Peripheral Neuropathy

Certain chemotherapy treatments can cause damage to the peripheral nervous system, which include all nerves outside the brain and spinal cord. The condition is called peripheral neuropathy, which commonly causes tingling, burning, weakness or numbness in the hands and/or feet.


Other symptoms of peripheral neuropathy include:

  • Loss of balance
  • Clumsiness
  • Difficulty picking up objects and buttoning clothing
  • Walking problems
  • Jaw pain
  • Hearing loss
  • Stomach pain
  • Constipation

If you have one or more of these symptoms, report them to your doctor immediately. Medications may be able to reverse peripheral neuropathy, and physical therapy can help you maintain normal function.  


Peripheral Neuropathy


What is peripheral neuropathy?

Peripheral neuropathy describes damage to the peripheral nerve. A peripheral nerve is any nerve that is outside of the brain and spinal cord. The peripheral nervous system consists of three different divisions:

Sensory division – provides us with the ability to feel normal sensations, different temperatures, and experience pain

Motor division – provides movement, maintenance of muscle strength and coordination

Autonomic division – is responsible for specific involuntary activities such as control of our heart rate, blood pressure, perspiration and intestinal activity


Peripheral neuropathy may affect any one or all three of these divisions. Any damage in nerve function may not necessarily be permanent as peripheral nerves can heal. However, as nerves heal there may be an increase in symptoms.

What are the signs and symptoms of peripheral neuropathy?

Peripheral neuropathy associated with chemotherapy occurs most commonly in the feet and hands. Symptoms may go away over time once treatment is stopped.


Sensation Common symptoms may include: numbness, tingling, prickling, burning, shooting, freezing, pinching, cramps and /or pain sensations.

Your ability to feel hot or cold may be decreased.

Sometimes, usual activities can cause pain, such as walking, putting on your shoes, or having covers on your feet.

You may have a loss of sensation, or numbness, in your feet when you walk.


Weakness and Loss of Balance You may feel a loss of balance and have a loss of coordination when walking, and as a result you may slap your feet or trip while you walk.

You may be at risk for falls.

You may not feel an injury in your legs or arms. If injuries are not detected early, they can lead to serious infections.

You may have difficulties buttoning your shirt or opening a jar


What are the causes of peripheral neuropathy?

Peripheral neuropathy is a potential side effect of some cancer treatments, such as chemotherapies consisting of vinca alkaloids, taxanes, and platinum compounds, as well as other agents. Other causes of peripheral neuropathycan be from exposures to certain toxins, diabetes, cancer, alcohol abuse, kidney disease, liver disease, vitamin deficiency, AIDS, hypothyroidism, rheumatoid arthritis, atherosclerosis (hardening of the arteries), carpal tunnel syndrome and acquiring an inherited form of neuropathy.

If you already have peripheral neuropathy, chemotherapy may make the symptoms worse.


What do I do if I have any symptoms of peripheral neuropathy?

Tell your physician. Peripheral neuropathy may be reversible. Treatment of peripheral neuropathy depends on its cause. Ask your doctor if it would be appropriate for you to have a consultation with a neurologist or with a physician that specializes in treatment of neuropathic pain. There are medications that are used to help control nerve related pain. If symptoms are interfering with your walking, ask for a referral to a physical and occupational therapist, as certain exercises can build strength and help you maintain your normal functioning.

Safety is an important consideration for people with peripheral neuropathy due to the lack of sensation, impaired strength or muscle control.

Follow these helpful safety hints:

Examine your feet and skin daily to detect any cuts or bruises.

Take care of your feet. Wear loose cotton socks and protective shoes with good support, padding and low heels.

Keep heavy bed covers off of your feet to avoid pain.

Take extra care when walking on uneven surfaces to prevent falls. Clear obstacles from walkways, and remove throw rugs and extension cords.

Have well-lighted spaces to avoid stumbling or falling (leave a light on at night).

Adjust the water heater temperature to avoid burns. Test your bathing or washing water with your elbow rather than with your fingers for a more accurate gauge of the temperature.

Use protective gloves when you wash dishes. Use potholders or mitts for handling warm or hot dishes when you cook.

Avoid sudden movements. Take time when getting up from a lying or seated position.

Use railings for support as you go up and down stairs.

Consider the use of a cane if you are unsteady on your feet.

Avoid leaning on elbows, crossing legs or repetitive activities of the hand and wrists.

If you have diabetes, maintain good control of the disease.

Avoid excessive alcohol use.

Consider a diet high in antioxidants (bright colored fruits and vegetables).