Certain types of chemotherapy and conditions from diabetes affect the small sensory nerves in the feet and hands, causing symptoms such as numbness, tingling, and pain in fingers and toes, called neuropathy. Daily activities requiring grip strength and fine motor control such as buttoning may be difficult. Using your hands for long periods of activity may be difficult. This condition can also impact balance and strength. Neuropathy can lead to muscle wasting, difficulty feeling objects, decreased healing time, difficulty walking, increased fall risk, and can affect mental well-being.
If you are on a neuropathy causing medication or are having difficulty managing your diabetes, this condition can continue to worsen. If you have completed a neuropathy causing chemotherapy, it can take up to one year for the nerves to heal and recover but they may not fully recover.
Because neuropathy often changes throughout treatment, talk with your provider throughout your treatment and recovery about concerns.
What can I do?
Clinical evidence is limited regarding strategies to prevent or reduce neuropathy but show the benefit for a variety of strategies you can utilize to reduce side effects and improve day to day life and function. These strategies can be helpful at any point including starting treatment, during treatment or after.
General movement and function
Balance training: Improve awareness of feet/legs and your body in space, reduce fall risk, improve quality of movement, increase circulation and help move fluid and blood flow to proper areas of your body.
- Example: Stand at the kitchen sink and place 1 foot in front of the other-using your hands to support your balance. Wider stance = easier. Narrower stance = more challenging. Do what is challenging, yet safe and try to hold a position x 10 seconds, then switch the positions of your feet.
- Strengthening: Increase leg strength to reduce muscle wasting, improve body awareness, improve brain function, helps with moving blood and fluid to proper areas of the body.
- Example: Repeated sit to stand from a chair. Stand at a counter and try to go up on your tiptoes, march in place and try to kick your rear end.
- Aerobic exercise: Maintain and improve good blood flow to affected areas. Improves brain function. Can preserve nerve function, can possibly prevent neuropathy in cancer patients in some studies.
- Examples: Walking (use a cane or walker if needed), stationary biking, swimming.
While clinical evidence is limited, some patients report relief from complementary strategies such as:
- Massage (by a massage therapist, family member or see below for self-massage ideas), acupuncture, acupressure, vibration therapies, as well as wearing compression socks or fitted soft knit gloves. Cryotherapy (using cold to reduce blood flow and sensation to the nerves or tissues) has been helpful for some patients in preventing neuropathy but it is important to talk to your provider as some medications increase cold sensitivity.
- Supplements have very limited data on effectiveness related to neuropathy. Talk to your provider before taking anything orally to check for any contraindications with chemotherapy medicines.
- Some supplements that have been discussed are: B-Complex, Vitamin E, Glutamine, Alpha Lipoic Acid. We don’t recommend doing a general online search for neuropathy supplements due to the lack of valid information that may be online. If you have questions, please talk with your provider.
Numb and tingling feet driving you crazy? Try these strategies to calm them down: Spend time each night rubbing your feet down with lotion-get in between toes, on the tops and bottoms of your feet.
Look for creams or heavy lotions that have arthritis benefits such as: Blu-Emu or Voltaren. These lotions can have some topic pain numbing to provide relief.
They may be very sensitive so be nice to your feet, but it is very important that they are touched and moved! Using a soft cloth and gently rub your feet and toes with this until the sensitivity calms down. Once the soft cloth does not make your feet as sensitive, try a rougher material to continue to increase the tolerance to different materials.
Calming your feet’s sensitivity down is important and can help you do things like tolerate socks and shoes better and help improve sleep.
Try foot exercises!
If possible, do these exercises while barefoot to improve your coordination and balance!
- Lift up your big toe. Lower. Lift up your 4 smaller toes. Lower. Alternate lifting and lowering big and small toes x 10 to improve coordination which can help with balance.
- Toe scrunches: Place foot flat on a towel. Try to use your toes to pick up the towel by curling your toes in. This improves toe coordination and supports the arch in your foot!
- Sitting up tall in a chair: hold your knee straight as you draw circles with your foot/ankle. Go clockwise and counterclockwise with each foot 10 times.
Contact the cancer wellness team for individual guidance or support, help with a personalized plan including home exercises or management strategies, or assistance with a referral to physical therapy.