Navigating Chemo-Induced Peripheral Neuropathy: How Physical Therapy Can Help

If you or a loved one are undergoing cancer treatment, you may have heard the term "neuropathy." Chemo-induced peripheral neuropathy (CIPN) is a common side effect of treatment, affecting anywhere from 30% to 68% of patients. In fact, it is the most frequent reason patients have to reduce their chemotherapy doses or stop treatment altogether.

While this can feel overwhelming, understanding what is happening in your body is the first step toward managing it. Even more importantly, physical therapy can be a vital partner in your journey.

Understanding Your Nervous System

To understand neuropathy, we first have to look at the three types of nerves in our peripheral nervous system:

• Sensory Nerves: These provide sensation, allowing you to feel pain, temperature, and light touch.
• Motor Nerves: These act as the bridge between your brain and your muscles, allowing you to move.
• Autonomic Nerves: These handle involuntary functions, like your heart rate, blood pressure, digestion, and body temperature.

Neuropathy occurs when these nerves are damaged, disrupting the communication signals between your brain, spinal cord, and the rest of your body. Because this damage usually starts in the hands and feet and moves inward (a pattern called "distal to proximal"), it often affects both sides of the body at once.

How Does Neuropathy Feel?

Because different nerves have different jobs, the symptoms of neuropathy can vary:

• Sensory changes: You may feel burning, sharp, shooting, or electric-like pain, as well as numbness, tingling, or dizziness.
• Motor changes: Damage here can lead to weakness, difficulty walking or balancing, trouble with fine motor skills (like buttoning a shirt), and muscle cramps.
• Autonomic changes: You might experience digestive issues (constipation or diarrhea), bladder changes, or fluctuations in blood pressure. 

While some patients recover, it is important to know that chemo-induced neuropathy can sometimes be irreversible. This is why early intervention is so critical.

The Role of Physical Therapy

You don’t have to "just live with it." Physical therapy is designed to maximize your function whether you are about to start treatment, currently undergoing chemotherapy, or have already completed it.

When should you see a physical therapist?

If you are struggling with your balance, experiencing frequent falls, dealing with dizziness, or noticing changes in your strength, talk to your doctor about a referral to physical therapy. A PT can help you build a personalized plan to improve your quality of life.

What happens during a PT evaluation?

A physical therapist will perform a comprehensive assessment to understand your unique impairments. This may include:

• Strength testing to identify muscle weakness.
• Balance and proprioception testing to see how well you sense your body’s position in space.
• Vestibular assessment to check your inner ear function.
• Cardiovascular testing to evaluate your overall endurance.
• Sensory integration testing to see how your nerves are responding to vibration and touch.

Your Goal is Our Goal

The primary goal of physical therapy is to keep you moving, safe, and independent. By evaluating your limitations and listening to your personal goals—whether that’s walking to the mailbox safely or getting back to gardening—a physical therapist can create a targeted program that improves your strength, stability, and confidence.

If you are a cancer patient or survivor, please speak with your oncology team today about whether physical therapy is the right next step for you. You have a team behind you, and there are tools available to help you navigate your recovery and regain your function.