From the Research
Treatment for leg pain related to Charcot-Marie-Tooth (CMT) neuropathy should prioritize a multifaceted approach combining physical therapy, supportive devices, and potentially medication, with a focus on improving functional outcomes and quality of life, as evidenced by the most recent and highest quality study 1.
Key Components of Treatment
- Physical therapy: gentle stretching exercises, strengthening routines for less affected muscles, and balance training to prevent falls
- Supportive devices: custom orthotic devices, ankle-foot orthoses (AFOs), or supportive footwear to improve stability and reduce pain from abnormal gait
- Medication: may include gabapentin, pregabalin, duloxetine, or tricyclic antidepressants like amitriptyline for pain management, as well as over-the-counter pain relievers like acetaminophen or NSAIDs for mild pain
- Regular moderate exercise: activities like swimming or cycling to maintain muscle strength and overall fitness without excessive strain
- Weight management: important to avoid exacerbating symptoms
Rationale for Treatment Approach
The treatment approach is based on the findings of a real-practice retrospective study 1 that demonstrated significant improvements in muscle strength, pain, fatigue, cramps, balance, walking speed, and ability in patients with mild to moderate CMT after an intensive neurorehabilitation protocol. While the improvement was lost at the 1-year mark, this study highlights the importance of regular and intensive rehabilitation in managing CMT symptoms. Other studies, such as 2, 3, 4, and 5, also support the use of rehabilitation, orthotics, and supportive devices in improving functional outcomes and quality of life for patients with CMT. However, the most recent and highest quality study 1 provides the strongest evidence for the recommended treatment approach.