Overview
Currently, peripheral neuropathy can be managed but can’t be reversed.
Your cancer treatment may be adjusted or paused to stop peripheral neuropathy from getting worse. There are also various medicines that may relieve symptoms.
There are ways you can reduce symptoms and the risk of injury, such as doing regular exercise, adjusting your home to reduce the risk of falls, and caring for your hands and feet.
What's on this page
Currently there is no treatment that can reverse nerve damage. To stop chemotherapy-induced peripheral neuropathy from getting worse, your doctor may change how much or how often you have chemotherapy. In severe cases, chemotherapy may need to be stopped altogether. If peripheral neuropathy is caused by the cancer itself, symptoms may ease once the cancer has been treated. For some people, the damage may be permanent.
You may be worried about telling your treatment team that you have symptoms of peripheral neuropathy because you want to complete the cancer treatment. But not telling them could mean that you miss any chance to reverse the nerve damage and symptoms. If your doctor recommends pausing or stopping chemotherapy, they will talk to you about other ways to treat the cancer.
Medicines to manage symptoms
Doctors use various medicines to help relieve symptoms including:
- pain medicines – you can try over-the-counter pain medicines (e.g. paracetamol, ibuprofen) but these may not be helpful; your doctor may prescribe stronger pain medicines (e.g. tramadol), but the side effects may mean that these are not good long-term solutions
- duloxetine – sometimes this antidepressant is recommended for managing peripheral neuropathy; while some studies have shown that it helps relieve numbness, tingling and pain, other studies have found no benefit
- other drugs – because treatment options are limited, some other types of antidepressants, the anticonvulsant pregabalin, and the topical creams capsaicin or lignocaine are sometimes recommended by doctors to relieve symptoms such as cancer pain, but how well they work is not clear
- laxatives or stool softeners – these can help manage constipation.
You may see a range of health professionals to help manage peripheral neuropathy symptoms, including a psychologist (or sometimes a pain specialist), exercise physiologist, occupational therapist, physiotherapist or podiatrist.
Driving safely
Ask your doctor if it’s safe to drive or operate machinery, especially if you do this for work. Depending on the symptoms, you may need a break from driving and your licence may be impacted.
Ways to manage peripheral neuropathy
Try these tips to help relieve symptoms, reduce the risk of injury and adapt to life with peripheral neuropathy.
Exercising
Exercising
Studies suggest that in people having chemotherapy, those who do some exercise have a lower risk of developing nerve damage. Gentle, regular exercise can also help reduce the symptoms of peripheral neuropathy pain. A daily gentle walk is a good starting point. Continuing to exercise after you finish treatment may also lower your risk of post-treatment peripheral neuropathy. A physiotherapist, exercise physiologist or occupational therapist can create a suitable exercise plan that’s personalised for your situation.
For more information, see Exercise for people with cancer.
Avoiding falls
Avoiding falls
- Avoid slippers or shoes with thick soles that might make you trip.
- Keep rooms well lit.
- Remove clutter and any loose rugs.
- Use a non-slip mat in the shower and bath.
- Place rails on stairs and in the bathroom.
- Talk to your doctor about a falls prevention program.
An occupational therapist suggests aids or equipment (e.g. special shoes) or strategies (e.g. using visual cues on uneven ground) to help you with daily tasks and to reduce your risk of falls. They may gradually introduce different textures to encourage normal use of your hands. A physiotherapist or exercise physiologist may help you to improve your strength and balance, and may also suggest walking aids.
Caring for hands and feet
Caring for hands and feet
- Moisturise and keep nails trimmed.
- Keep hands and feet warm.
- Wear gloves when washing the dishes or gardening.
- Use heatproof potholders when cooking.
- Test water temperature with your elbow.
- Make sure your shoes fit well.
- Untuck sheets and bedcovers. Try silk or bamboo sheets if your feet are sensitive or use a special frame to keep sheets off your feet.
- Some people find magnesium (in a cream or tablet) eases muscle cramps in the feet and legs.
A podiatrist can trim your toenails, treat any skin problems (e.g. blisters and corns), and check your feet for signs of any injuries that you may not have noticed.
Preventing dizziness
Preventing dizziness
- Drink plenty of fluids.
- Go slowly when you stand up to allow your blood pressure to adjust. Stay by the chair or bed for 20 seconds after standing up.
- Wear support stockings during the day to improve your circulation.
- Sit down when brushing teeth or putting on shoes.
- When getting out of bed, sit up and gently move your feet and legs for a little while, before standing up.
Managing constipation
Managing constipation
- Eat plenty of fruit, vegetables, whole grains and high-fibre foods.
- Drink plenty of fluids.
- Do some physical activity (such as walking) daily, as this often helps.
- Talk to you doctor and take any laxatives as prescribed.
Coping with pain and other challenges
Coping with pain and other challenges
Learning relaxation or meditation may help you manage pain and discomfort. A psychologist can teach you these techniques, or try our Finding Calm During Cancer podcast. Some people find massage helps nerve pain, but check with your doctor first. TENS (transcutaneous electrical nerve stimulation) devices which send small electrical currents to parts of the body, and certain dietary supplements, are in clinical trials to see if they help. A counsellor or psychologist can help with the challenges caused by your diagnosis.
For more information, see Cancer pain.
Talking about your sex life
Talking about your sex life
Talk to your doctor about issues with erections, vaginal dryness or loss of libido as there may be medicines that can help.
For more information, see Sex, intimacy and cancer.
The impact of peripheral neuropathy
This varies from person to person, but can include:
- discomfort and pain from physical symptoms
- trouble completing usual tasks (e.g. doing up buttons)
- high risk of burns and cuts due to numbness, which can increase the risk of infection during chemotherapy
- risk of not noticing injuries, which may become more serious because they aren’t treated promptly
- high risk of falls and difficulty walking due to numbness or pain in your feet or feeling off-balance
- constipation and lack of bowel or bladder control
- poor sleep because of shooting pains
- not being able to drive because of symptoms
- feeling isolated or that you have lost your independence
- not being able to return to work or usual activities
- money issues because of health care costs.
Coping with peripheral neuropathy can be challenging. Call Cancer Connect on 13 11 20 for more information and support.
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