The short answer to this question is no, not really. You see, your foot length always stays the same. However, a reduction of up to one and a half shoe sizes is not unusual due to an overall decrease in the circumference of the foot. But how can the circumference of your foot change so drastically? Well, in this blog, that’s precisely what you’ll find out.
Weight Loss
Significant weight loss is probably the most common reason some people may feel some extra space in their shoes. People underestimated how packing on the pounds can affect their feet. Excess weight stretches out the connective tissues in our feet, which puts extra strain on our foot muscles. It can also wear down the natural fat pads, which cushion your feet and absorb the shock when you take steps or stand for long periods.
Losing excess weight can cause fat loss and reduce inflammation in your feet. So, if you lose some weight and you have to change your shoe size, your foot has gotten smaller, kind of. The overall structure of your foot hasn’t changed, but as mentioned, you’ve lost fat and reduced inflammation.
Neuropathic Joint Disease
Neuropathic joint disease, also known as Charcot foot, can cause bones to disintegrate due to nerve damage. In general, Charcot foot is an inflammatory process that affects the soft tissues, bones, and joints in the foot or ankle. This condition can result from complete or near-complete numbness in one or both feet and ankles. The bones in the front become weak, making them prone to fractures and dislocations. If left untreated, it can lead to severe deformity, disability, or amputation.
Charcot Foot Causes
Charcot foot occurs in people who have numbness in their feet and legs because of a type of nerve damage called peripheral neuropathy. Peripheral neuropathy is associated with several conditions:
- Alcohol use disorder
- Diabetes
- Drug use
- HIV
- Infection, trauma, or damage in the peripheral nerves
- Inflammatory conditions (sarcoidosis or psoriasis)
- Leprosy
- Parkinson’s disease
- Polio
- Syphilis
- Syringomyelia
There are three stages of Charcot foot that outline what someone who suffers from it can expect.
Stage 1—Fragmentation & Destruction
You can identify the first stage by redness and significant swelling of the foot and ankle. Said areas might also be warm or hot to the touch. First, soft tissue swelling and bone fractures occur, which results in the destruction of the joints and surrounding bone. This causes the joints to lose stability, resulting in dislocation. Bones may even “jellify,” softening completely. The bottom of the foot may take on a flat appearance, and bony protrusions may also appear on the bottom of the foot. If left untreated, this stage can last up to a year.
Stage 2—Coalescence
It’s at this stage that the body attempts to heal itself. The destruction of the bones and joints slows down, which reduces swelling, redness, and warmth. Fragments of bone will attempt to fuse themselves together. Your doctor will most likely suggest a type of cast or brace to keep the area still and to relieve pressure from the damaged tissue.
Stage 3—Reconstruction
Here, joints and bones of the foot heal. However, they do not go back to their original condition or shape on their own. It’s unfortunate, but even though there’s no more damage to the foot, it can still be left in a deformed and unstable state. At this stage, the foot may also be more prone to sores and ulcers, leading to further deformities and even amputation.
Charcot Foot Treatment
If caught early, treatment centers around reducing swelling and heat in the affected areas. You’ll also want to stabilize the foot by keeping it immobile. It’s essential to eliminate any weight or pressure on the foot to stop additional damage from being done. This is called “off-loading.”
There are also several low-tech, nonsurgical treatments for Charcot foot that may help stop the progression of Charcot foot:
- Wearing a protective splint, walking brace, or customized walking boot
- Minimizing or eliminating all weight on the affected foot by using a wheelchair, crutches, or a walking scooter
- Using an orthopedic brace to correct alignment of the foot
- Wearing a contact cast explicitly fitted to your leg and foot
Once your foot or feet heal enough, you may be fit for a therapeutic shoe to reduce your chances of getting Charcot foot again.
The Foot & Ankle Center
If you have any concerns about your feet and ankles or have noticed a difference in their shape or function, please contact The Foot & Ankle Center today. We can help you live a better life by addressing your foot and ankle issues right there on the spot. Don’t wait and let these health problems get out of hand. Call us today at 314-487-9300 or request an appointment online with us!