Medical Oncologist
Nerve side effects
Numbness and tingling during chemotherapy
Some chemotherapy drugs affect the long nerves to the fingers and toes, causing numbness, tingling, burning, or a feeling of wearing gloves that are not there. It usually builds with each cycle. The one thing that changes the outcome is reporting it early, while your team can still adjust treatment to protect the nerves.
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
Why do hands and feet go numb during chemotherapy?
Some chemotherapy drugs affect the long nerves that run to the fingers and toes, and the result is numbness, tingling, pins and needles, burning, or a feeling of wearing gloves or socks that are not there. It usually starts in the tips of the fingers and toes and can creep upwards as cycles accumulate. Not every drug causes it, and it is far more likely with some than others.
The one thing that changes the outcome is reporting it early. When your team knows about it while it is still mild, they can adjust the dose or the schedule before the nerve damage becomes lasting. When patients keep quiet until the end of the course, that option has gone.
Report it at the first sign, every cycle
Even if it is mild, even if it comes and goes, even if you are worried it will mean a change to your treatment. That change is exactly what protects the nerves.
Ask whether your drugs cause it
Platinum drugs, taxanes, vinca drugs and a few others are the usual causes. Knowing whether yours are among them tells you how closely to watch.
It is usually cumulative
Each cycle tends to add to the last, so it is often mild early and more noticeable later. That predictability is what makes early reporting so useful.
Tell your team specifically if buttons, writing, holding a cup or walking have become harder.What patients describe
How nerve changes show up
- Tingling or pins and needles
- Usually the first sign, in the tips of the fingers or toes. It may come and go at first, and patients often dismiss it as sleeping on an arm or sitting awkwardly.
- Numbness
- A loss of feeling, as if wearing thin gloves or socks. Things feel muffled, and small objects are harder to pick up or feel in a pocket.
- Burning or shooting pain
- Some people get pain rather than numbness: burning feet at night, electric shocks in the fingers, or pain on touching something cold. This is managed differently and should be reported separately.
- Clumsiness with fine tasks
- Buttons, earrings, writing, typing, picking up coins, tying laces. Often noticed by the family before the patient mentions it.
- Unsteadiness
- Numb feet make it harder to sense the ground, particularly in the dark or on uneven surfaces. Falls become more likely, especially in older patients.
- Sensitivity to cold
- With certain drugs, cold drinks, cold air or touching the fridge triggers tingling or pain in the hands, mouth or throat. It is specific and worth mentioning.
Not sure whether this applies to you?
Ask an oncologistPractical
What to do when it starts
Report first, then protect the hands and feet.
Tell the team before the next cycle
Describe where it is, whether it comes and goes or stays, whether it hurts, and what it stops you doing. Specific descriptions help the team decide whether to adjust anything.
Say specifically
- Which tasks have become harder
- Whether it is worse than last cycle
Protect the feet
Closed, well-fitting footwear indoors and out, no walking barefoot, and check the feet every evening for cuts, blisters or redness you may not have felt.
Prevent falls
A night light on the route to the bathroom, loose mats removed, a hand on a rail on the stairs, and extra care on wet or uneven ground.
Especially
- At night
- For older patients
Take care with heat and sharp things
Numb fingers do not register a hot pan or bath water properly. Test water temperature with an elbow or a thermometer, use oven gloves, and take care with knives.
Keep moving
Gentle walking and balance exercise are among the few things with real support for helping. Ask whether a physiotherapist can advise on a plan for you.
!
Get medical help the same day for any of these
Sudden weakness of an arm or leg, or of one side of the face · loss of control of the bladder or bowels · numbness spreading quickly over hours or days · difficulty walking that has come on suddenly · severe back pain with new numbness or weakness in the legs · a fall with a head injury · a cut or wound on a numb foot that is red, swollen, hot or discharging, especially with a fever. Go to the nearest emergency department and say clearly that the person is on chemotherapy.
Being straight with you
What this page cannot tell you
It cannot tell you whether your nerve changes will fully recover. For many patients they improve substantially over the months after treatment ends; for some they persist. That depends on the drug, the total amount given, how severe it became, and other conditions such as diabetes. Your oncologist can give you a more specific view.
It also cannot tell you whether your dose should change. That is a balance between treating the cancer and protecting the nerves, and it belongs to your oncologist with your input about what matters most to you.
Do not hide it to protect your treatment
Patients sometimes stay quiet because they fear a dose reduction will make the treatment less effective. Talk that fear through openly. The decision should be made with full information, not by keeping symptoms back.
Be sceptical of supplements sold for nerves
Vitamin injections, nerve tonics and supplements are heavily marketed to patients with numbness. Most have little support and some interact with treatment. Ask your team before taking any.
Diabetes raises the stakes
Patients who already have nerve damage from diabetes are at higher risk and have more to lose. Mention it at the start, and look after the feet particularly carefully.
What to do next
Ask whether your drugs cause nerve changes. Report any numbness or tingling at the first sign, before each cycle. Protect your feet, prevent falls and take care with heat. Show any supplement to your team, and ask about physiotherapy if balance is affected.
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Commonly believed
Four beliefs about numbness on treatment
"A bit of tingling is not worth mentioning."
Early, mild tingling is exactly what the team needs to hear, because it is when an adjustment can still protect the nerves. Waiting until it is severe removes that option.
"If I report it, they will stop my treatment."
Usually they adjust the dose or schedule rather than stopping, and they weigh that against the benefit of treatment. Talk the fear through; do not hide the symptom.
"Vitamin injections will fix the nerves."
Most supplements sold for nerve damage have little support, and some interact with chemotherapy. Ask your team before taking anything, whoever recommends it.
"It will definitely go away when treatment ends."
For many people it improves over months, and for some it persists. Early reporting is one of the few things that improves the odds of a good recovery.
Questions we are asked
Common questions about numbness and tingling
Which chemotherapy drugs cause numbness?
Most commonly platinum drugs, taxanes and vinca drugs, and a few others. Ask your team whether your own regimen carries this risk, so you know how closely to watch.
When does it usually start?
Often after several cycles rather than at the start, because the effect tends to build up with each cycle. With some drugs, cold-triggered tingling can appear within days of an infusion.
Should I tell my doctor if it is mild?
Yes, at the first sign and before every cycle. Mild symptoms are when a dose or schedule change can still protect the nerves from lasting damage.
Will it go away?
For many patients it improves over the months after treatment, sometimes slowly. For some it persists. Your oncologist can give a better view based on your drugs and how severe it became.
Is there a treatment for it?
Options are limited. Adjusting chemotherapy early, physiotherapy and exercise, and medicines for nerve pain can help some people. Most supplements sold for it have little support.
Can I still drive?
Only if you can feel the pedals properly and operate the controls safely. If numbness affects your feet or grip, stop driving and discuss it with your team.
I have diabetes. Does that matter?
Yes. Existing nerve damage from diabetes raises the risk and the stakes. Tell your team at the start and take particular care of your feet.
What can I do at home?
Protect your feet with closed footwear, check them daily, prevent falls, test water temperature carefully, keep gently active, and report any change before each cycle.
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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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