Understanding and Managing Chemotherapy-Induced Neuropathy

At Horizon Spine & Pain of Utah, we understand how chemotherapy-induced neuropathy (CIPN) can affect your recovery journey after cancer treatment. This condition not only causes physical discomfort but can also interfere with daily activities and overall quality of life. Our expert team is dedicated to providing advanced, compassionate care to help manage symptoms and restore function.

Chemotherapy-induced peripheral neuropathy (CIPN) is nerve damage caused by certain cancer-fighting drugs. It typically affects the hands, feet, arms, or legs, resulting in pain, tingling, numbness, and weakness. This side effect can begin during chemotherapy treatment or develop after therapy is completed.

CIPN can range from mild discomfort to severe, disabling pain, depending on the type of chemotherapy and individual risk factors.

Several chemotherapy drugs are known to cause neuropathy, including:

• Platinum-based drugs (cisplatin, carboplatin, oxaliplatin)
• Taxanes (paclitaxel, docetaxel)
• Vinca alkaloids (vincristine, vinblastine)
• Proteasome inhibitors (bortezomib)

These drugs can directly damage peripheral nerves, impairing their ability to send and receive signals correctly.

Certain patients are more likely to develop chemotherapy-induced neuropathy, including those who:

• Receive higher doses or prolonged courses of chemotherapy
• Have pre-existing neuropathy (such as diabetic neuropathy)
• Have diabetes or other metabolic disorders
• Are older adults
• Have a history of alcohol abuse

Recognizing risk factors early allows for timely management and potentially modifying treatment plans.

Symptoms of chemotherapy-induced neuropathy vary but may include:

• Numbness or tingling in hands, feet, or extremities
• Burning, stabbing, or shooting pain
• Muscle weakness and difficulty with balance or coordination
• Increased sensitivity to touch, temperature, or pressure
• Cramping, twitching, or muscle wasting in severe cases

Symptoms often appear symmetrically (both sides) and can persist long after chemotherapy ends if not properly managed.

At Horizon Spine & Pain of Utah, we follow a detailed approach to diagnosing CIPN:

• Thorough medical history, focusing on cancer treatments and symptoms
• Neurological examination assessing strength, reflexes, sensation, and coordination
• Electrodiagnostic tests (nerve conduction studies and EMG) to evaluate the extent of nerve damage
• Blood tests to rule out other causes like vitamin deficiencies or thyroid disorders

A precise diagnosis allows us to customize the most effective treatment plan for your needs.

Managing CIPN is about reducing pain and improving function through non-invasive treatments, including:

Medications:

• Anticonvulsants (gabapentin, pregabalin) to stabilize nerve signals
• Antidepressants (duloxetine, amitriptyline) for neuropathic pain
• Topical treatments (lidocaine patches, capsaicin cream)

Physical therapy:

• Exercises to improve balance, strength, and coordination

Occupational therapy:

• Strategies to adapt daily activities and minimize injury risks

Nutritional support:

• Maintaining optimal blood sugar and vitamin levels to promote nerve health

Lifestyle changes, such as avoiding alcohol and smoking, can also support nerve recovery.

When symptoms are severe or persistent, we offer advanced interventional therapies, including:

• Peripheral nerve blocks:
  • Local anesthetic injections around affected nerves to reduce pain
• Spinal cord stimulation (SCS):
  • An implantable device delivering gentle electrical pulses to block pain signals to the brain
• Epidural steroid injections (in selected cases):
  • Reducing inflammation around spinal nerves contributing to neuropathy

These advanced treatments can significantly improve quality of life for patients with refractory CIPN.

Surgical intervention is rare in the management of chemotherapy-induced neuropathy. However, surgery might be considered if:

• There is a specific compressive nerve lesion exacerbating symptoms (such as carpal tunnel syndrome)
• There is severe, localized nerve entrapment requiring decompression

At Horizon Spine & Pain of Utah, surgery is only considered after non-surgical options have been explored.

Patients trust Horizon Spine & Pain of Utah for:

• Board-certified pain and nerve specialists with extensive experience in treating CIPN
• Personalized, multidisciplinary care plans based on individual symptoms and needs
• Advanced diagnostics and minimally invasive treatment options
• Compassionate care focused on restoring independence and daily function

Our goal is not only to manage your symptoms but to help you reclaim your life after cancer treatment.