For a long time CMT was described as a painless condition. That does not match what patients report: pain is one of the most frequently mentioned complaints, and it is often more treatable than the muscle weakness itself.
Two kinds of pain, two approaches
Overload pain comes from your joints, muscles and the soles of your feet. It develops because you walk differently: high arches concentrating your weight on a small surface, an ankle that constantly corrects, a back compensating for your gait. This pain is usually worse in the evening, after a long day, and eases with rest.
Neuropathic pain comes from the nerves themselves. It feels different: burning, tingling, shooting, or like an electric shock. Some people also have allodynia — the bed sheet on your feet hurting. This pain cares little about rest or activity and can be worst at night.
The distinction matters, because overload pain is treated with shoes, orthoses and physiotherapy, and neuropathic pain is not.
What helps with overload pain
- Good footwear and, where needed, insoles or an ankle-foot orthosis that redistributes the load.
- Physiotherapy aimed at gait, strength around the ankle and calf flexibility.
- Pacing: the pain often arrives hours after the effort, so you notice too late that you went too far.
- Weight management, because every kilo travels through those overloaded feet.
What helps with neuropathic pain
There is no medicine developed specifically for CMT. Doctors use the same drugs as for other nerve pain: amitriptyline, duloxetine, gabapentin or pregabalin. Ordinary painkillers such as paracetamol and anti-inflammatories usually do not work on this type of pain.
One point matters especially in CMT: these drugs can cause drowsiness, dizziness and slower reactions. If your balance is already precarious, that means more falls. Start low, build up slowly, and report it if you start walking less steadily — that is a reason to review the dose or the drug, not something to quietly put up with.
Cramps
Night cramps in calves and feet are common. Stretching before bed, drinking enough and paying attention to your footwear during the day help most often. Medicines agencies advise against quinine for cramps because of rare but serious side effects.
When to see a doctor sooner
- Pain that changes markedly over a short time, or becomes one-sided.
- A painful, red or warm spot on the foot — that may be a wound or infection you cannot feel because of reduced sensation.
- Pain that structurally wrecks your sleep.