CMT is described as causing peripheral neuropathy. This simply means that the peripheral nerves are damaged. Peripheral means the outlying areas, or the edge, and your peripheral nerves are any of the nerves outside of your brain and spinal cord. Given that the peripheral nerves start at your spinal cord, it should be no surprise that your feet and hands, the farthest from your spinal cord, are usually the first areas to display symptoms of CMT.
People with good CMT survival skills learn to view all foot problems as potentially dangerous, to prevent them if possible and to seek podiatric/chiropody care immediately if they occur. Foot care is essential for CMT survival.
Neuropathy can cause numbness, burning pain, and the inability to feel pain, heat or cold. CMT may cause you to lose sensation in your feet, and foot care takes on an entirely new dimension. You may not feel an injury to your foot and you have to become aware of the state of your feet by inspecting them. Without inspection and proper care, serious problems such as pressure ulcers and sores, can occur and go undetected. Infection may go unnoticed and appropriate care may be delayed leading to potentially severe consequences.
If you are losing the sensation of pain in your feet, then you need to become serious about foot-care tips and techniques like these:
Important Foot Care for People with CMT
- Be very careful walking barefoot; thoroughly inspect the toes and bottoms of your feet if you do walk barefoot, especially if you have been outside.
- Wear shoes that allow room for your toes, yet still support your heel and arch. There should be ½ inch (a thumb’s width) between your longest toe and the end of the shoe. A rounded “toe box” is recommended; the upper portion of the shoe should be soft and flexible. The lining should be smooth and free of ridges, wrinkles and seams.
- Break in new shoes gradually and wear them only a few hours at first to prevent blisters and sore spots. Check your feet for red areas indicating too much pressure.
- Check inside your shoes daily for sharp edges and foreign objects.
- Be careful soaking your feet. Many foot soaks overly dry the feet; some create too much moisture between the toes. Many fine herbal foot soaks are available that can condition skin and help with aching in the feet. Be aware of too much moisture between the toes as athlete’s foot can occur. When drying your feet, remember to get in between all your toes.
- For calloused or extra dry areas, use an oil like coconut, jojoba or shea butter to moisturize the area and keep it from cracking. Do not apply between toes.
- Change your socks at least once a day and minimize cotton and nylon in them. Look instead for wicking fibres that also provide cushioning to the soles of the feet.
- Inspect your socks daily for stains, blood or other drainage that would indicate an open sore which you may not realize you have because you cannot feel it.
- Keep your toenails trimmed. If you have reduced feeling, nerve problems or circulation problems, it is recommended that you see your podiatrist to trim your nails. This will help reduce the risk of cutting yourself, preventing a potential infection and many other problems.
- Corns and calluses are signs of excess pressure and should be evaluated and treated by your podiatrist. OTC/commercial brand corn and wart remedies (including verruca remedies) contain harmful acids that are very dangerous for people with CMT. Please do not use them!
- Avoid extremes, such as cold or heat, and if your feet are cold, wear warm boots. Never use hot water bottles or heating pads.
- Be aware that the tops of some socks can act as a tourniquet around your calf or ankle; if your legs swell, ask your podiatrist for a recommendation for a support sock. Always avoid wearing anything tight around your legs or ankles that may in any way reduce or cut off the blood supply to your feet.
- Do not smoke! Smoking constricts the blood vessels and directly affects the blood supply to your feet.
- Crossing your legs can decrease circulation; keep feet and legs moving!
- Do not apply adhesive material such as moleskin or adhesive tape to the skin of the feet without first consulting your podiatrist.
- Most importantly, examine your feet daily, including between your toes. Using a mirror can help you to see challenging spots. If you have a difficult time seeing your feet, have a family member or friend do the inspection. If you find any sores, cuts, redness, swelling, pus, or blisters (EVEN IF YOU HAVE NO PAIN), make an appointment to see your podiatrist immediately.
It is very important for everyone, of any age, with CMT to establish a relationship with a podiatrist. There is a saying that goes “the time to fix a leaky roof is when it is sunny.” In other words, do not wait to fix it when it is raining. You should be able to see a podiatrist on the NHS – ask your GP for a referral. If they quibble, remind them that CMT neuropathy can manifest itself similarly to diabetic neuropathy!
Please remember, PREVENTION IS THE BEST MEDICINE!