Charcot-Marie-Tooth (CMT)
Charcot-Marie-Tooth or CMT is a genetic disorder that affects the peripheral nerves (the nerves outside the brain and spinal cord). These nerves control muscle movement and transmit sensory information, so when they are damaged, it can lead to muscle weakness, atrophy, and sometimes sensory loss, especially in the feet, lower legs, hands, and forearms.
The symptoms of CMT usually start to appear in childhood, although some people do not develop symptoms until they are well into adulthood. CMT is a progressive condition. This means the symptoms slowly get worse.
What causes CMT?
CMT is caused by genetic mutations that damage the peripheral nerves, which control the body’s muscles and senses. In some forms, faulty genes cause the myelin sheath (the protective covering around nerves) to break down, which damages the nerve axons and disrupts signals between the brain, muscles, and sensory organs. This can lead to muscle weakness, numbness, and reduced coordination.
In other forms, the axons themselves are affected, preventing nerves from transmitting signals properly. This reduces muscle and sensory use, causing muscle wasting, weakness, and sensory problems.
The peripheral nerves are essential for movement and sensation, so damage from CMT can impact mobility, daily activities, and quality of life.
What are the symptoms of CMT?
The symptoms of CMT can vary, even among family members with the condition, and it is difficult to predict when they will appear or how quickly they will progress. Because CMT affects the peripheral nerves, most symptoms involve muscle weakness, sensory changes, and balance difficulties.
In young children, early signs may include clumsiness or difficulty walking due to foot drop. Other common symptoms include:
- Muscle weakness in the feet, ankles, and legs
- Poor circulation
- Numbness or reduced sensation, particularly in the hands and feet
- Tingling or burning sensations
Symptoms usually begin in the feet and legs and may gradually progress to the hands and arms. Many people first notice subtle changes in walking, balance, or fine motor skills before recognizing there is an underlying nerve disorder.
Treating CMT
While there is currently no cure for CMT, a variety of therapies and treatment options can help manage symptoms, maintain mobility, and improve quality of life. Treatment is typically guided by a multi-disciplinary team including neurologists, physiotherapists, occupational therapists, and orthotists.
Common treatment options include:
- Physiotherapy to maintain muscle strength, flexibility, and balance
- Ankle-Foot Orthoses (AFOs) and Silicone Ankle-Foot Orthoses (SAFOs) support walking and reduce foot drop, helping to prevent falls and reduce fatigue
- Custom orthotics and splints, tailored to individual foot or hand structure and specific mobility needs
Early intervention and consistent therapy can help slow progression, enhance mobility, and support independence for people living with CMT.
Living with CMT can present daily challenges, but with the right support and management, people can maintain an active and fulfilling life. Regular exercise, physical therapy, and the use of orthotics or mobility aids can help preserve strength, balance, and independence.
Interested in finding out more about how we can support you or your loved one? Book an appointment with our Orthotists and discover a custom solution designed to support your mobility and daily comfort.