1. What is peripheral neuropathy?
2. What causes peripheral neuropathy?
3. What are the symptoms of peripheral neuropathy?
4. How is peripheral neuropathy treated?
5. How to manage symptoms of peripheral neuropathy
6. Can I reduce my risk of peripheral neuropathy?
7. Can I drive if I have peripheral neuropathy?
8. Further support
Peripheral nerves send messages between the brain and the spinal cord (the central nervous system) and the rest of the body.
Peripheral neuropathy happens when these nerves are damaged. It’s most common in the hands and feet because the nerves are longer than in other parts of the body.
The most likely cause of peripheral neuropathy in people with breast cancer is chemotherapy.
The most common chemotherapy drugs that cause peripheral neuropathy are:
Other cancer treatments can cause peripheral neuropathy, such as surgery or radiotherapy.
Peripheral neuropathy can also be caused by the cancer pressing on a nerve.
Whether you develop peripheral neuropathy will depend on:
- the drug or combination of drugs you’re having
- the dose you’re prescribed
- whether you’ve had previous cancer treatment that causes peripheral neuropathy
- whether you have diabetes or another condition that can cause nerve damage
You can discuss your risk of developing peripheral neuropathy with your treatment team.
Symptoms of peripheral neuropathy can include:
- pain (often burning or shooting)
- numbness in hands and feet
- altered sensations in your feet
- loss of balance
- pins and needles or tingling
- a feeling of warmth or cold
- increased sensitivity to pain and hot or cold temperatures
- difficulty doing ‘fiddly’ tasks such as fastening buttons
- muscle weakness
- feeling light-headed or dizzy
For some people the symptoms are mild and go away soon after treatment stops. However, for most, the symptoms will last longer but gradually improve over the weeks and months after treatment has finished. Symptoms may not disappear completely and, occasionally, neuropathy can worsen after the treatment has stopped.
The most effective treatment is to prevent further damage. If you develop any symptoms of peripheral neuropathy, it’s important to let your treatment team know. If your symptoms are having a big impact on your quality of life, they may talk to you about delaying, reducing or stopping treatment to try and make sure it doesn’t get any worse.
Treatment is mostly given to relieve nerve pain (sometimes called neuropathic pain). You may be given drugs that are usually prescribed for depression or epilepsy, which can also help to reduce pain caused by damaged nerves. These include amitriptyline, pregabalin and gabapentin. Unlike many other types of pain, nerve pain isn’t usually relieved by common pain relief drugs such as paracetamol and ibuprofen.
You can also ask your treatment team to refer you to a specialist pain clinic. They may suggest other types of pain relief or alternative ways of trying to manage symptoms, for example physiotherapy or acupuncture.
You can search for a pain management service near you on the NHS website.
- avoid injuring your feet by wearing slippers and well-fitting shoes
- check the temperature of water with your elbow to make sure it isn’t too hot
- use oven gloves when cooking to avoid burning your hands
- if your balance is affected, make sure your home is well lit and floors are clear of trip hazards (you can ask to be referred to a physiotherapist for advice about walking aids)
- check regularly for injuries to your hands and feet so that if you do hurt yourself it can be dealt with quickly (this may prevent the injury getting worse or developing an infection)
Other things that may help
- keep your hands and feet warm by wearing socks and gloves
- if you’re having difficulty with fiddly tasks such as fastening buttons, ask for a referral to a physiotherapist or occupational therapist
- if you feel light-headed or dizzy, stand up slowly and make sure the dizziness has passed before you start to walk around
Currently there’s no proven way to prevent or reverse peripheral neuropathy, though studies are looking into this.
You’re legally required to inform the Drivers and Vehicle Licensing Authority if you have peripheral neuropathy.
Peripheral neuropathy can be difficult to manage, but you don’t have to cope alone. You can call our Helpline free on 0808 800 6000 to talk to one of our nurses. Our Someone Like Me service can put you in touch with one of our trained volunteers, who have personal experience of breast cancer and know what you’re going through. You might also find it helpful to talk to others on our online discussion Forum.