How Hina Khan, currently undergoing chemotherapy, is dealing with ‘severe’ neuropathic pain: ‘I lose control of my legs and fall over…’

For Hina, exercise is what keeps her going. “Exercise or any kind of physical activity is vital for maintaining a healthy lifestyle. But it’s even more essential and effective when one’s going through a phase of illness. Working out regularly not only helps you feel stronger physically but also gives sustenance to your mental health. And keeping a healthy mind is obviously unavoidable (sic),” shared Khan.

What is neuropathic pain?

Chemotherapy can have a significant impact on your immunity, hence it’s vital not to ignore symptoms like extreme weakness, fever, oral ulcers, or diarrhoea and inform your treating doctor about it at the earliest, said Dr Atul Narayankar, consultant medical oncologist, Wockhardt Hospitals, Mira Road.

According to a 2019 National Center for Biotechnology Information review, chemotherapy-induced neuropathic pain is owing to injury to the somatosensory nervous system after anticancer drug treatment, and it is one of the major causes of neuropathic pain in clinical practice. Also called chemotherapy-induced peripheral neuropathy (CIPN), the condition causes chronic pain and balance issues.

Notably, a July 2024 study published recently in JAMA Internal Medicine also hinted at exercise, precisely neuromuscular training, to reduce the occurrence of CIPN by “50 to 70 percent” which “may improve rates of survival”.

Neuropathic pain can manifest a sharp burning sensation causing discomfort. “It is more than just a mere discomfort, it can negatively impact one’s overall quality of life making it stressful to perform daily activities,” explained Dr Tirathram Kaushik, consultant oncosurgeon, Wockhardt Hospitals Mira Road.

Simple activities like walking or even holding a cup feel like a challenging task due to constant nerve pain, he added.

“Neuropathic pain often goes away on its own after the first or second week of stopping chemotherapy. However, if the pain sustains for more than a few weeks then your doctor may prescribe certain treatment options like medications, acupuncture, physiotherapy, exercise therapy, scrambler therapy, or transcutaneous electrical nerve stimulation (TENS) for effective results,” mentioned Dr Kaushik.

Dr Ashwani Maichand, director, dept of orthopaedics, CK Birla Hospital (R), Delhi noted that neuromuscular coordination is extremely important. “Neuromuscular coordination engages the ankle, knee, hip, and core muscles, building strength and endurance in the smaller stabilising muscles that are vital for balance,” said Dr Maichand.

 

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During chemotherapy, it is important to focus on maintaining a healthy lifestyle. According to Dr Narayankar, the focus should be on eating a “balanced diet” recommended by your healthcare team, including nutrient-dense foods that support your immune system.

“Engaging in regular exercise within your energy limits and according to your doctor’s recommendations can help as it gives the body the necessary energy to fight the effects,” said Dr Narayankar.

Stress-managing techniques like deep breathing exercises and meditation can help reduce the mental load caused by neuropathic pain during chemotherapy, added Dr Kaushik.