One of the most common questions that people have when they are about to start a course of chemotherapy is whether it is painful.
While chemotherapy itself is not necessarily painful, having chemotherapy can cause some painful side effects. This might include nerve pain, mouth issues, or pain in the muscles and joints. Most symptoms will improve over time, and there are a number of ways in which treatment can be made more comfortable.
Here we take a look at some of the most common types of chemotherapy related pain, and what you can do to help make things more comfortable and live better.
What is chemotherapy related pain?
Chemotherapy itself does not typically cause pain. The treatment is often given as an infusion into a vein, and there may be some mild soreness at the injection site. Some people also describe feeling a slight burning or cold sensation as the drugs enter the body, but this soon wears off.Please note, if any pain or burning is felt whilst the drug is being administered it is important to tell a nurse immediately,
However, chemotherapy can cause a number of painful or uncomfortable side effects. Chemotherapy works by using a combination of chemicals to attack the cancer cells. It can be a highly effective treatment, but it can also damage healthy cells, leading to some painful symptoms.
The exact effects of chemotherapy will vary from person to person, depending on which drugs are being used, the dosage and length of treatment, the type and location of the cancer, and the individual’s own body.
The good news is, for most people the symptoms will normally get better over time – and there are lots of things you can do to help reduce their impact.
Chemotherapy related nerve pain
Nerve pain is one of the most common types of chemotherapy related pain. Some chemotherapy drugs can damage the nerve endings, particularly in the hands and feet, causing pain and discomfort. This is know as ‘peripheral neuropathy’, and its effects can build up during treatment.
Nerve problems can take the form of shooting pains, or a painful numbness, burning, itching or tingling sensation (‘paresthesia’), which some people say is like having ‘pins and needles’.
Most people find that problems with nerve sensitivity start to improve after their treatment has stopped, but for some people it can take a long time to recover.
Tips for managing neuropathy
If you are suffering from chemotherapy related nerve pain, you should speak to your doctor in the first instance. They may be able to offer pain relief medication or nerve blocks, or they may adjust the treatment dosage.
There are also a number of other steps you can take to help reduce the symptoms of neuropathy:
Keep your hands and feet protected
You may find that your sensitivity to heat, cold and pressure are affected. You should keep your hands and feet warm and protected by wearing gloves, socks and well-fitting shoes or slippers. If the skin on your hands and feet is dry, sore or irritated from treatment you can help to protect it with an intensive moisturising cream.
Avoid extremes of temperature
If you’re handling or using hot items such as oven dishes or bathwater, you may not be as aware of the heat so it’s important to take extra care. Touching hot and cold metal items, such as cutlery, can also make symptoms worse. Using gloves and wooden cutlery or cutlery covers can help with this.
“I wore light cotton gloves around the house when I was doing housework. It really helped protect my hands from that awful tingling sensation brought on by touching cold objects.” – Betty, Live Better With community member
Take care with sharp implements
If you have peripheral neuropathy you should be very careful when using instruments such as scissors, knives or toenail clippers. Remember to ask for help if you need it.
Try a TENS machine
Many people find that using a TENS machine can help with the pain of neuropathy. The unit produces a small, harmless electrical signal which can help to reduce pain signals and stimulate the production of the body’s natural painkillers, or endorphins. It’s always advisable to check with your doctor first.
Avoid alcohol
You should also avoid drinking alcohol, as this can make the neuropathy worse.
Chemotherapy related mouth pain
Another common painful side effect of chemotherapy is a sore and inflamed mouth. The chemicals used for treatment can irritate the lining of the mouth, causing mouth ulcers, swelling or infection. This is known as ‘mucositis’, and it may begin a few days into treatment. Some people can also experience a metallic or chalky taste in their mouth.
These symptoms can be very uncomfortable, and can also make it more difficult to eat and drink well during treatment.
Tips for managing mouth problems
There are a number of things you can do to help to reduce the impact of chemotherapy related mouth pain:
- Keep your mouth clean – good oral hygiene will reduce the risk of infection and help to prevent painful sores or infections. Brush your teeth regularly, using a soft toothbrush or a finger brush. Mint toothpastes can sting a sore mouth, so try an unflavoured toothpaste and finish off with an alcohol-free mouthwash
- Act immediately – use a protective gel on any sores or ulcers as soon as they appear. This will form a coating and help your mouth to heal
- Visit your dentist – pay regular visits to the dentist during the course of your treatment, so they can monitor your teeth and mouth. Always make your treatment centre aware of any dental visits as additional blood samples may need to be taken prior to any work being performed.
- Drink plenty of fluids – if your mouth feels dry, try sucking on ice cubes, chewing gum or using a saliva replacement spray or stimulant.
“If you’re suffering dry mouth try chewing juicy chewing gum as this helps to moisten the mouth and increase saliva.” Live Better With community member
- Avoid acidic drinks – fruit juices can contain a lot of acid, which can sting your mouth, so try opting for herbal or milk-based drinks, or flavoured waters
For a range of products designed to help with mouth pain and soreness, visit: https://cancer.livebetterwith.com/collections/mouth-trouble/
Chemotherapy related joint and muscle pain
Some chemotherapy treatments can cause pain and aching in the joints, bones or muscles. Your doctor may be able to give you medication to help, such as painkillers and anti-inflammatories, or adapt your treatment to reduce the symptoms.
Tips for managing joint and muscle pain
You can also take a number of steps to help soothe painful joints and muscles:
- Use a heat wrap – this can help to reduce muscle spasms and soothe painful limbs. The Live Better With community recommend the fleecy microwaveable lavender wheat body wrap
- Take a bath – having a good soak in the bath can offer relief for aches and pains. Try adding Kneipp Arnica Herbal Bath, which contains arnica, a natural anti-inflammatory to help soothe sore joints and muscles
- Apply a pain-relieving gel – applying a cooling gel like Biofreeze Pain Relieving Gel can help relieve pain and inflammation
- Try relaxation techniques – many people find that relaxation techniques, such as mindfulness or reflexology can help with muscle pain and tension
- Have a soothing massage – having a gentle massage with a massage rub can help to relax tense, sore muscles and ease joint pain. The Live Better With community recommend Badger Balm Muscle Rub
“While undergoing chemo I often had muscle pain in my arms and shoulders, I found the normal muscle rubs to be too aggressive. The burning sensation was too strong and the smell really affected me. I was very pleased when I found a natural and milder alternative.” Live Better With community member
Other side effects of chemotherapy
Chemotherapy can cause a range of other side effects which might be described as uncomfortable rather than painful. These can include tiredness, sore or irritated skin, nausea or sickness, bowel issues, skin and nail problems, and hair loss.
However, you are unlikely to suffer from all of the side effects of chemotherapy, and there are lots of things you can do to help reduce the impact of any symptoms and make life more comfortable.
You can view our Live Better With Guides to coping with cancer symptoms and side effects here.
How can I make chemotherapy treatment more comfortable?
To make your chemotherapy treatment as comfortable as possible, it can be helpful to bring some favourite items with you to the hospital. The Live Better With community recommend taking:
- A soft blanket, to help keep you warm and comfortable
- A hat and soft, fluffy socks
- Loose, comfortable clothing and footwear
- Plenty of water, to keep your system hydrated and ward off headaches
- Some favourite snacks
- Boiled sweets or queasy drops to help combat nausea
- Moisturiser and lip balm to soothe dry, irritated skin
- A good book or magazine
- A tablet or iPad
- Some music
- A journal
Many people also find it helpful to take a friend or family member with them for their treatment.
Having chemotherapy can be a daunting prospect. However, it’s important to remember that chemotherapy is an effective treatment for many types of cancer. For most people, any side effects are normally short term and will start to improve once treatment has ended. In the meantime, you can take steps to control any symptoms and help make life as comfortable as possible. Whilst this information can be useful for managing symptoms, it is important to contact your treatment unit immediately if side effects are not manageable at home.
Further information
You can find information on a range of cancer drugs here: https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/cancer-drugs