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Diabetic Foot Care

Diabetes can cause nerve damage (neuropathy) and reduced blood flow, making small cuts turn into serious wounds that are slow to heal. Our orthopedic foot and ankle specialists help protect joints, correct deformities, and restore function while coordinating vascular, wound-care, and endocrine support for true limb preservation.

Woman holding the painful sole of her foot
Specialist examining a patient's swollen foot

Why Diabetic Feet Need Special Care

Diabetes affects the feet in two main ways. Peripheral neuropathy reduces the ability to feel pain, pressure, and temperature, so blisters, cuts, and pressure sores can go unnoticed. Reduced circulation slows healing and makes infection harder to fight.
 
Together, these changes can turn a small problem into a foot ulcer, infection, or deformity such as Charcot foot. Regular foot checks, protective footwear, and early treatment are the foundation of limb preservation.

Treatment Options For Diabetic Foot Care

Healing a diabetic foot ulcer depends on relieving pressure, caring for the wound, controlling infection, and ensuring good blood flow.

Wound healing and protection

  • Offloading (pressure relief). Non-removable devices like total contact casts have the strongest evidence for faster healing.
  • Advanced wound care. Regular sharp debridement and dressings chosen for the wound, with negative-pressure therapy or biologics when appropriate.
  • Infection management. Deep tissue cultures after debridement and targeted antibiotics when infection is suspected.
  • Circulation optimization. Vascular screening and timely referral for revascularization when blood flow limits healing.
  • Footwear and orthotics. Custom inserts and protective shoes redistribute pressure to prevent recurrence.

Minimally invasive procedures

  • Percutaneous flexor tenotomy. A tiny release for toe-tip ulcers from clawed or hammertoes.
  • Gastrocnemius recession or Achilles lengthening. Eases forefoot pressure that fuels plantar wounds.
  • Keyhole exostectomy. Smooths a bony hotspot under an ulcer.
  • Limited-incision osteotomy. A targeted bone cut, or metatarsal head resection, to unload a stubborn ulcer.

When an ulcer keeps coming back because bone or alignment is the problem, we start with the smallest fix that truly removes pressure.

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How We Evaluate Your Feet

At your visit, we take a thorough, step-by-step approach. We review your diabetes history, footwear, prior ulcers, and activity level, and check sensation and circulation, with monofilament testing for neuropathy and a pulse exam or ankle-brachial index (ABI) when needed.
 
We also check the skin and structure of the foot for calluses, deformities such as bunions and hammertoes, pressure points, and early Charcot changes. X-rays or MRI are used when infection or Charcot arthropathy is suspected, and wound cultures are taken after debridement if infection is present.
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Diagram comparing a healthy foot with a diabetic foot ulcer

Prevention: The Strongest Medicine

Daily habits dramatically cut the risk of foot problems. These cornerstone self-care steps are endorsed by the American Diabetes Association:

Check your feet every day

Tops, soles, and between the toes, for blisters, redness, cracks, or drainage.

Moisturize carefully

Moisturize heels but not between the toes.

Trim nails straight across

And never perform "bathroom surgery" on calluses.

Always wear socks and shoes

Protective footwear, even indoors.

Control blood glucose

Good control protects nerves and blood vessels.

Do not smoke

Smoking further reduces circulation to the feet.

Adults with diabetes should have their foot risk assessed at diagnosis and at least annually, with more frequent checks if risk is higher (neuropathy, deformity, or a prior ulcer).

When Minimally Invasive Is Not The Best Fit

For more severe problems, we step up to sturdier reconstruction to protect you long-term:

Open exostectomy or realignment fusionFor severe deformity or Charcot collapse.
DebridementWith possible hardware removal, when deep infection involves bone or implants.
Partial ray or forefoot proceduresPermanently eliminate a chronic pressure point.
Staged reconstructionInternal or external fixation for unstable feet that need stronger support.

Frequently Asked Questions

Can diabetic foot ulcers really heal?

Yes, especially when pressure is truly offloaded, wound care is consistent, circulation is adequate, and infection is controlled. Non-removable offloading such as total contact casts has the strongest evidence for higher healing rates and shorter time to closure.

Do I always need antibiotics for a foot ulcer?

No. Uninfected ulcers do not typically need antibiotics. When infection is suspected, guidelines recommend deep tissue cultures after debridement and targeted therapy based on severity and organisms.

What if I have Charcot foot?

Early recognition and immobilization or offloading are crucial. Once inflammation settles, surgical reconstruction may be considered to restore a stable, braceable foot and prevent recurrent ulcers.

How often should people with diabetes have a foot exam?

Adults with diabetes should have their foot risk assessed at diagnosis and at least once a year, with more frequent checks if they have neuropathy, deformity, or a prior ulcer.

Why do people with diabetes get foot ulcers?

Diabetes can cause nerve damage (neuropathy) and reduced blood flow. Without normal sensation, pressure and small injuries go unnoticed, and poor circulation slows healing.

What is offloading?

Offloading means removing pressure from a wound so it can heal, using total contact casts, boots, special shoes, or inserts. It is central to healing diabetic foot ulcers.

When is surgery considered for diabetic foot problems?

Surgery is considered when an ulcer keeps coming back because a bone or alignment problem is causing pressure. We start with the smallest procedure that removes the pressure.

Where can I get diabetic foot care?

Our foot and ankle specialists provide diabetic foot care in Melbourne, Orlando (Lake Nona), and Titusville. Call (321) 499-4646 to schedule.

Warning Signs To Act On

If you have diabetes, contact a specialist promptly for:

  • A blister, cut, or sore that is not healing.
  • Redness, warmth, or swelling in the foot or ankle.
  • Drainage or odor from a wound.
  • A change in foot shape, such as a collapsing arch.
  • New numbness, burning, or tingling in the feet.
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Close-up of a person holding a painful foot

Related Conditions

Charcot Foot

Charcot foot is a serious condition most often seen in people with diabetes or peripheral neuropathy. It occurs when the bones, joints, and soft tissues of the foot weaken, leading to fractures, dislocations, and significant deformity. If not addressed, Charcot foot can result in severe instability, ulceration, and even amputation.

Hammertoe Correction

Toe deformities such as hammertoe, claw toe, and mallet toe are common conditions that can lead to pain, corns, calluses, and difficulty finding shoes that fit comfortably. These deformities are often caused by imbalances in the muscles and tendons that control toe movement, sometimes worsened by arthritis, genetics, or wearing tight footwear.

Foot and Ankle

Total Spine & Orthopedics treats common foot and ankle conditions with conservative and minimally invasive care in Melbourne and Orlando, FL.

Ankle Sprains

An ankle sprain is a stretched or torn ligament, usually from rolling or twisting the ankle. Learn the grades, symptoms, and treatment, and when a sprain needs a specialist.

Ankle Fractures

Ankle fractures are common orthopedic injuries that occur when one or more bones in the ankle break. They can result from a traumatic event, such as a fall or a sports injury, or from gradual wear and tear over time. If left untreated, ankle fractures can lead to chronic pain and decreased mobility, making it important to seek prompt medical attention if you suspect you have sustained an ankle fracture.

Achilles Tendonitis

Achilles tendonitis is irritation of the tendon at the back of the heel, often from overuse. Learn the symptoms, causes, and treatment options.

Heel Pain

Heel pain most often comes from plantar fasciitis, heel spurs, or the Achilles tendon. Learn the common causes and how heel pain is treated.

Flatfoot Correction

Flatfoot, also known as fallen arches or adult acquired flatfoot deformity, occurs when the arch of the foot collapses. This condition can cause pain, swelling along the inside of the ankle, and difficulty walking or standing for long periods. Over time, the deformity may worsen, leading to joint arthritis, tendon damage, and impaired mobility.

Bunions

Bunions are a common foot condition that can be treated with minimally invasive surgery to minimize disruption to daily life.

Wound Care

Foot wounds and ulcers need careful care, especially with diabetes, neuropathy, or poor circulation. Learn how foot wounds are treated and when to be seen.

Nail Fungus

Nail fungus (onychomycosis) causes thick, brittle, discolored toenails. Learn the symptoms, risk factors, and treatment options.

Our Patients Stories

Hear our patients share their experience with us, All in their own words.

Why Choose Total Spine and Orthopedics

Expert, ultra-minimally invasive spine and orthopedic care, close to home.

  • Ultra-minimally invasive and endoscopic techniques

    We specialize in procedures performed through incisions smaller than a dime, sparing muscle and supporting a faster recovery.

  • Same-day, outpatient procedures

    Most patients walk in and return home within hours, rather than facing an overnight hospital stay.

  • Board-certified, fellowship-trained surgeons

    Our team includes early leaders in endoscopic spine surgery.

  • A complimentary MRI review

    Understand your diagnosis and options from a board-certified specialist before committing to any treatment.

  • Trusted by our community

    More than 1,100 patient reviews at a 4.6-star average, and over 50,000 patients treated.

  • Coordinated care for limb preservation

    We coordinate vascular, wound-care, and endocrine support alongside orthopedic foot care.

  • Comprehensive spine and orthopedic care

    From injections to advanced procedures, your full continuum of care is handled in one place.

  • Convenient locations across the Space Coast and Orlando

    Care close to home in Melbourne, Orlando (Lake Nona), and Titusville.

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