Do I Have Peripheral Neuropathy?

Tonya Butler is now cancer-free after being treated for both cervical and thyroid cancers. But the chemotherapy that helped save her life has left her with a painful numbness and tingling in her hands, along with muscle cramps and aches. What Butler has is known as peripheral neuropathy, a set of symptoms caused by damage to nerves.

Peripheral neuropathy can be a long-term side effect caused by chemotherapy, other cancer treatment, or the cancer itself. Other causes include diabetes, infections, injuries, alcohol abuse, low vitamin B levels, some autoimmune disorders, and poor circulation.

Symptoms

Symptoms of peripheral neuropathy vary depending on which nerves are involved. Peripheral refers to all the nerves in your body other than the brain and spinal cord. Peripheral neuropathy can cause pain and make it difficult to walk or do things with your hands. The most common symptoms are:

• Pain (which may be there all the time or come and go, like shooting or stabbing pain)
• Burning
• Tingling (“pins and needles” feeling) or electric/shock-like pain
• Loss of feeling (which can be numbness or just less ability to sense pressure, touch, heat, or cold)
• Trouble using your fingers to pick up or hold things; dropping things
• Balance problems
• Tripping or stumbling while walking
• Being more sensitive to cold or heat
• Being more sensitive to touch or pressure
• Shrinking muscles
• Muscle weakness
• Trouble swallowing
• Constipation
• Trouble passing urine
• Blood pressure changes
• Decreased or no reflexes

Rarely, it can cause serious changes in your heart rate and blood pressure, dangerous falls, trouble breathing, paralysis, or organ failure.

Treatment

Medicine to treat the pain of peripheral neuropathy can include:

• Steroids for a short time until a long-term treatment plan is in place
• Numbing creams or patches
• Antidepressant medicines, often in smaller doses than are used to treat depression
• Anti-seizure medicines, which are used to help many types of nerve pain
• Opioids or narcotics, for when pain is severe

Other treatments that have helped some people with nerve pain and its effects include:

• Electrical nerve stimulation
• Occupational therapy
• Physical therapy
• Relaxation therapy
• Guided imagery
• Distraction
• Acupuncture
• Biofeedback

Living with peripheral neuropathy

The symptoms of peripheral neuropathy may lessen or go away over time, but in some cases they never go away. These are some ways to learn to live with it:

• Use pain medicines as your doctor prescribes them. Most pain medicines work best if they are taken before the pain gets bad.
• Avoid things that seem to make it worse, such as hot or cold temperatures, or tight clothes or shoes.
• Give yourself extra time to do things. Ask friends for help with tasks you find hard to do.
• Don’t drink alcohol. It can cause nerve damage on its own and might make neuropathy worse.
• If you have diabetes, control your blood sugar. High blood sugar levels can damage nerves.
• Be very careful when using knives, scissors, and other sharp objects.
• Protect your hands by wearing gloves when you clean, work outdoors, or do repairs.
• Sit down as needed, even while brushing your teeth or cooking.
• Take care of your feet. Look at them once a day to see if you have any injuries or open sores. Wear shoes that cover your whole foot when walking, even at home. Talk to your doctor about shoes or inserts that can help protect your feet.
• If you have problems walking, support yourself with a walker or cane. Consider installing hand rails in hallways and bathrooms.
• Use night lights or flashlights when getting up in the dark.
• Protect yourself from heat injuries. Set hot water heaters between 105° to 120°F to reduce scalding risk while washing your hands. Use oven gloves and hot pads when handling hot dishes, racks, or pans. Check bath water with a thermometer.
• Keep your hands and feet warm and well covered in cold weather.
• If constipation is a problem, follow your doctor’s recommendations about laxatives and exercise. Drink plenty of water and eat fruits, vegetables, and whole grains to get enough fiber.
• Talk to your doctor or nurse about the problems you are having in daily life. They might be able to suggest ways to make you feel better or function better.