Charcot Marie Tooth Disease and Foot Pain

[DOSouthpaw]

Just received a referral for this. Anyone treated it before. Did a literature search and orthotics and surgery is all that is mentioned. Anything injection wise you guys have tried?

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[PMR 4 MSK]

I've got one right now. 30-ish woman. Using walker for long distances and AFOs all the time. She's rapidly losing function in her hands. NCVs in her hands are around 12 m/s (normal 50+) LE responses absent below the knees.

I have her on gabapentin 1200 TID and it works well, with an occasional hydrococodone. Lyrica and SNRIs as well as tricyclics are alternatives.

There is no injection for it. PT can sometimes help, mostly for stretching and desensitizing. Topicals may be of benefit to some, such as Lidoderm.

Since diabetic PPN can sometimes be helped with SCS, I wonder if CMT can?

 

[lobelsteve]

I've got one right now. 30-ish woman. Using walker for long distances and AFOs all the time. She's rapidly losing function in her hands. NCVs in her hands are around 12 m/s (normal 50+) LE responses absent below the knees.

I have her on gabapentin 1200 TID and it works well, with an occasional hydrococodone. Lyrica and SNRIs as well as tricyclics are alternatives.

There is no injection for it. PT can sometimes help, mostly for stretching and desensitizing. Topicals may be of benefit to some, such as Lidoderm.

Since diabetic PPN can sometimes be helped with SCS, I wonder if CMT can?

The SCS studies on DMPN is a total of 17 patients with reported 70% success. That is not a resounding "yes, it works". Just a hey, maybe we should try this. Knowing hundreds of SCS cases were tried for this, I think it is near useless.

Topical triple cream for foot pain. Try Brown's Pharmacy in CO. #6 is my favorite there, it has everything in it, including dragonfly ripple.

I also have a CMT patient, but we are RF'ing her T-spine. No foot pain.

 

[DOSouthpaw]

Yeah, this is the first referral I've received from this PCP and it had to be something that is near impossible. PCP is referring for "injection treatment" but like I thought and you guys confirmed, unless he wants to come in for a block everyday there really isn't anything injections would do. Guess I'll just Pamlor it and slap on some topical.

 

[nvrsumr]

The SCS studies on DMPN is a total of 17 patients with reported 70% success. That is not a resounding "yes, it works". Just a hey, maybe we should try this. Knowing hundreds of SCS cases were tried for this, I think it is near useless.

Topical triple cream for foot pain. Try Brown's Pharmacy in CO. #6 is my favorite there, it has everything in it, including dragonfly ripple.

I also have a CMT patient, but we are RF'ing her T-spine. No foot pain.

Steve

I get all my thoracic RFs denied. Do you have any studies? I'd take n of 17 with 70% success