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Peripheral neuropathy

What is peripheral neuropathy?

Typically developing in the feet, legs, arms and hands, peripheral neuropathy may be caused by a number of cancer treatments, including radiation therapy and certain chemotherapy drugs. Tumors that press on nerves can also cause peripheral neuropathy, which occurs when peripheral nerves send disruptive sensations to the area of the brain that controls limb movement.

Signs of peripheral neuropathy vary depending on the nerves involved. Symptoms include:

  • Numbness
  • Shooting or stabbing pain
  • Burning
  • Tingling
  • Muscle weakness
  • Balance disruptions
  • Loss of fine-motor skills
  • Difficulty picking up small objects
  • Constant or random pain
  • Sensitivity to cold or heat
  • Limited reflexes
  • Lack of mobility

How likely are cancer patients to experience peripheral neuropathy?

An estimated 10 percent to 20 percent of cancer patients experience peripheral neuropathy, according to the Leukemia and Lymphoma Society. It is even more common in patients receiving chemotherapy. The National Comprehensive Cancer Network estimates that 30 percent to 40 percent of patients treated with chemotherapy develop “some degree” of peripheral neuropathy.

In a meta-analysis of 31 studies published in 2014 in the American Journal of Hematology/Oncology, nearly half of the 4,179 cancer patients studied experienced chemotherapy-induced peripheral neuropathy. After one month of chemotherapy, the incidence rose to almost 69 percent, then dropped to 30 percent after six months or more of chemotherapy.

A 2014 study published by American Society of Clinical Oncology concluded that the signs and symptoms of peripheral neuropathy may continue to develop and progress for two to six months after treatment—a protracted reaction known as “coasting.”

How can integrative care help?

One way to manage peripheral neuropathy is to treat the underlying causes. A combination of integrative care therapies may help to manage and lessen the effects of peripheral neuropathy, especially when the plan is personalized for the patient based on his or her needs and symptoms.

Acupuncture

Seeing an acupuncturist regularly—approximately two to three times a week—may reduce the effects of peripheral neuropathy. Acupuncture uses thin, sterile needles that are inserted lightly into the skin at various targeted acupoints to alleviate pain and lessen the severity and extent of neuropathy symptoms. 

Chiropractic Care

Trained, experienced chiropractors may help address numbness caused by neuropathy, using non-invasive manual or instrument-based procedures. Muscle weakness may also be managed with chiropractic adjustments and targeted therapies designed to increase mobility, flexibility, strength and function.

Naturopathic Medicine

Dietary supplements are among the many tools naturopathic clinicians use to help alleviate symptoms of peripheral neuropathy. These integrative oncology providers may recommend a number of different supplements to help manage and combat nerve damage caused by chemotherapy.

Oncology Rehabilitation

The wide range of therapies used in oncology rehabilitation may help patients with peripheral neuropathy. Physical and occupational therapy exercises, particularly techniques that promote mobility, stability and range of motion, may counteract symptoms and improve patients’ ability to perform everyday tasks. Oncology rehabilitation clinicians help patients understand limitations that may result from their condition, employing safety techniques that protect them from hot surfaces, sharp objects or loss of balance, for example. Physical therapy’s balance training exercises train patients on three levels: visual, vestibular (equilibrium) and proprioceptive (sensory perception). Recommendations for adaptive equipment, such as the use of a walker, cane or shower chair, may offer additional benefits.

Pain Management

Pain management physicians may recommend over-the-counter medications for mild pain, while prescribed analgesics or painkillers and/or topical treatments may help manage more severe neuropathic pain. Nerve blocks or implanted pain pumps may also help.