Chemotherapy-induced peripheral neuropathy (CIPN)

What is CIPN

CIPN is a side effect of some chemotherapy medicine. CIPN can cause weakness and sensory changes in the feet and hands.

Weakness in the muscles can lead to muscles becoming tight which can affect how a child walks, balances, holds objects and writes. There is also pain when the affected area is touched. 

CIPN does not occur in every child who is given chemotherapy medicine, but it is a common side effect.

Physiotherapists and occupational therapists can help with a management plan as soon as CIPN is identified. 

CIPN often resolves within three months after completion of chemotherapy, however, some symptoms may persist.

Signs to look out for

  • ‘pins and needles’ sensation
  • pain
  • numbness
  • extra sensitivity to touch
  • weakness
  • difficulties with walking or balance
  • difficulties with hand skills.

Chemotherapy drugs that are more likely to cause CIPN

Children who receive any of the following may be at risk:

  • Vincristine
  • Vinblastine
  • Cisplatin
  • Carboplatin
  • Etoposid

Treatment

Treatment of CIPN requires a team approach due to the wide range of symptoms. Treatment may include some or all of the following:

  • strengthening exercises to strengthen muscles affected by CIPN
  • stretching exercises to preventing tight muscles
  • walking to help your child walk as normally as possible
  • desensitisation exercises that are completed with textures and temperatures to decrease the sensitivity to touch 
  • orthotic device that helps support a part of the body
  • a resting hand splint may be used to help stretch the muscles in the forearm and hand, similar to the orthotics
  • learning how to relieve pain with gentle exercise and pacing of activities. 

These therapy activities aim to reduce the impact of CIPN. Medicines can also be used to manage the pain associated with CIPN. The best outcomes are achieved when medications are used with an active physiotherapy or occupational therapy program.

What to do if you think your child has CIPN

You should tell your doctor or nurse who can then have the physiotherapist or occupational therapist review, assess and make recommendations for your child.

For more information please contact the therapy departments on (02) 7825 3369 and ask for the oncology physiotherapist or oncology occupational therapist.