-seizure drugs that are sometimes used to ease nerve pain.

Foot ulcers are open sores on the skin of the foot. These tend to develop on the ball of the foot or at the bottom of the big toe – areas that absorb the most pressure when walking. Trauma and circulatory problems cause skin tissue to break down in a particular spot, creating the ulcer.

Even if you are experiencing no pain or other symptoms, if you see an ulcer or open wound on your feet, see your doctor as soon as possible. The podiatrists at The Podiatry Group of South Texas are experts at identifying and treating injuries to prevent more serious complications for their diabetic patients.

Uncontrolled diabetes makes it very difficult to fight infection. That is why it is so important for diabetic patients to closely monitor the health and condition of their feet.

A blister caused by poor-fitting shoes can lead to an open sore, which may then become infected within a matter of days. Gangrene, or tissue death due to a lack of blood, can occur and can be life-threatening if it spreads.

Smoking compounds the problem: it decreases blood flow to the feet and can inhibit wound healing. In fact, many diabetic patients who undergo amputation are smokers.

For patients with advanced nonhealing wounds and infection that has spread, our goal is to save the foot and leg from amputation, also known as limb salvage. Our foot and ankle surgeons remove dead and diseased tissue and replace it with tissue from other areas of the body to save part or all of your foot.

Peripheral vascular disease (PVD) is an extremely common circulatory condition among diabetics. Diabetes can cause the blood vessels to narrow and harden, reducing blood flow to the hands and feet and causing numbness, tingling, swelling, and joint pain, among other symptoms. It is also sometimes called peripheral arterial disease (PAD).

One of the most common symptoms of PVD is claudication, or pain with muscle movement due to insufficient blood flow to muscle tissue. The pain and cramping usually go away when at rest.

Symptoms of peripheral vascular disease include:

• Lower leg pain and cramps with exercise
• Leg weakness and numbness
• Difficulty walking or climbing stairs
• Leg pain that subsides at rest
• Skin discoloration when lifting the leg (it may be pale or turn blue)
• Nonhealing wounds on the feet or toes
• Erectile dysfunction

In extreme cases, this circulation disorder can lead to tissue death (gangrene).

Lifestyle changes such as quitting smoking, exercise, and a healthy diet can help treat PVD, and for diabetics it’s critical to control blood sugar levels. Medications such as blood thinners or vasodilators (which widen blood vessels) may be recommended.