If your child has chemotherapy, their hands or feet might feel numb or weak at times. This can happen during or after a treatment. It happens because chemotherapy medicines sometimes damage the nerves. The medical term for this is “chemotherapy-induced peripheral neuropathy,” or CIPN.
The information below tells you about nerve problems from chemotherapy, if your child is at risk, what the signs are, and which treatments can help.
What are nerve problems from chemotherapy?
These problems happen when chemotherapy damages the nerves. It can damage 3 different types of nerves.
- Sensory nerves. The nerves that control what we see, smell, taste, and touch. If your child has sensory nerve damage, they might say they have pain. Or they might not be able to feel a light touch. An example of a light touch is feeling a mosquito on your arm.
- Motor nerves. The nerves that control movement. If your child has motor nerve damage, their hands or feet might become weak.
- Autonomic (ah-TOE-naw-mic) nerves. The nerves that control things your body does automatically (on its own). This includes breathing, digesting food, and keeping blood pressure steady. Dizziness is one (1) sign of autonomic nerve damage.
Is my child at risk?
Some types of chemotherapy put your child at a higher risk for nerve problems. Below is a list of chemotherapy medicines that might lead to nerve damage.
Important things to know
- If your child is receiving more than one (1) type of chemotherapy, they have a greater risk of nerve damage.
- Higher doses of chemotherapy increase the risk.
- Different types of chemotherapy cause damage to different nerves. Your child might have more than one (1) type of nerve damage.
Symptoms often go away after your child finishes treatment. However, in some cases, the changes may be permanent.
Signs of nerve damage from chemotherapy
- Tingling, burning, sharp pain, or muscle cramps in the feet or hands.
- Muscle weakness. Your child might have difficulty with everyday tasks like opening water bottles or holding onto objects.
- Numb arms or legs.
- Extra sensitivity to touch. Your child might be more sensitive than usual to clothing, hugs, or other feelings.
- Difficulty with activities that use small movements, such as buttoning things up, texting, or tying their shoes.
- Dizziness when getting up from sitting or lying down.
- Losing their balance and tripping or falling down often. Your child might also walk differently. For example, you might hear your child’s feet slap on the floor when they walk barefoot.
How occupational therapy can help
An occupational therapist, or OT, can help by learning how your child’s nerve problems affect their everyday life. The therapist tests your child’s sensory nerves, strength, and ability to do tasks that use small movements. Then, the therapist will recommend treatment. The goal is to help your child keep doing everyday activities on their own as much as possible. Treatment may include some or all of the following activities.
- Strengthening. Your child might do exercises to strengthen muscles affected by nerve damage such as in the hands or upper arms.
- Pain relief. Learning to relieve pain by doing relaxation techniques or deep breathing exercises.
- Fine motor skills. Your child uses these skills for tasks that use small movements. Examples are zipping something up, tying their shoes, or working with beads.
- Handwriting. The therapist might give your child a tool to help them hold onto a pencil or have them practice their handwriting skills.
- Orthotics. An orthotic (or-THOUGHT-ick) is a piece of material that helps support part of the body. For example, it might wrap around your child’s wrist to keep their hand or wrist in the right position.
- Adaptations. An adaptation (add-ap-TAY-shun) is a trick or tool to help your child use their hands better and more safely. Examples include using a hook to button a shirt if their hands are weak, or learning to check the temperature of bathtub water on the back of their hand so they do not get burned.
How physical therapy can help
A physical therapist, or PT, can help by learning how your child’s nerve damage affects their ability to move around. The therapist tests your child’s strength as well as how far they can move their arms, legs, hands, and feet (range of motion). They will also test your child’s balance, ability to feel, and ability to walk normally. Then they will recommend treatment. The goal is to help your child move and play on their own as much as possible. Treatment may include some or all of the following activities.
- Strengthening. Exercises to strengthen muscles affected by nerve damage, including in the feet, ankles, and legs.
- Stretching. Stretches to help your child keep moving their ankles normally while they recover from nerve damage.
- Gross motor skills. “Gross motor skills” are skills that use the big muscles of the body, such as jumping, climbing stairs, squatting, and running. The therapist will help your child work on these, if necessary.
- Walking. Helping your child walk as normally as possible, such as making their feet slap or drag less or helping them learn to walk faster.
- Balance. Practicing balance by doing specific activities, such as standing on one foot or walking across a balance beam.
- Orthotics. An orthotic is a piece of material that helps support part of the body. For example, your child might get one to help support and protect their feet and ankles, help them lift their feet when they walk, or walk further. An arch support is an example of a common orthotic.
- Preventing falling. Helping your child avoid falling and getting hurt. The physical therapist might give your child orthotics or a walker. Or they might teach them to wear safe shoes and avoid sandals and flip-flops.
- Pain relief. Learning to relieve pain with gentle exercise or by wearing different shoes.
Your child’s doctor might prescribe medicine for nerve pain if physical or occupational therapy does not completely control it. Having therapy might allow your child to control pain with less medicine.
Try giving your child a warm bath to help with pain. You can also try gentle massage and stretching. If your child has leg pain, ask the nurse or physical therapist if propping your child’s legs up on pillows might help.
Talk to your child’s doctor or nurse if you think your child might have nerve damage from chemotherapy. You can also ask questions about this condition or learn if your child might have it.
This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.
St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
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