However, in some cases it may be irreversible and never diminish in intensity or the area of the body affected. Various techniques have been tried by patients and recommended by physicians to prevent, lessen the severity or treat chemotherapy side effects such as peripheral neuropathy. There is no "one-size-fits-all" regimen that works for everyone.
Much of the treatment is based on trial and error, and finding what combination of interventions works for the individual. Protection and Safety against Peripheral Neuropathy :. Measures to relieve constipation induced by neuropathy :. Medications recommended for chronic neuropathic pain are also used for other medical conditions.
Among the most effective are a class of drugs first marketed to treat depression. Another class of medications that quiets nerve cell electrical signaling is also used for epilepsy. Common drugs include gabapentin, pregabalin, and less often topiramate and lamotrigine. Carbamazepine and oxcarbazepine are particularly effective for trigeminal neuralgia, a focal neuropathy of the face. Local anesthetics and related drugs that block nerve conduction may help when other medications are ineffective or poorly tolerated.
Medications put on the skin topically administered are generally appealing because they stay near the skin and have fewer unwanted side effects. Lidocaine patches or creams applied to the skin can be helpful for small painful areas, such as localized chronic pain from mononeuropathies such as shingles. Another topical cream is capsaicin, a substance found in hot peppers that can desensitize peripheral pain nerve endings. Doctor-applied patches that contain higher concentrations of capsaicin offer longer term relief from neuropathic pain and itching, but they worsen small-fiber nerve damage.
Weak over-the-counter formulations also are available. Lidocaine or longer acting bupivicaine are sometimes given using implanted pumps that deliver tiny quantities to the fluid that bathes the spinal cord, where they can quiet excess firing of pain cells without affecting the rest of the body.
Other drugs treat chronic painful neuropathies by calming excess signaling. Because pain relievers that contain opioids can lead to dependence and addiction, their use must be closely monitored by a physician.
One of the newest drugs approved for treating diabetic neuropathy is tapentadol, which has both opioid activity and norepinephrine-reuptake inhibition activity of an antidepressant. Surgery is the recommended treatment for some types of neuropathies.
Trigeminal neuralgia on the face is also often treated with neurosurgical decompression. Injuries to a single nerve mononeuropathy caused by compression, entrapment, or rarely tumors or infections may require surgery to release the nerve compression.
Polyneuropathies that involve more diffuse nerve damage, such as diabetic neuropathy, are not helped by surgical intervention. More sophisticated and less damaging procedures such as electrically stimulating remaining peripheral nerve fibers or pain-processing areas of the spinal cord or brain have largely replaced these surgeries. Transcutaneous electrical nerve stimulation TENS is a noninvasive intervention used for pain relief in a range of conditions.
TENS involves attaching electrodes to the skin at the site of pain or near associated nerves and then administering a gentle electrical current. Although data from controlled clinical trials are not available to broadly establish its efficacy for peripheral neuropathies, in some studies TENS has been shown to improve neuropathic symptoms associated with diabetes.
The best treatment is prevention, and strategies for reducing injuries are highly effective and well tested. Since medical procedures ranging from casting fractures to injuries from needles and surgery are another cause, unnecessary procedures should be avoided.
The new adjuvanted vaccine against shingles prevents more than 95 percent of cases and is widely recommended for people over 50, including those who have had previous shingles or vaccination with the older, less effective vaccine. Diabetes and some other diseases are common preventable causes of neuropathy. People with neuropathy should ask their doctors to minimize use of medications that are known to cause or worsen neuropathy where alternatives exist.
Some families with very severe genetic neuropathies use in vitro fertilization to prevent transmission to future generations. The mission of the National Institute of Neurological Disorders and Stroke NINDS is to seek knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. Sullivan, who is the clinical program manager for Patient Education at Dana-Farber, answered questions about prevention, safety, and managing side effects.
A transcript of the chat follows:. A: Neuropathy does not affect every patient and symptoms can differ depending on the chemotherapy type, dosage, frequency, or other pre-existing health issues. The risk for neuropathy depends not on the diagnosis, but the type of treatment used to treat the cancer. A: Specific types of chemotherapy, radiation, and surgery can cause damage to nerves that can lead to neuropathy Patients with pre-existing conditions, such as diabetes or peripheral vascular disease, may already have neuropathy as a result of these diseases.
If you already have neuropathy and are starting cancer treatment, speak to your team about your specific symptoms. Prior to treatment, it is important that all patients talk with their oncologists about any diseases or conditions they may have. A: There is no clear treatment for neuropathy that will improve nerve damage, but a combination of pain medications, vitamins, lotions and exercise can help you manage symptoms.
A: Neuropathy can happen at any time during or after your chemotherapy treatment it is drug specific. While it is rare, it is possible for symptoms to develop several years after treatment.
A: There is a genetic type of neuropathy that is called I-A Type and is linked to auto-immune diseases. The type of neuropathy we are discussing today is related to specific chemotherapy medicines. A: The most important prevention tip is to be attentive to your symptoms and to report any concerns to your doctor right away.
Your cancer team will be able to create a treatment plan that will protect you from injury and possibly prevent your symptoms from worsening. A: Physical therapy is one of the most effective treatments for neuropathy — it can help with balance, strength and safety. Occupational therapy can also be beneficial and can help patients improve fine motor skills like buttoning shirts. In addition to these therapies, low-impact exercise like swimming and biking, as well as acupuncture, relaxation techniques, meditation, and guided imagery exercises can all help with the side effects of neuropathy.
A: Low-impact exercises are best; swimming and biking are two examples. For neuropathy in the hands, patients can try finger taps tap each finger to the thumb, one at a time or finger rolls bend fingers, one at a time, into a fist. More information on exercises to help neuropathy.
A: There is some evidence that a well-balanced diet can help prevent or reduce symptoms of neuropathy. It is also important to avoid alcohol and smoking, as they can make neuropathy worse. More information on healthy eating during cancer treatment.
Remember, it the combinations of medications, vitamins, lotions, and exercise that may be most helpful. Use night lights or flashlights when getting up in the dark. Protect yourself from heat injuries. Use oven gloves and hot pads when handling hot dishes, racks, or pans. Check bath water with a thermometer. Keep your hands and feet warm and well covered in cold weather. Drink plenty of water and eat fruits, vegetables, and whole grains to get enough fiber.
Talk to your doctor or nurse about the problems you are having in daily life. They might be able to suggest ways to make you feel better or function better. Reviewed by. The American Cancer Society medical and editorial content team Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
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