Medical Oncologist
Nerve side effects
Burning and shooting nerve pain
Some people develop pain rather than, or as well as, numbness: burning feet, shooting or electric-shock pains, or pain from light touch or cold. Nerve pain behaves differently from ordinary pain and often does not respond to everyday painkillers, but specific medicines, physical approaches and practical changes can ease it.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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The short answer
What causes burning or shooting pain in the hands and feet after chemotherapy?
When chemotherapy damages nerves, some people feel numbness, but others feel pain: burning feet, especially at night, sudden shooting or stabbing pains, electric-shock sensations, or pain from things that should not hurt, such as bed sheets touching the feet or holding something cold. This is nerve pain, and it behaves differently from the pain of a cut or a sprain.
That difference matters because ordinary painkillers often help very little. Nerve pain usually needs specific medicines that calm over-active nerve signals, along with physical and practical approaches. It is worth reporting clearly and separately from numbness, because it can be treated, and untreated nerve pain wrecks sleep, mood and the ability to walk.
Describe the pain precisely
Burning, shooting, stabbing, electric, crawling, or pain from light touch. These words help your team recognise nerve pain and choose treatment.
Nerve pain medicines need patience
They are usually started at a low dose and increased gradually, and it can take some weeks to feel the full effect. Stopping too soon is common.
Sleep is often the first casualty
Pain that is worse at night deserves attention in its own right, because poor sleep makes pain feel worse and coping harder.
Tell your team about nerve pain at every appointment, and say how it affects sleep, walking and daily tasks.How nerve pain feels
The sensations people describe
- Burning
- A hot, burning feeling in the soles, toes or fingertips, often worse at night or after standing, even when the skin feels cool to touch.
- Shooting or stabbing pains
- Sudden sharp jolts that come and go, sometimes several times a minute, often without any obvious trigger.
- Electric-shock sensations
- Brief electric feelings along the fingers or into the feet, occasionally triggered by bending the neck or moving a limb.
- Pain from light touch
- Bed sheets, socks or gentle contact causing discomfort or pain, which can make it hard to wear shoes or lie comfortably.
- Pain with cold
- Sharp or aching pain when touching cold objects or in cold air, particularly after certain platinum drugs.
- Aching or cramping
- Deep aching or muscle cramps in the feet, calves or hands, sometimes alongside numbness.
Not sure whether this applies to you?
Ask an oncologistPractical
Approaches that can ease nerve pain
Usually a combination works better than any one thing.
Specific nerve pain medicines
Certain medicines, including some originally developed for depression or seizures, calm over-active nerve signals. Your team will choose based on your symptoms, kidneys, heart, mood and other medicines.
Expect
- A low starting dose, increased slowly
- Possible drowsiness or dizziness at first
Treatments applied to the skin
Some prescribed creams, gels or patches can help localised burning pain for some people. Ask your team before using any product on the skin.
Movement and physiotherapy
Gentle activity, stretching and balance work can reduce pain and stiffness and help sleep. A physiotherapist can suggest what suits you.
Try
- Short walks in cushioned shoes
- Gentle ankle and finger movements
Practical comfort measures
A frame to keep sheets off painful feet, soft seamless socks, cool rather than hot foot soaks, and avoiding tight shoes can reduce triggers.
Sleep and mood support
Pain, poor sleep and low mood feed each other. A regular sleep routine and talking to your team or a counsellor about mood can make pain easier to manage.
!
Get medical help the same day, or immediately, for any of these
Sudden severe back pain with new leg weakness or numbness · loss of control of the bladder or bowels · sudden weakness of an arm, leg or the face · severe pain with a red, hot, swollen area or a wound on the foot · a painful swollen calf · severe drowsiness, confusion, fainting or breathing difficulty after starting or increasing a pain medicine · thoughts of harming yourself because of the pain. Go to the nearest emergency department and say clearly that the person is having or has had chemotherapy.
Being straight with you
What this page cannot tell you
It cannot recommend a specific medicine or dose. Nerve pain medicines have important interactions and side effects, and the right choice depends on your kidneys, liver, heart, mood, other medicines and whether you drive or work. Your team will prescribe and adjust them.
It also cannot promise that pain will disappear completely. For many people it can be reduced to a manageable level, and it may ease as nerves recover, but some need longer-term management.
Do not stop nerve pain medicines suddenly
Some cause unpleasant effects if stopped abruptly. If side effects are a problem, tell your team so the dose can be reduced safely.
Be careful combining medicines
Sleeping tablets, strong painkillers, alcohol and some nerve pain medicines together can cause dangerous drowsiness. Tell your team everything you take.
Pain specialists can help
If pain remains severe despite treatment, ask for a referral to a pain clinic or palliative care team, who specialise in difficult nerve pain.
Report it to your oncologist during treatment
Painful nerve symptoms during chemotherapy may affect decisions about the dose of the drug causing them. Mention pain, not only numbness.
Keep a simple pain diary
Note when the pain is worst, what it feels like, what triggers it, how it affects sleep, and any medicine taken. Bring it to appointments. It helps your team see whether a medicine is working and whether the dose needs changing.
Tell people close to you
Nerve pain is invisible, and family may not realise why you are irritable or not sleeping. Explaining it helps them support you.
What to do next
Describe your pain precisely to your team, including how it affects sleep and walking. Ask about nerve pain medicines and give them time to work, try gentle movement and comfort measures, and ask for a pain specialist referral if pain stays severe.
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Commonly believed
Four beliefs about nerve pain
"Ordinary painkillers will control it."
Nerve pain often responds poorly to everyday painkillers. Specific medicines that calm nerve signals usually work better, prescribed and adjusted by your team.
"An antidepressant means they think the pain is in my head."
Some medicines first used for depression also calm nerve pain directly. They are prescribed for the pain itself, not because anybody doubts it is real.
"If the medicine did not work in a week, it does not work."
Nerve pain medicines usually start low and increase slowly, and the full effect can take weeks. Discuss progress with your team before stopping.
"Hot water soaks will ease burning feet."
Heat can worsen burning pain and numb skin can scald without being felt. Cool, not cold, soaks and soft socks are safer.
Questions we are asked
Common questions about nerve pain
Why do my feet burn at night?
Damaged nerves can send pain signals without a real injury, and many people notice it more at night when there are fewer distractions. Tell your team, because specific medicines and comfort measures can help.
Will ordinary painkillers help?
Often only a little. Nerve pain usually needs medicines that calm nerve signals. Ask your team rather than increasing ordinary painkillers on your own.
Why was I prescribed an antidepressant for pain?
Some medicines first developed for depression also reduce nerve pain. They are used for the pain itself, and your team will explain the benefits and side effects.
How long do nerve pain medicines take to work?
They usually start at a low dose that is increased gradually, and full benefit may take several weeks. Keep your team informed about progress and side effects.
The sheets touching my feet hurt. What can I do?
A simple frame or pillows to keep bedding off the feet, soft seamless socks, and treatment of the nerve pain itself can help. Mention it to your team.
Can I drive while taking nerve pain medicines?
Some cause drowsiness or dizziness, especially at first. Do not drive until you know how the medicine affects you, and ask your team for advice.
Will the pain go away?
It may ease as nerves recover, often slowly over months. For some it persists and is managed longer term. Treatment usually reduces it to a more manageable level.
Who can help if the pain is not controlled?
Ask for a referral to a pain clinic or palliative care team. They specialise in difficult nerve pain and can offer further options.
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Sources
- National Cancer Institute — Chemotherapy and You: Support for People With Cancer
- Cancer Research UK — Side effects of chemotherapy
- Macmillan Cancer Support — Chemotherapy
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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