Pins and Needles – Peripheral Neuropathy

What is Peripheral Neuropathy?

Peripheral neuropathy occurs when there is an injury or damage to the peripheral nervous system. Peripheral nerves are those nerves located outside the brain and the spinal cord. Peripheral nerves send information back to the brain and spinal cord, for example for pain (a finger is burned), temperature (feet are cold), and touch and movement. Damage to the peripheral nervous system can cause a problem with these messages between the brain and the rest of your body. However, peripheral neuropathy associated with chemotherapy occurs most commonly in the feet and hands and symptoms may go away over time once treatment has finished.

What are the symptoms of peripheral neuropathy?

Because every peripheral nerve has a special function in a specific part of the body, a wide variety of symptoms can occur when nerves are damaged.

Symptoms may include:

  • a feeling of numbness, tingling, cold, prickling, pinching, cramps, burning, and/or "pins and needles" sensation in your hands and/or feet

  • a decreased sensation of hot and cold

  • muscle weakness and balance problems

  • difficulty picking up an object or buttoning your blouse or shirt

  • pain which may present as

  • a dull aching sensation in hands and/or feet

  • an intense burning sensation or

  • a shooting or electrical shock type of pain

  • ringing in your ears and/or difficulty hearing

  • difficulty opening your bowels (constipation)

What chemotherapy treatments can cause peripheral neuropathy?

Peripheral neuropathy is a potential side effect of some cancer treatments. The most common drugs to cause it are vincristine, vinorelbine, vinblastine, cisplatin, carboplatin, oxaliplatin, paclitaxel, docetaxel, bortezomib, thalidomide.

You may be at higher risk for developing peripheral neuropathy if you have pre-existing conditions such as diabetes, alcoholism, malnutrition, vitamin B deficiencies, or have had previous chemotherapy, radiation or surgery.

What should I do if I have symptoms of peripheral neuropathy while on chemotherapy?

It is important to tell you doctor and nurse if you have any symptoms before your next treatment. Although it may not be possible to prevent the occurrence of early nerve damage from some drugs it can often be prevented from getting any worse. Commonly early nerve damage may go away some time after the cancer treatment has finished. Your treatment plan may be changed to stop further nerve damage.

How is peripheral neuropathy diagnosed?

Peripheral neuropathy is usually diagnosed by the symptoms you have reported. Occasionally tests may be done to understand the specific type of nerve damage and the extent. You may be referred to a neurologist or a doctor who specialises in the treatment of nerve (neuropathic) pain as there are medications that are used to help control nerve related pain.

If I develop peripheral neuropathy what do I need to consider?

Safety is an important consideration due to a lack of sensation, and having less strength or muscle control

Points to remember for your safety:

  1. keep your rooms uncluttered and well lit so you can see where you are going to prevent a fall

  2. if there are rugs on the floor, especially in the bathroom, they should have a non-slip backing.

  3. avoid slippery, wet floors, wipe up liquids immediately. Use portable over-the-tub handgrips or install shower grips.

  4. adjust the water heater temperature to avoid burns and test your bathing or washing water with your elbow rather than with your hands.

  5. around the kitchen use rubber gloves, pot holders and oven mitts to handle items that are hot or cold

  6. shield your fingers when cutting foods and take care opening jars.

  7. wear rubber shoes or boots and gloves when working in the garage or garden.

  8. wear gloves and warm socks in cold weather

  9. ask someone else to drive especially if you are not able to feel the brake pedals and or steering wheel.

  10. avoid excessive alcohol consumption