Charcot Marie Tooth Disease

Charcot-Marie-Tooth disease (CMT) is a genetic, inherited condition that is usually detected in childhood. It affects the way you can use your feet due to experiencing greater muscle weakness, instability, and problems detecting what is happening around your feet.

CMT describes a group of conditions that damage the peripheral nerves, meaning the nerves outside of our brain and spinal cord – such as the ones to the arms and legs. Think of your nerves as cables from the brain to the rest of the body, that work to help you feel sensations and move your muscles. When these don’t work properly, you can experience:

• Muscle weakness (which may lead to problems like foot drop)
• Reduced muscle size
• Decreased sensation around your feet
• Severely high arched feet
• Hammer toes
• Problems with your gait (the way you walk)
• Nerve pain

Due to the high-arched foot shape experienced by many CMT sufferers, they develop ankle instability and are more prone to spraining their ankles. This can worsen over time, as the symptoms of CMT progressively grow more severe. 

CMT runs in families, being passed down in gene mutations that give our body faulty instructions for how the body creates and sustains normally functioning peripheral nerves. Although early detection may be simpler when a parent already has a CMT diagnosis, many types of CMT are hidden in recessive genes.

Can you fix it?

The genetic nature of CMT means that there is nothing anyone can do to ‘fix’ it as there is (at the time of writing) no cure. But what our podiatrists do for many patients is to manage the symptoms that arise as a result of their CMT so they can live a much more comfortable life. By working with our podiatrists, you can expect to:

• Optimise your comfort on your feet
• Stay as mobile as possible, for as long as possible
• Be fully informed about the effects of CMT on your feet and legs, both with what you may already be experiencing now and possible effects in the future
• Know how to be taking the best care of your feet at home
• Know the warning signs to look out for
• Feel confident in your management plan
• See your podiatrist periodically if needed to manage any problems like corns and calluses
• Be fully supported along the way

How do podiatrists treat Charcot Marie Tooth disease?

In order to optimise the foot health and improve the quality of life of a person with CMT, we can use a variety of treatment methods including:

• Using an ankle brace or an ankle foot orthotic (AFO) to promote stability at the ankle to make walking easier and reduce the risk of falls and other injuries
• Recommend specific shoes that will best support the foot and ankle, this may include a high-top shoe or an extra-depth low-cut shoe depending on what other treatments (orthotics, braces) are being used
• Custom foot orthotics that are accommodative in nature – working to best support the foot and offload high-pressure areas to reduce the risk of ulcers and injuries, while promoting optimal gait 
• Debriding any corns or calluses that arise, as well as helping to prevent them
• An exercise program including stretching and gentle strengthening

FAQs

Is Charcot Marie Tooth Disease a progressive condition?

Yes, Charcot Marie Tooth Disease is generally a progressive condition, meaning that symptoms tend to worsen over time. The rate of progression can vary among individuals and different subtypes of CMT.

Can Charcot Marie Tooth Disease affect other parts of the body besides the feet?

Yes, Charcot Marie Tooth Disease can affect other parts of the body besides the feet. It is a hereditary neurological disorder that primarily affects the peripheral nerves, leading to muscle weakness and atrophy in the feet and lower legs. However, it can also impact the hands, resulting in weakness and impaired dexterity.

Are there any specific treatments or interventions available for Charcot Marie Tooth Disease?

While there is no cure for Charcot Marie Tooth Disease, various treatments and interventions can help manage its symptoms and slow down its progression, helping you optimise your independence, mobility and quality of life. These may include physical therapy, occupational therapy, orthotics, braces or splints, assistive devices to aid with mobility, pain management strategies, and more.

Can Charcot Marie Tooth Disease cause foot deformities?

Yes, Charcot Marie Tooth Disease can cause foot deformities. As the condition progresses, muscle weakness and imbalance can lead to abnormalities in foot structure and function. Common foot deformities associated with CMT include high arches (pes cavus), hammertoes, foot drop, and instability.

Are there any specific exercises or physical therapy techniques that can help with the management of Charcot Marie Tooth Disease?

Physical therapy can play an essential role in managing Charcot Marie Tooth Disease. Your exercise program will be custom designed to your unique needs, focusing on improving muscle strength, flexibility, balance, and gait. Exercises may include strengthening exercises, stretching, range of motion exercises, and functional training.

Can Charcot Marie Tooth Disease lead to complications in daily activities and mobility?

Yes, Charcot Marie Tooth Disease can lead to complications in daily activities and mobility. As the condition progresses, muscle weakness and foot deformities can affect walking, balance, and overall functional abilities. However, with appropriate management, including physical therapy, assistive devices, and adaptations, individuals with CMT can continue to maintain an active lifestyle and manage daily activities.

Are there any surgical options available for the treatment of Charcot Marie Tooth Disease?

Surgery is generally not considered a primary treatment for Charcot Marie Tooth Disease. However, in certain cases where severe foot deformities or complications arise, surgical interventions such as tendon transfers, osteotomies, or fusion procedures may be considered to improve foot stability, correct deformities, and enhance overall function.

Can Charcot Marie Tooth Disease affect lifespan and overall health?

Charcot Marie Tooth Disease is a chronic condition that primarily affects the peripheral nerves and muscles. While it does not typically affect lifespan, the progressive nature of the disease can lead to functional limitations and impact an individual’s quality of life. Regular medical care, symptom management, and maintaining a healthy lifestyle can help optimise overall health and well-being.