Well, unfortunately, there is no cure for Charcot Marie Tooth (CMT), treatment is mainly supportive and symptomatic. Charcot Marie Tooth occurs due to mutations in certain genes that help in the transmission of nerve signals in the peripheral nerves. These mutations cause abnormal and poor signal transmission and that leads to muscle weakness and sensory loss in the peripheral nerves mainly the extremities. (1)
What Is The Best Treatment For Charcot Marie Tooth?
The main debilitating symptoms are muscle weakness which can affect your walking and movements in the legs and fine movements of the hand. So, physical therapy, occupational therapy, orthopedic devices including braces and orthopedic surgery can help these problems and prevent further complications such as muscle atrophy and joint contractures.
Physical and occupational therapy involves muscle strength training, stamina training, muscle and ligament stretching and aerobic exercises. Most patients have their specialized treatment program according to the patient’s degree of disabilities with the approval from the treating physician. Muscle strengthening exercises should be started early before your muscle weakness and nerve degeneration as this can prevent muscle atrophy and joint contractures.
Exercises also help to build stamina and this will prevent the muscle weakness that occurs during daily activities. This helps increases endurance and prevents muscle fatigue. Most patients find physical exercises beneficial and had improved their symptoms to a great extent. Moderate aerobic exercises can keep you fit and maintain cardiovascular fitness as well. physical therapist recommends a no-impact or low-impact exercises such as biking and swimming rather than walking and jogging as these can put extra stress on the weak muscles and joints.
Most of the Charcot Marie Tooth patients need ankle and or leg braces to maintain mobility and prevent ankle and leg sprains. Some of you might need other orthopedic devices which can support and stabilize your walking and other movements. Boots and high-top shoes can support weak ankles. Hand weakness and loss of fine motor skills can be overcome by thumb splints. These assistive devices should be used before the onset of disability as that can prevent muscle weakness and strains. If deformities are already present, then orthopedic surgery can be done to reverse the deformities, tighten muscles and joint contractures.
The home environment should be safe and certain adjustments are needed for safety. E.g. Special rubber grips for your house doors can be applied so that you do not have any difficulty in opening doorknobs.
Most patients do not need wheelchairs to go around, they usually manage well with braces and other orthopedic devices. Older patients who are in severe types of Charcot Marie Tooth might need a wheelchair or a motorized scooter for traveling.
Pain Killers: Some patients have severe pain associated with muscle weakness and neuropathic pain. The pain is not due to an external stimulus but due to the defective signal transmission between the nerves.
Sensory Loss: There is no way to reduce sensory loss to prevent it. the main problem with sensory loss is the unnoticed injuries which can lead to ulceration and infections. Therefore, you need to check your feet daily for injuries and if any injury is present immediate treatment is required. Sensory loss can also cause dry skin and hair loss and can even lead to hearing loss and visual impairment. (1) (2)
There is no cure for Charcot Marie Tooth, it is only supportive and symptomatic management. But most patients live a normal life with these treatments. Treatment mainly consists of physical therapy, occupational therapy, orthopedic devices including braces and orthopedic surgery for your muscle weakness and deformities. Special devices are there to manage different disabilities and most of you can manage your day to day activities with these devices. Pain killers are given for neuropathic pain and pain associated with muscle weakness. There is no method to reduce or prevent sensory loss but checking for injuries in the extremities daily is needed to prevent ulcer formation and infections.
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