Charcot-Marie-Tooth Disease
Treatment

Although there is currently no cure for CMT, there are treatments available to help manage its complications and improve patients' quality of life. Therapies may include physical therapy, occupational therapy, braces and other mobility devices, as well as orthopedic surgery.

Physical and Occupational Therapy

Physical and occupational therapy is an essential part of CMT therapy. This may involve muscle strength and stamina training, muscle and ligament stretching and moderate aerobic exercise. The goal is to preserve function and maintain comfort. Your child's stretching program will be monitored by the physiotherapist, but needs to become part of the family's daily routine.

Many factors contribute to the tendency for joints to get tight or "contracted." These include the muscle becoming less elastic due to limited use and positioning, or the muscles around a joint becoming out of balance, with one stronger than another. Maintaining good range of movement and symmetry at different joints is important to maintain the best possible function, prevent the development of fixed deformities and prevent pressure problems with the skin.

Our therapists can help design an individualized plan for your child that will encourage muscle strengthening and flexibility.

With time, usually in adulthood, strength becomes more of an issue. Physiotherapists and occupational therapists can recommend assistive devices to help the patient maintain independence. It is important to think proactively about the kind of equipment that will best support independence and participation in daily activities, and plan ahead to provide it in as timely a manner as possible. Additional adaptations may be needed to help with reaching for or lifting objects, getting up stairs, transferring from one place to another (such as from the bed to a chair) and bathing.

Mobility Devices

Mobility devices may increase a person's ability to move, provide support and decrease the risk of injuries. Many people with CMT develop foot deformities that may be corrected with braces. Custom-made shoes or inserts can improve gait and help to evenly distribute the body weight on the foot. Rarely people require extra support for getting around, including canes, walkers or motorized equipment such as a scooter.

Special braces that hold the foot at a 90-degree angle to the leg may also help if muscle weakness causes the foot to drag while walking. If the entire lower leg is severely weakened, braces that extend above the knee and attach to the stronger muscles of the upper leg can provide adequate support.

Surgery

If a foot deformity prevents the foot from being manipulated into proper alignment with a brace, surgery may help. The goal of surgery is to help the foot and leg function as normally as possible, so the patient can walk with minimal difficulty. When foot muscles are too weak to hold the bones in proper position, the foot bones can be surgically fused to provide stability and support.

Managing Complications of Sensory Loss

Combined with the regular abrasions caused by foot deformities, the lack of pain sensitivity makes people with CMT at risk for developing ulcerations — wounds that go unnoticed and become severely infected. People with CMT, and especially those with foot deformities, should check their feet regularly for injuries.

In many people with CMT, sensory loss is associated with dry skin and hair loss in the affected area. In rare cases, sensory loss can include gradual hearing impairment and sometimes deafness. Watching out for these potential problems will enable patients to seek appropriate treatment if necessary.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

Related Information

UCSF Clinics & Centers

Pediatric Brain Center

Neuromuscular Clinic
1825 Fourth St., Sixth Floor
San Francisco, CA 94158
Phone: (415) 353-7596
Fax: (415) 353-2400
Appointment information