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What Is Chemo-Induced Peripheral Neuropathy?

Any injury, inflammation, or degeneration of the peripheral nerve fibers due to the effects of chemo or radiation.  

Why Is Massage Therapy Helpful?

In Chemo-Induced Peripheral Neuropathy, nerve endings (most commonly in the fingers and toes) have been damaged.  Cell debris obstructs the capillaries in functional nerve endings, limiting the oxygen needed to maintain good function.  Stimulating the tissues with massage helps to break up and clear out the cell and toxic debris while also increasing circulation and oxygen delivery.  This promotes restoration of sensation. 

 Potential Massage Benefits

·         Comfort is increased in affected areas.

·         Normal sensation is returned more quickly over time.

·         Improved quality of life with activities like walking, holding objects, buttoning shirts, etc.


 For hand neuropathy massage, limit your massage time to a maximum of 2-3 minutes if any of the axillary (armpit) lymph nodes on that side were removed.  Because lymphedema is always a risk, it is imperative that you use light pressure and observe a shorter timeframe on the affected side.

Important to Know

The sooner massage is started (by self or others) when symptoms first appear, the better.  Ideally, one would begin this protocol at the same time chemo treatment starts as an attempt to impede the accumulation of cell and toxic debris.  When neuropathy symptoms have continued for years, the likelihood of recuperating sensation is lower, but there are still ways to provide comfort if this is the case (see Massage Technique #3).  However, the prognosis is very good for reversing symptoms if it is treated early.

Massage pressure does not need to be deep and painful to be effective.  Deep massage can tax a body that is already under stress.  Light to medium pressure with a good firm contact on the skin is ideal.

Massage should be performed daily and no more than twice daily.  Duration should be as long as it takes to cover the whole area that is experiencing neuropathy symptoms (you may do the protocol for as long as desired, unless you’ve had axillary lymph nodes removed).  See Precautions.

The direction of massage strokes is important!  Your stroke should ALWAYS be moving towards the rest of the body (ie. always in the direction of the ankle if working on the foot or the wrist if working on the hand).

Massage Techniques Based on Severity of Symptoms

It is wise to begin each session by inspecting your hands and/or feet.  Take care not to massage over broken skin.  Let your doctor know if dark spots are present. 

Technique #1: If neuropathy symptoms are primarily in the toes or fingertips, place your thumb on the tip of your toe or finger with your index finger behind the digit helping to keep it stable.  Begin moving your thumb in an inchworm fashion down the toe or finger until you reach an area that is unaffected.  Then begin again at the top and move down all sides and areas until you’ve massaged the entire circumference of that digit.  

Technique #2: If neuropathy symptoms have progressed past the toes or fingers into parts of the foot or hand, start massaging at the edge of where the symptoms are present and work your way towards the ankle or wrist.  Return to the edge again and gradually move into the affected area in an inchworm fashion while still maintaining the direction of your strokes towards the ankle or wrist.     

Technique #3:  If neuropathy symptoms are present in the entire foot or hand and it is too painful to massage, then gentle and sustained compression (holding) often helps to soothe, comfort and calm the nervous system.  

Additional Information

·         Lotion or oil for this specific massage is not advised unless you find it to be more soothing.  However, use very little so as not to impede your grip while working.  It is wise to choose options with 100% natural ingredients (ie. organic coconut oil). 

·         For extra therapy, a good oil to consider is Mahanarayan Oil (online through Banyan Botanicals).  It is considered to be good for nerve damage with joint-targeting herbs in a base of organic sesame oil. (Note: purchase a small amount to start as it is fairly expensive, has a strong earthy smell and can stain fabric).  It is not recommended as a glide for massage work, but as an oil to be left on the hands/fingers or feet/toes after the massage protocol and covered with gloves or socks.  Initially, experiment with it on a small section of the hands/feet to see how your body responds.  It is not known to cause adverse reactions


Medicine Hands: Massage Therapy for People with Cancer.  Gayle MacDonald, 3rd Edition. 2014