Coping with Neuropathy: Tips for Preventing and Managing Nerve Pain During Treatment

Chemotherapy and some targeted therapies used in the treatment of bowel cancer can trigger a side effect known as chemotherapy-induced peripheral neuropathy (CIPN). It often shows up as tingling, numbness, burning sensations, or sharp pain in the hands and feet, and it can seriously mess with your quality of life.

While not everyone develops neuropathy, those undergoing treatment for early-onset bowel cancer are encouraged to take proactive steps in managing and, where possible, preventing its onset.

Understanding and managing neuropathy isn’t just about comfort. It’s about staying functional, independent, and in control throughout your cancer journey.

What Causes Neuropathy in Bowel Cancer Treatment?

Chemotherapy-induced peripheral neuropathy is primarily caused by damage to the small nerves in the peripheral nervous system. Common culprits include:

• Oxaliplatin – often used in bowel cancer treatment, well known for causing cold-sensitive neuropathy
• Capecitabine – which may trigger hand-foot syndrome (palmar-plantar erythrodysesthesia)
• Targeted therapies – less common, but can also impact nerve function

Symptoms usually start during treatment and can persist long afterward. Some people experience only mild discomfort, while others find it painful or debilitating.

Common Symptoms to Watch For

• Tingling or “pins and needles” sensations
• Numbness in fingers, toes, or lips
• Burning or shooting pain
• Heightened sensitivity to touch, cold, or heat
• Difficulty with balance or coordination
• Muscle weakness or cramps
• Trouble doing small tasks (like buttoning a shirt or picking up coins)

Early recognition is key. Always report symptoms to your oncologist or nurse as soon as they appear.

Preventing and Minimising Neuropathy Risk

There’s no guaranteed way to prevent neuropathy, but several strategies may reduce your risk or slow its progression:

• Cold avoidance: If you’re receiving oxaliplatin, avoid cold drinks and exposure to cold air or water, particularly within the first few days of treatment (the one exception: icing during infusion).
• Icing during chemotherapy infusion: Some studies suggest that applying ice packs or wearing cold gloves and socks during infusion may significantly reduce the chances of developing neuropathy, particularly with oxaliplatin. Learn how to do this safely in our upcoming blog: Icing During Chemo.
• Gentle exercise: Walking, yoga, or tai chi can help keep circulation and nerve pathways active.
• Blood sugar management: Keeping blood glucose in a healthy range is especially important for people with diabetes or pre-diabetes.
• Supplements (with medical approval): Some oncologists recommend B vitamins, alpha-lipoic acid, or magnesium, but only under guidance, as evidence is mixed.
• Acupuncture: A growing body of research supports its role in both preventing and treating neuropathy symptoms, more on that below.

My Experience with Neuropathy and Acupuncture

After about eight rounds of oxaliplatin, I had neuropathy so bad my hands and feet were almost completely numb or tingling 24/7. It made everyday tasks a struggle. I hadn’t heard about icing at the time, wish I had, but I did eventually try acupuncture, and it made a massive difference. The tingling and numbness didn’t vanish overnight, but it became limited to my fingertips and toes rather than my whole hands and feet.

That change was enough to let me finish all 12 rounds of FOLFOXIRI without needing a dose reduction. I kept doing acupuncture afterwards, and now I don’t have any lingering signs of neuropathy at all. It absolutely helped, and if I’d started it earlier, I reckon it could’ve prevented some of the worst of it.

What to Do if You Start Experiencing Neuropathy

If symptoms begin during treatment, speak up immediately. The earlier it’s addressed, the more options you’ll have for relief. Your healthcare team may:

• Adjust your chemotherapy dosage
• Switch medications if neuropathy becomes too severe
• Refer you to supportive therapies like physio, OT, or pain management

In many cases, neuropathy improves over time, but for some, it can be long lasting or permanent.

At-Home Tips for Managing Neuropathy Symptoms

• Protect your hands and feet:
  • Wear gloves when cooking, gardening, or cleaning
  • Choose padded socks and cushioned footwear
  • Inspect your feet daily for injuries or pressure spots
• Modify your environment:
  • Install grab rails or anti-slip mats in bathrooms
  • Use utensils with padded grips or modified handles
• Prioritise foot care:
  • Keep nails trimmed and feet moisturised
  • Avoid walking barefoot
  • See a podiatrist if needed
• Maintain warmth:
  • Avoid direct cold air or AC on your hands and feet
  • Use heating pads on low or warm water foot soaks, always test the temperature first if you have reduced sensation

Pain relief options might include:

• Paracetamol or ibuprofen (with medical guidance)
• Prescription meds like duloxetine, pregabalin, or amitriptyline
• Topical treatments like menthol creams or capsaicin patches

The Role of Acupuncture in Neuropathy Care

Acupuncture is a traditional Chinese medicine practice that’s increasingly used in cancer care to manage treatment side effects, including peripheral neuropathy. It involves inserting fine needles into specific points to stimulate blood flow and calm the nervous system.

Why Acupuncture?

• May reduce nerve pain and tingling by modulating nerve signals
• Improves circulation and encourages relaxation
• Non-drug relief, great for avoiding more meds

Several small studies and clinical trials show that acupuncture may reduce the severity and frequency of neuropathy symptoms, especially those linked to oxaliplatin.

Choosing the Right Practitioner:

• Look for an acupuncturist experienced in cancer care (ideally trained in integrative oncology)
• Ask if they’ve worked with chemotherapy-induced neuropathy before
• Check credentials via the Australian Acupuncture and Chinese Medicine Association (AACMA)

Some public hospitals and cancer centres in Australia may offer access to oncology-trained acupuncturists. Always ask, you might be surprised what’s available.

When to Seek Specialist Help

Persistent or severe neuropathy that affects your daily life should be evaluated by a neurologist or pain specialist. Your oncologist or GP can refer you.

Specialist support might include:

• Nerve conduction studies to assess damage
• Physiotherapy or rehab for mobility and strength
• Prescription pain plans
• Counselling if chronic pain is affecting your mental health

Don’t suffer in silence. Ongoing nerve pain can chip away at your independence, mood, and sleep. There’s no shame in getting help. In fact, it’s a smart move.

Support Services in Australia

• Bowel Cancer Australia – Offers patient support, resources, and referrals for supportive care services
• Cancer Council – Call 13 11 20 for free information, counselling, and local referrals
• Painaustralia – Provides education and advocacy for people living with chronic pain
• Allied health professionals: Ask your team about access to physios, OTs, or podiatrists with cancer-specific training

Final Thoughts

Living with neuropathy during or after bowel cancer treatment can be frustrating and painful, but you don’t have to go through it alone. Early action, informed choices, and support from a multidisciplinary team can make a real difference.

Consider integrating acupuncture, gentle movement, and nerve-protective strategies into your care plan. Ask your hospital or cancer centre if they offer acupuncture or support icing during chemo, it’s worth the question.

Your nerves may take a hit during treatment, but your ability to advocate for yourself doesn’t have to.