Chemotherapy-Induced Peripheral Neuropathy (CIPN)

What is Chemotherapy-Induced Peripheral Neuropathy?

Chemotherapy-Induced Peripheral Neuropathy (CIPN) occurs when certain cancer treatments damage the nerves outside the brain and spinal cord, affecting sensation, movement, and coordination. Understanding how this condition develops helps explain why symptoms can persist even after chemotherapy ends.

The Peripheral Nervous System Explained

Your peripheral nervous system is a vast network of nerves that extends from your brain and spinal cord to every other part of your body. These nerves are like the body’s electrical wiring, responsible for carrying signals that control sensation (like touch, temperature, and pain), motor function (muscle movement), and automatic bodily functions (like heart rate and blood pressure).

How Chemotherapy Impacts These Nerves

Certain powerful chemotherapy drugs, while effective at destroying cancer cells, can also be toxic to these delicate peripheral nerve cells. They can damage the nerve endings themselves or their protective outer layer, called the myelin sheath. This damage disrupts the flow of signals between the brain and the extremities, leading to the debilitating symptoms of chemo induced neuropathy.

Common Signs and Symptoms of CIPN

Symptoms most often appear in a "stocking-glove" pattern, starting in the longest nerves first, those that travel to your feet and hands. Key symptoms include:

• Tingling, pins-and-needles, or numbness in the hands and feet.
• Burning sensations or sharp, shooting pains.
• Weakness in the hands and legs, making it difficult to grip objects or walk.
• Decreased balance and coordination, leading to an increased risk of falls.
• Difficulty with fine motor tasks, such as buttoning a shirt, tying shoes, or writing.

Underlying Causes of Chemotherapy-Induced Peripheral Neuropathy

Not all chemotherapy drugs cause neuropathy. The risk is primarily associated with specific classes of neurotoxic agents used to treat a wide range of cancers.

Platinum-Based Chemotherapy Agents

Drugs like Cisplatin, Carboplatin, and Oxaliplatin are widely used to treat cancers of the lung, colon, ovary, and testicles. They are known to be significant culprits in causing peripheral nerve damage.

Taxanes

This class includes drugs like Paclitaxel (Taxol) and Docetaxel (Taxotere), which are cornerstones in the treatment of breast, ovarian, and lung cancers. They are also strongly linked to the development of CIPN.

Other Neurotoxic Agents

Other drugs that can cause CIPN include Vinca alkaloids (like Vincristine) used for leukaemias and lymphomas, and proteasome inhibitors (like Bortezomib) used to treat multiple myeloma.

Risk Factors for Chemotherapy-Induced Peripheral Neuropathy (CIPN)

The development and severity of chemotherapy-induced peripheral neuropathy can vary greatly from person to person. Several factors can increase an individual's susceptibility.

• Chemotherapy regimen and dosage: Higher cumulative doses, longer treatment duration, and combination therapies significantly increase nerve toxicity risk.
• Pre-existing health conditions: Diabetes, prior neuropathy, vitamin deficiencies, or chronic alcohol use make nerves more vulnerable to damage.
• Age and genetic factors: Older adults may recover more slowly, and genetic differences can affect how nerves respond to chemotherapy.

How CIPN Is Diagnosed

A precise diagnosis is the first step toward effective management. This process involves a combination of patient feedback and clinical evaluation.

Patient-Reported Symptoms and History

The diagnosis almost always begins with you. Your oncologist or physiotherapist will ask detailed questions about your symptoms: what they feel like, where they are located, when they started, and how they impact your daily activities. This history is crucial.

Comprehensive Neurological Examination

A therapist will conduct a physical exam to assess the function of your nerves. This includes testing your reflexes, muscle strength, and your ability to feel sensations like light touch, vibration, and temperature. They will also carefully evaluate your balance and walking pattern (gait).

Advanced Diagnostic Tools

In some cases, your doctor may recommend nerve conduction studies (NCS) or electromyography (EMG). These tests measure the speed and strength of electrical signals travelling through your nerves and muscles, providing concrete evidence of nerve damage and helping to rule out other potential causes.

Role of Neuro Rehabilitation in the Management of CIPN

While there is no single cure for CIPN, neuro rehabilitation is a cornerstone of effective management. It empowers patients to regain function, reduce pain, and improve their quality of life.

Restoring Balance and Preventing Falls

Loss of sensation in the feet can severely impact balance, making falls a serious risk. Physiotherapists design specific exercises that challenge and retrain your balance systems. This helps your body learn to compensate for the lost sensory information, dramatically improving stability and confidence.

Improving Strength and Regaining Motor Control

Weakness and poor coordination can make everyday tasks feel impossible. A tailored program of strengthening exercises helps combat muscle atrophy, while fine motor skill training—practising tasks like picking up small objects or buttoning—helps retrain the neural pathways for better hand function.

Alleviating Pain and Discomfort

Neuropathic pain can be relentless. At a specialized neuro rehab centre like Physiotattva, therapists use a variety of techniques to provide relief. These can include manual therapy to improve joint mobility, desensitization techniques to calm overactive nerves, and Transcutaneous Electrical Nerve Stimulation (TENS) to help block pain signals.

Choosing the Right Neuro Rehab Centre for Your Recovery

Finding the right support is crucial for your recovery journey. When selecting a clinic, consider these key qualities:

Look for Neurological Specialization

Choose a clinic where therapists have advanced training and proven experience in treating neurological conditions. They will understand the unique challenges of CIPN and have the specialised skills necessary to help.

Insist on a Personalized Treatment Plan

CIPN affects everyone differently. Avoid a one-size-fits-all approach. A great rehabilitation program is built around you—your specific symptoms, your functional limitations, and, most importantly, your personal goals.

Ensure a Goal-Oriented Approach

The true measure of success isn't just reduced pain; it's getting back to the life you love. An excellent neuro rehab centre focuses on functional goals, whether that means walking confidently in the park, gardening without pain, or playing with your grandchildren.

Recovering Strength and Independence After CIPN with Physiotattva

Chemotherapy-induced peripheral neuropathy is a significant post-treatment challenge, but it does not have to define your life. Through an accurate diagnosis and a proactive management plan centered on specialized neuro-rehabilitation, you can effectively manage your symptoms, restore function, and reclaim your independence.

At Physiotattva physiotherapy clinics in Bangalore and Hyderabad, you receive personalised care tailored to your specific needs, ensuring effective results and comfort throughout your journey to recovery. 

Don’t wait to start your recovery! Get in touch with Physiotattva for more details! Contact us at +91 89510 47001.