Peripheral Neuropathy (Nerve Damage)

What is peripheral neuropathy?

Neuropathy is irritation or damage to the nerves. Nerves are long, wire-like fibers in our body that send messages from one area of our body to another.  Peripheral nerves are how the brain communicates to the skin, muscles, and organs. They carry sensations (feelings) of temperature, pressure, and pain to the brain and 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?

• Tumors can put pressure on the nerves.
• Some chemotherapy medications, especially at higher doses or after many doses.
• Radiation therapy or surgery may cause scarring. These scars can put pressure on the nerves.
• Eating, drinking, or touching something cold or breathing in cold air.

How long will 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 6-12 months. Others have symptoms for a longer time period and for some people, symptoms become permanent.

What are the common symptoms of peripheral neuropathy?

Call your care team if you have any of the following:

• Arms or legs feel heavy, numb, or tingling, or feel like "pins and needles."
• Tripping, falling, or pain when walking.
• Difficulty lifting your foot or toes.
• Trouble picking up or holding objects, or moving them in your hand.
• Difficulty using buttons.
• Cold feeling in arms or legs.
• Increased sensitivity to hot and cold.

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

What can I do?

• Tell your care team right away if you have any of the above symptoms. Treating nerve damage early, lowering the dose, or taking a break from the chemotherapy causing the problem may stop the symptoms from getting worse.
• Wear gloves and warm socks, especially in winter.
• Stay Safe! Since peripheral neuropathy may affect your mobility and ability to sense temperatures, it is important to take some simple measures to ensure your safety. Ideas include:
  • 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 any 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.
  • Tape down the edges of all throw rugs to avoid tripping.
  • 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 starting.
• If you have pain, your provider may recommend medications that are used to treat pain caused by nerve damage, such as Elavil, Pamelor, Neurontin, or Lyrica. These medications may have side effects and should be closely monitored by your care team.
• Physical therapy can help with your balance, strength, and safety. Braces may be needed to help with extreme muscle weakness and instability.
• Occupational therapy can help fine motor coordination, such as writing, and therapists can help adapt your home to account for the changes in your situation.

Speak with your care team if you feel that you have symptoms of peripheral neuropathy so that you can create a plan of how to manage it.