Charcot-Marie-Tooth disease, a group of disorders affecting about 115,000 Americans, targets the body’s peripheral nerves. These nerves transport messages between the brain and the muscles of the body. Also referred to as CMT, the disease is degenerative and includes four types and multiple sub-types. Most often appearing during adolescence, CMT can also develop in adults.
Causes and Symptoms
CMT is a genetic, hereditary disease in which genes that affect nerves in the legs, hands, arms and feet mutate, causing damage to those nerves. Also prone to damage is the myelin sheath, which is the protective coating around the nerves. This damage causes weaker messages sent between the body’s extremities and brain. Those with a family history of CMT are more likely to develop the disease.
CMT sufferers have muscle weakness and loss of sensation in the limbs, hands and feet, but symptoms and the severity of them varies from one person to another. Typically, a patient experiences the symptoms in the feet and legs first. As the disease progresses, it can lead to bone deformities in the feet. This can include hammertoes and high arches. Because there is a loss of muscle in the legs and feet, these areas are weak, and walking is often difficult. Some patients may have trouble lifting their feet at the ankles and develop an awkward or abnormally high step.
Physical therapy can help strengthen and stretch muscles while preventing muscle tightening and muscle loss. Occupational therapy can help patients through devices that assist with arm and hand mobility. Splints, leg and ankle braces and other orthopedic devices help maintain mobility, promote stability and prevent injury. Surgery is also an option. An orthopedic physician may perform soft tissue surgical procedures to rebalance the muscles that pull on deformed feet. These stabilizing procedures include tendon release, tendon transfer and fasciotomy. Orthopedic surgeons may perform osteotomies to trim bony lumps from the affected area or arthrodesis, which is bone fusion. Both procedures can help correct bone alignment and reduce pain. Some patients may have their arches lowered or their toes pinned or straightened.
Recovery time for CMT surgery could be lengthy and challenging. And, patients should recognize that a progressive disease such as CMT continues to destroy nerves and muscles, which means their deformity may return. Patients should consult their orthopedic doctor to proceed with the best treatment for their condition.