Understanding and Managing Radiation-Induced Neuropathy

At Horizon Spine & Pain of Utah, we specialize in treating complex nerve conditions, including radiation-induced neuropathy. This rare but serious form of nerve damage can develop months or even years after cancer treatments involving radiation therapy. Our team is here to help you understand your condition and explore the most advanced options for managing nerve pain and restoring function.

Radiation-induced neuropathy occurs when radiation therapy, used to treat cancer, unintentionally damages the nearby nerves. This can cause chronic nerve pain, numbness, weakness, and other sensory or motor problems depending on which nerves were affected.

This type of neuropathy most commonly impacts the:

• Brachial plexus (shoulder/arm nerves) after radiation for breast or lung cancers
• Lumbosacral plexus (lower back/pelvis nerves) after radiation for prostate, bladder, or cervical cancers

Radiation can damage nerves through:

• Direct injury to nerve fibers
• Reduced blood supply (ischemia) leading to nerve degeneration
• Development of scar tissue (fibrosis) that compresses or entraps nerves over time

Higher doses of radiation, larger radiation fields, and combined chemotherapy can increase the likelihood of nerve injury.

Patients may have a greater risk of developing radiation-induced neuropathy if they:

• Received high doses of radiation
• Underwent combined chemotherapy and radiation therapy
• Had pre-existing nerve issues prior to cancer treatment
• Experienced radiation exposure to critical nerve plexuses (brachial or lumbosacral)
• Developed radiation fibrosis syndrome

Prompt recognition of symptoms is critical to starting early treatment.

Symptoms vary depending on the affected area but often include:

• Burning, shooting, or stabbing pain
• Numbness or tingling in arms, hands, legs, or feet
• Muscle weakness or muscle wasting
• Balance problems or difficulty walking
• Loss of coordination
• Severe cases: Bladder, bowel, or sexual dysfunction (especially with lumbosacral plexopathy)

Symptoms typically develop gradually, sometimes years after radiation therapy ends.

At Horizon Spine & Pain of Utah, diagnosing radiation-induced neuropathy involves:

• Comprehensive medical history review, especially cancer and radiation treatment records
• Detailed neurological examination assessing motor strength, reflexes, and sensation
• MRI or CT imaging to rule out tumor recurrence or other structural causes
• EMG/Nerve conduction studies to assess the extent of nerve injury

A precise diagnosis ensures we deliver the right treatments to help you recover.

Many patients benefit from a combination of non-surgical treatments, including:

Medications:

• Gabapentin or pregabalin to reduce nerve pain
• Antidepressants like amitriptyline for neuropathic pain relief
• Pain relievers or anti-inflammatory medications

Physical therapy:

To maintain strength, flexibility, and prevent joint stiffness

Occupational therapy:

To improve daily function and adapt to changes in strength or sensation

Cognitive Behavioral Therapy (CBT):

To help manage the emotional effects of chronic nerve pain

For patients with persistent or severe symptoms, we offer advanced pain management techniques, including:

• Nerve blocks: Targeted anesthetic injections to reduce pain and inflammation
• Epidural steroid injections: Particularly useful if inflammation is compressing nerve roots
• Spinal cord stimulation (SCS): A small implant that sends mild electrical pulses to the spine to block pain signals

These therapies can significantly improve pain control and quality of life when medications alone are not enough.

Surgery is rarely needed for radiation-induced neuropathy but may be considered if:

• Scar tissue severely compresses a nerve or nerve root
• Other reversible structural abnormalities are identified

Surgical procedures must be carefully planned because nerves previously exposed to radiation are often more fragile.

Patients trust Horizon Spine & Pain of Utah because we offer:

• Board-certified physicians specializing in pain management and complex neuropathies
• Personalized treatment plans tailored to your unique history and symptoms
• Advanced diagnostic tools and therapies
• Non-surgical and minimally invasive options, whenever possible
• Patient education resources

Our team understands the unique challenges of radiation-induced neuropathy and is dedicated to helping you manage symptoms and restore function.