The Center for Podiatric Care and Sports Medicine

Osteomyelitis: What to Do When a Diabetic Foot Ulcer Infects the Bone

Posted by on Friday, February 28th, 2014


Two in 10,000 people will come down with a serious bone infection called osteomyelitis. It is estimated that a quarter of diabetics will develop a foot ulcer at some point in their lives. The spread of an ulcer’s infection almost always causes the bone to become infected, which complicates up to 20% of all diabetic foot ulcers, according to the British Medical JournalSymptoms of this condition include: fever, nausea, fatigue, tenderness, swelling, and loss of motion. If left untreated, surgery or amputation may be the only recourse for treatment.

This image shows hematogeneous osteomyelitis of a child’s bone.
Image Source:

Man Received Help from Church

A man from Wisconsin recalled how a cut on the bottom of his foot turned into a chronic infection.”I needed daily antibiotics through an IV to treat the infection and save my foot,” Mike Ross explained. He said his osteomyelitis treatment also included medication for blood pressure, cholesterol, and newly onset diabetes.

“Church Health Services helped me get my very high blood sugars regulated and also helped me to feel good about myself,” he added. “They assisted me in a life changing diet – through hard work and help with my exercise goals.” As you can see, treatment of foot bone infections really requires a total body wellness approach.

bone infection prevention
Nutrition, exercise, and medication may be part of a bone infection prevention program for diabetics.
Image Source:

Preventing Complications from Osteomyelitis

Controlling blood sugar levels is an important step in preventing bone infection that may require amputation. Diabetics should also examine their feet daily and have a trained podiatrist regularly inspect the foot for irregularities as well.

Individuals who fracture their bones should take antibiotics within six hours of injury and seek prompt medical attention from a foot surgeon. Antibiotics should be taken for up to six weeks if there is a soft tissue infection, and up to 12 weeks for bone infections, according to American Family Physician.

Advanced state osteomyelitis (involving sepsis, bone deformities, abscesses, and limited range of  motion) is usually treated with surgical debridement (tissue removal), dead space management, and bone stabilization  methods.

The Importance of Proper & Hygienic Footwear

Lastly, wearing proper footwear is crucial in keeping the feet healthy and free from ulcers or bone infections. Whether you have Charcot joints or other abnormalities associated with diabetes or not, wearing protective footwear specially adapted for diabetic patients is a good way to prevent foot complications. Also, surgery patients should wear a postoperative shoe that takes pressure off the wound.

diabetic ulcer prevention
Diabetic shoes can help prevent foot wounds by reducing pressure.
Image Source:


Here at The Center for Podiatric Care and Sports Medicine in New York City, treatment of diabetic foot ulcers is one of our specialties. Associate podiatrist Dr. Katherine Lai is board-certified in foot and ankle surgery, and has lectured extensively on diabetic foot wound care. She integrates holistic podiatry and integrative medicine into her scope of practice to offer a suite of well-rounded solutions for diabetic patients. Dr. Nadia F. Levy has also received extensive training in the areas of foot deformity and diabetic wound care.

Nearly a third of patients with osteomyelitis suffer recurrences within two years, so don’t wait for infection to strike! Contact us for a consultation regarding your diabetic feet today.



If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.