If you have diabetes, a small blister, cut, callus, or sore on your foot can become a more serious problem if it is not treated early. A diabetic foot ulcer is an open sore or wound that can be difficult to heal due to complications associated with diabetes, including nerve damage and reduced circulation.
Knowing the warning signs of a diabetic foot ulcer and checking your feet regularly can help you catch problems before they become more serious.
What Are the Warning Signs of a Diabetic Foot Ulcer?
A diabetic foot ulcer does not always look or feel the way you might expect. Diabetes-related nerve damage can reduce sensation in the feet, meaning a wound may develop without causing significant pain.
Here are things to watch for:
- An open sore, cut, or wound that is not healing
- A blister or area of broken skin
- Redness, swelling, or warmth
- Drainage or fluid from a wound
- A foul odor
- Bleeding underneath a callus
- Changes in the color or temperature of the foot
- Numbness, tingling, or burning
- A wound that continues to get larger
- A sore that repeatedly develops in the same location
A lack of pain does not mean a wound is minor. If you have diabetes and notice a sore, blister, cut, or other change in your foot, it is important to have it evaluated promptly.
Why Do Diabetic Foot Ulcers Develop?
Diabetes can affect your feet in several ways. Diabetic neuropathy can cause numbness, making it harder to feel pain, pressure, or changes in temperature. As a result, you may continue putting pressure on an injured area without realizing it.
Diabetes can also affect circulation, making it harder for the body to deliver the oxygen and nutrients needed for healing. In addition, an abnormal foot structure or biomechanical problem can place extra pressure on certain areas of the foot. Over time, this repeated pressure can lead to a callus, blister, or open wound.
Why Do Some Diabetic Foot Wounds Keep Coming Back?
If a wound repeatedly develops in the same area, it is important to determine why the wound is occurring in the first place.
For example, an abnormal pressure point, foot deformity, or other biomechanical problem may continue to place stress on the same area every time you walk. Simply treating the open wound may not address the underlying cause.
This is why Dr. Foster takes a different approach to recurring foot wounds. Rather than focusing only on repeated wound care, his goal is to identify and address the underlying problem contributing to the wound whenever possible.
Can Minimally Invasive Surgery Permanently Fix a Recurring Foot Wound?
In some patients, a chronic or recurring foot wound is caused by an area of excessive pressure that can be addressed through minimally invasive foot surgery.
Dr. Joel Foster performs minimally invasive procedures designed to correct certain underlying structural or pressure-related problems contributing to recurring wounds. These procedures use very small incisions, often 2–3 mm, and may be performed under local anesthesia when appropriate.
Unlike traditional surgery, some of these minimally invasive procedures do not require sutures. By reducing or correcting the pressure that is contributing to the wound, the goal is to create an environment where the wound can heal and reduce the likelihood of it returning.
For appropriately selected patients, addressing the underlying mechanical problem may offer an alternative to months of repeated wound care and debridements.
The goal is resolution, not endless wound care.
Dr. Foster's approach is straightforward: identify the problem, address the cause, help the wound heal, and work toward preventing it from coming back. Every patient is different, and minimally invasive surgery is not appropriate for every wound. A comprehensive evaluation is necessary to determine whether a procedure is appropriate based on the wound's location and severity, circulation, nerve function, foot structure, overall health, and other factors.
If you have a diabetic foot wound that won't heal, continues to return, or requires repeated wound care, ask whether an underlying pressure or structural problem could be contributing to it.
How Can I Prevent a Diabetic Foot Ulcer?
The best way to deal with a diabetic foot ulcer is to prevent one whenever possible. If you have diabetes, check your feet every day. Look at the tops, bottoms, heels, and areas between your toes. If you cannot easily see the bottoms of your feet, use a mirror or ask someone to help.
Look for:
- Blisters or cuts
- Cracks in the skin
- Redness or swelling
- Calluses
- Changes in skin color
- Drainage
- New areas of irritation
- Changes in the shape of your foot
- Check with your endocrinologist or primary care physician regularly.
Wearing properly fitting shoes, avoiding walking barefoot, managing your diabetes, and receiving regular foot examinations can also help reduce your risk of serious foot complications. If a wound won't heal, keeps coming back, or continues to develop in the same location, it may be especially important to investigate whether an underlying pressure point or biomechanical problem is contributing to the wound.
At Dr. Joel Foster's podiatry office in Lee’s Summit, MO, our goal is not simply to manage a wound indefinitely. We focus on identifying the cause, treating the wound appropriately, and addressing underlying problems when possible.
