What is peripheral
neuropathy?
Nervous system is one of the most integral parts of our
body. It is divided as central nervous system and peripheral nervous system which
is concerned with generation of sensory and motor impulses and production of a
muscular contraction. This takes place when peripheral nerves sends and receive
impulses to and fro between brain, spinal cord and skeletal muscle fibers. Any
damage to this normal working leads to peripheral neuropathy which is
characterized by tingling, numbness, pain, burning and motor losses.
How is neuropathy
related to chemotherapy? / Chemotherapy induced
Peripheral neuropathic pain and other symptoms are directly
related to the dosages of chemotherapy drugs, the number of chemotherapy
sessions and risks of pre existing neuropathies. Certain drugs used in
chemotherapy like cisplatin, Paclitaxel, thalidomide and interferon can damage
roots and branches of peripheral nerves. Moreover, people with diabetes,
alcoholism, malnutrition or previous chemotherapy sessions are at a higher risk
of nerve damage.
Commonly affected
areas
Since peripheral nerves become more vulnerable with repeated
chemotherapy sessions, they can result in a strong discomforting sensation and
most commonly affect:
- Finger and toes in a stocking glove fashion.
- Bowel – Constipation or intestinal blockage.
- Face, back and chest pain
What measures can be
taken to minimize after effects?
There is no particular regimen which works for everyone
accounting for individual differences. However, a combination of several
interventions works to some extent. Any abnormal feeling, discomfort or signs
of sensation disturbances should be reported to the doctor. Follow all
necessary instructions regarding rest and treatment protocols and always be
active in decision making when the concern is treatment versus quality of life.
Self protection and
safety
- Protect your feet and hands if there is loss of sensation. Wear thick socks and shoes with soft soles.
- Never expose body to extreme cold situations.
- Be careful while washing dishes or taking a bath.
- Use gloves while gardening, handling glass surfaces or washing.
- Use pot holders when you cook.
- Quit alcohol
- Use hand rails and assistive devices while walking.
- Inspect your skin time to time for any cuts, abrasions or burns.
Comfort measures
- Protect affected areas with flexible splints.
- Indulge yourself in active exercises.
- Massage for relaxation helps.
- Vitamins like B1, B6, B12, vitamin E and niacin are known to improve nerve nutrition.
- Take laxatives to relieve constipation.
- Take regular medications, steroids or patches and topical ointments.
Treatment of
neuropathy after chemotherapy
The treatments for peripheral neuropathy comprises of
analgesics, anti depressants and anti seizure medications.
This is followed by some physical therapy sessions to
relieve pain and rehabilitate the weak muscles using resistive exercises. A
physical therapist also explains to manage the activities of daily living and
suggests use of braces, splints or walking aids if required.
Apart from these, electrical modalities like TENS,
biofeedback or dry needling are proven remedies for pain and can be safely
administered even in severe cases.
