Charcot Foot

Bone and Joint Conditions· Also known as: Charcot neuroarthropathy, Charcot neuropathic osteoarthropathy, Charcot joint, neuropathic arthropathy of the footUpdated Oct 2026

Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026

At a Glance

Charcot foot is a rare but serious problem that mostly affects people with diabetes. Nerve damage (neuropathy) means you can't feel your foot properly, and the bones and joints slowly weaken and break down. This can change the shape of your foot and lead to ulcers. The main sign is a foot that is warm, swollen and often red, usually on one side, and it may not hurt much. Treatment works best when it starts early, so a warm, swollen foot needs to be checked the same day.

What is it?

Charcot foot (also called Charcot neuroarthropathy) is a complication of diabetes. Nerve damage (peripheral neuropathy) makes the bones and joints of your foot break down over time. The bones become fragile, so they can break or slip out of place easily, even from a small knock.

Over time this can change the shape of your foot. A changed shape puts pressure on new spots, which raises the risk of ulcers (open sores). The middle of the foot is most often affected, but the heel area, ankle and front of the foot can be involved too.

Charcot foot is described as rare. It is serious, though, and it is easy to miss because it may not hurt.

Who does it affect?

It affects people with nerve damage in their feet. In most cases the nerve damage comes from diabetes. Some things are linked with a higher risk in people with diabetes: having had diabetes for longer, eye damage from diabetes, protein leaking into the urine (a sign of kidney damage), high long-term blood sugar levels (a high HbA1c) and narrowed or hardened arteries.

Nerve damage from other causes can lead to it too, though this is less common. Examples include heavy alcohol use, some drugs, leprosy, diseases of the spinal cord, Parkinson's disease, HIV, sarcoidosis, rheumatoid disease and psoriasis. It doesn't happen without nerve damage.

Signs and symptoms

The early signs are a foot or ankle that is swollen and warm. It is often red as well, and usually only one foot is affected. The redness can look like an infection.

Pain is often small or missing, because nerve damage dulls the feeling in your foot. Some people have mild to moderate pain or discomfort, so pain is not a reliable guide. Over time the shape of your foot may change.

A foot that is warm, swollen and red can also be an infection, a blood clot in the leg (deep vein thrombosis, or DVT) or gout. You can't tell these apart by looking, so it needs checking by a health professional.

What causes it?

Nerve damage is the underlying cause. Many people, about half, remember a minor injury that seemed to set it off, such as a small knock or twist. With reduced feeling, you may not notice the injury or keep walking on it, and the foot's bones can then give way.

How nerve damage leads to bone and joint breakdown isn't fully settled. One idea is that repeated, unnoticed injuries trigger inflammation in the foot that goes on for too long. This inflammation may add to the loss of bone strength.

How is it diagnosed?

Your practitioner will ask about your diabetes and any recent foot injuries. They will check how well you can feel your foot and look at its shape and skin. They will also compare the warmth, swelling and redness of both feet. Swelling that goes down when you raise your leg points more towards Charcot foot than infection, which tends not to ease.

They will also check for any break in the skin and any signs of infection. You may have scans or other tests. If Charcot foot is suspected, treatment should start straight away without waiting for scan results. A suspected case is treated as Charcot foot until it is proven otherwise.

Speed matters. Many people wait a long time for the right diagnosis, and most are misdiagnosed at first. A delay of 8 weeks or more is linked with five times the risk of poor outcomes.

Treatment

Treatment is directed by a specialist team, usually a diabetes foot service or an orthopaedic (bone and joint) team. If your podiatrist or GP suspects Charcot foot, they will refer you to this team promptly. The best treatment methods, how to monitor the foot and how to judge when the condition has settled are not yet clear. Your team will plan this with you.

Treatment from your podiatrist

Your podiatrist is often the first to spot a warm, swollen foot. They will check you the same day, look for infection and refer you on quickly to the specialist team. They can also work with the team on a long-term plan for foot checks and footwear.

Surgery

Some people have surgery to rebuild the foot (reconstruction). Whether and when it is right for you is a decision for your specialist team. After this surgery, amputation was strongly linked with diabetes, ulcers and infection. People with Charcot foot and an ulcer were 12 times more likely to need a major amputation. This is why ulcers and infections need quick attention.

Recovery

Charcot foot is a serious condition. It carries a marked risk of amputation and of death, which is why acting early matters. Getting the right diagnosis soon is linked with better outcomes.

Ulcers and infection are the biggest threats to your foot. An ulcer larger than 2 cm² with bone showing raises the risk of infection in the bone, and any ulcer should be checked for infection.

If your foot isn't improving, go back to your specialist diabetes foot team for a review.

Preventing it

There is no sure way to prevent Charcot foot, but you can lower the risks. Keep up your diabetes care, and have regular foot checks with your podiatrist or diabetes team.

If you already have Charcot foot in one foot, keep a close eye on the other foot. Act quickly on any new wound, ulcer or sign of infection. Ask your diabetes foot team for a long-term plan for foot checks and footwear.

When to see a podiatrist

Book an appointment if

You have diabetes or reduced feeling in your feet and want a foot check or a long-term plan for foot checks and footwear. Also book if you have Charcot foot and it isn't improving, or you want the other foot checked.

Seek prompt assessment if

See your GP or another doctor today if one foot is red, hot or swollen, especially if you have diabetes or can't feel your feet well. Pain may be mild or missing, so don't wait for it. See a doctor today too if you have known Charcot foot and notice a red, hot or swollen toe or foot, a new break or sore in the skin, new redness or colour change, or new or unexplained foot pain. The same goes for a calf that is painful, swollen, warm or red. If your GP can't see you today, go to an urgent care clinic or an after-hours GP. Call your local emergency number if you feel very unwell with a foot wound, ulcer or infection, with fever, confusion or slurred speech, severe shivering or muscle pain, a fast heartbeat, severe breathlessness, mottled or discoloured skin, or little or no urine, as this could be sepsis. Also call if you suddenly become short of breath, have chest pain, or cough up blood.

Frequently asked questions

Why doesn't Charcot foot hurt?

Nerve damage dulls the feeling in your foot, so a foot that is inflamed and weakened may hurt little or not at all. Some people do have mild to moderate pain, but many don't. A warm, swollen foot needs checking even if it doesn't hurt.

Is Charcot foot the same as a broken foot?

No, but they are linked. In Charcot foot the bones become fragile, so they can break or slip out of place easily, even from a small knock. The foot is also inflamed and the damage keeps going over time, so it needs specialist care rather than treatment for a simple break.

Can Charcot foot affect both feet?

Usually one foot is affected first. About 1 in 4 people go on to develop similar changes in the other foot. Look after the other foot carefully and have it checked.

How long does Charcot foot take to heal?

It isn't yet clear how long it takes, and it varies from person to person. Your specialist team will monitor your foot and tell you how it is going. Keep your appointments, and go back to the team if your foot isn't improving.