Peripheral Neuropathy (Nerve Damage)

What is peripheral neuropathy?

Neuropathy is irritation or damage to the nerves. Nerves are long, wire-like fibers in your body that send messages from one area to another.  Peripheral nerves are how your brain communicates with your skin, muscles, and organs. They carry sensations (feelings) of temperature, pressure, and pain to your brain. Nerves control the movement of your arms and legs. Peripheral neuropathy happens when a nerve or group of nerves has trouble communicating with each other. 

What causes peripheral neuropathy?

There are many causes of peripheral neuropathy, including diabetes. This article focuses on peripheral neuropathy caused by your cancer or its treatment.

If you have cancer, peripheral neuropathy can be caused by:

• Tumors that put pressure on the nerves.
• Some chemotherapy medications, especially higher doses or many doses.
• Radiation therapy or surgery that can cause scarring. These scars can put pressure on the nerves.

What are the symptoms of peripheral neuropathy?

Call your provider if you have:

• More sensitivity to hot and cold. This can feel like burning, pain, or numbness.
• Heavy, numb, or tingling arms or legs.
• "Pins and needles" in your arms or legs.
• Pain while walking, or if you are tripping or falling.
• A hard time lifting your feet or toes.
• Trouble picking up or holding objects, or moving them in your hand.
• A hard time using buttons.
• Cold feeling in arms or legs.

Peripheral neuropathy can become severe and can cause injuries. Talk to your provider about how to stay safe while managing peripheral neuropathy.

How long does peripheral neuropathy last?

• It can be acute: meaning it happens during or shortly after having treatment and lasts a few days.
• It can be chronic: meaning it is long-lasting and continues during and after treatment.

Some people feel better within 6 to12 months. Others have symptoms for a longer time, and for some people, symptoms never go away.

What can I do?

• Tell your provider right away if you have any of the above symptoms. Treating nerve damage early, lowering the dose, or taking a break from the chemotherapy that is causing the problem may stop the symptoms from getting worse.
• Wear gloves and warm socks, especially in winter.
• Stay safe! Since peripheral neuropathy can affect your mobility (how you move your body) and ability to sense temperatures, there are some things you can do to make sure you are safe: 
  • Always wear shoes, both indoors and outside.
  • If you have neuropathy in your hands, use knives, scissors, box cutters, and other sharp objects with care.
  • Protect your hands by wearing gloves when you clean, work outdoors, or do repairs.
  • Make sure your house is well-lit.
  • Keep a night light on in your room and along the path to the bathroom.
  • Cover steps and bathtub/shower with a non-skid surface.
  • Clear stairs and hall of objects.
  • Mark the edge of the step with a bright color to help determine where the step ends.
  • Use handrails.
  • Remove throw rugs.
  • Test the temperature of the water with an area of your body that is not affected by neuropathy before any bathing and dishwashing.
  • Always check your feet and shoes at the beginning and end of each day. Look for any redness, blisters, or open sores that you may not feel.
• If you have pain, your provider may suggest medications that are used to treat nerve pain, such as Elavil, Pamelor, Neurontin, or Lyrica. These medications may have side effects and should be closely monitored by your provider.
• Physical therapy (PT) can help with your balance, strength, and safety. Braces may be needed to help with extreme muscle weakness and instability.
• Occupational therapy (OT) can help your fine motor coordination, such as writing. 

Speak with your provider if you feel that you have symptoms of peripheral neuropathy to make a treatment plan.