Chemotherapy-Induced Peripheral Neuropathy

Chemotherapy-induced peripheral neuropathy (CIPN) is a side-effect of some chemotherapy drugs. However, the precise mechanism of injury to the nerves remains unclear. Often, the symptoms of CIPN will improve over time, especially if the chemotherapy was given fairly recently and has now been discontinued.

Typical symptoms of CIPN may include pain, numbness, tingling, weakness and/or clumsiness. The symptoms may be present in the feet and/or the hands. When present in both, its presence is often described as a “stocking-glove distribution”.

A more detailed description of the symptoms of CIPN includes:

  • Discomfort or pain
  • Pins & needles or tingling
  • Sensitivity to light touch or pressure
  • Numbness or decreased sensation
  • Balance problems
  • Weakness in the hands and/or feet
  • Difficulty with fine motor skills (e.g., buttoning a shirt, typing, etc.)

Nerve injuries may take up to two years to heal after chemotherapeutic treatment has been discontinued. Even if CIPN symptoms have been present for more than 1-2 years, there are quite a few things that can be done to reduce your discomfort and/or disability.

Questions to Ask Your Doctor

  1. Do I need any further testing?
  2. Are there any medications or treatments that you recommend?

Your Feet: Reducing Discomfort and Improving Function

The following guidelines may help you reduce the discomfort that you feel in your feet and improve your overall function:

  • To prevent injuries, avoid going barefoot.
  • Try using “rocker-bottom” shoe soles and/or soft shoe inserts (orthotics). These footwear modifications can help reduce pressure on your feet. Most shoes (except high heels and some sandals) can be taken to a shoe repair shop to have rocker bottom soles installed. There are also several commercially available rocker bottom sole shoes. Ask at your local shoe store or search for them online. Be sure to try a gentle rocker slope at first so that the shoes do not pitch you to far forward.
  • Keep all of your shoes updated and make use of shoes with good support and cushioned soles on a regular basis (running sneakers are usually a good option). You might need to consult with a pedorthist (a specialist in prescribing and fitting of therapeutic footwear) to find the best shoe.
  • Make sure that there is plenty of room in your shoes for your feet. Extra width and deep toe boxes (the front part of the shoe) will allow your feet to feel more comfortable.
  • Add Velcro® straps and/or elastic laces to your shoes to make them easier to put on and take off.
  • Use stress mats (spongy mats) in the kitchen, bathroom or other areas where you frequently stand to relieve pressure and/or pain in your feet.
  • Sit to do chores such as grooming and working in the kitchen.
  • Keep your feet warm by wearing warm socks in the winter, even if they do not feel cold.

Your Hands: Reducing Discomfort and Improving Function

The following guidelines may help you reduce the discomfort that you feel in your hands and improve your overall function:

  • Purchase smaller grocery and household items in order to avoid having to use both hands to carry things.
  • Use potholders in the kitchen to avoid burns.
  • Use tools with large, nonslip handles that are easier to hold and use.
  • Substitute electric appliances for manual ones whenever possible (e.g., an electric rather than manual can opener).
  • Try using nonskid liners or mats on counters and tables to steady plates or bowls when cooking or eating. These liners can also be used as an aid in opening jars.
  • Use voice-activated software for computer use or a one-handed key pad.
  • Explore voice activated “smart phones” for making calls and using the Internet. Explore other hands-free devices as well.
  • Avoid holding heavy books and instead try an electronic book reader or use a book stand/holder.
  • Use assistive devices such as zipper pulls, dressing sticks and button hooks to make dressing easier.
  • Use Velcro® style button aids or magnetic buttons to make fastening clothes easier.
  • Try a blow dryer stand, so that you do not have to hold your blow dryer.
  • Wear gloves in cold weather to keep your hands warm, even if they do not feel the cold.

Your Home: Reducing Your Risk for Falls

The following guidelines may help you reduce your risk of falls:

  • Use non-skid bath mats in the bathroom.
  • Install grab bars in the bathroom.
  • Remove or tack down loose rugs.
  • Remove clutter in your house and yard.
  • Keep rooms well-lit, even at night.
  • Use on/off switches that do not require you to bend over (e.g., clicker, fingertip touch or motion sensor).

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