For all of chemotherapy&rsquo;s benefits, the treatment can come with a host of side effects, including numbness and increased sensitivity in the hands and feet. Fortunately, patients experiencing those symptoms don&rsquo;t have to take them lying down. Chemotherapy-induced peripheral neuropathy, or CIPN, is a fact of life for many cancer patients and can make daily life harder to bear because of its impact on extremities. &ldquo;Patients have told me that it hurts to put their socks on, and that if they go outside and it&rsquo;s really windy and the wind brushes against their arm, their skin is uncomfortable,&rdquo; says Karen Hock, PT, MS, CLT-LANA, a physical therapist who specializes in working with cancer patients at The Ohio State University Comprehensive Cancer Center &ndash; James Cancer Hospital and Solove Research Institute (OSUCCC &ndash; James). CIPN is caused by damage to the peripheral nerves, which transmit information between the brain and spinal cord to every other part of the body. While chemotherapy is the most common cause for cancer patients, it can also result from surgery, radiation and tumors that press on nerves. The symptoms are usually felt in the fingers, hands, toes and feet. &ldquo;It can be a shooting or stabbing pain, tingling or numbness, or increased sensitivity to heat or cold or touch,&rdquo; Hock says. Up to 60 percent of patients undergoing chemotherapy treatments experience CIPN, according to research by Maryam Lustberg, MD, MPH, director of breast cancer survivorship services at the OSUCCC &ndash; James. &ldquo;This is not simply a quality of life concern &mdash; CIPN can impact a patient&rsquo;s ability to receive treatment at all, limiting the potential for a cure,&rdquo; Lustberg says. While the condition has the potential to make some situations unbearable, it&rsquo;s not untreatable. &ldquo;[Several studies show that] effective physical therapy interventions can help,&rdquo; Hock says. &ldquo;It can increase function and decrease pain and sensitivity and improve your quality of life.&rdquo; This movement as medicine can make a big difference for CIPN patients, whom Hock recommends employ exercises from four categories: range of motion, strengthening, desensitization and tissue mobilization. Range of motion &ldquo;It&rsquo;s a bit of a catch-22,&rdquo; Hock says. &ldquo;When you have pain, you don&rsquo;t move your joints as much, and this makes it even harder to move them.&rdquo; So it&rsquo;s important for patients with CIPN to move their hands and feet. &ldquo;Put a towel on the table and use your fingers to scrunch it up into a ball, and you can put it on the floor and do the same thing with your toes.&rdquo; Other exercises include: drawing the alphabet with your ankle or wrists, and doing toe raises while holding onto a chair or the wall. Strengthening &ldquo;Take some therapy putty or Silly Putty or even a stress ball and pinch it, squeeze it, put it on a flat surface and press your fingers into it,&rdquo; Hock says. &ldquo;You can do the same exercises with your feet, but put some wax paper down under the putty so it doesn&rsquo;t pick up all the fuzzies on the floor. Push down on it with the balls of your feet.&rdquo; The use of resistance bands and standing on one foot while holding onto something for balance are other exercises that can build strength in CIPN patients. Desensitization Find something soft, like a cotton ball, and rub it slowly and gently on sensitive areas. &ldquo;Spend a good deal of time with something soft, and once it doesn&rsquo;t feel so awful, switch to something with a little rougher surface,&rdquo; Hock says. &ldquo;You won&rsquo;t notice a change that first day. It&rsquo;s something you need to do for a while and eventually you will reap the benefits.&rdquo; Another desensitization exercise is to fill a bowl or larger container with dried beans or rice, and gently move your fingers and hands or toes and feet around in the bowl. &ldquo;Try and pick up beans with your toes,&rdquo; Hock says. &ldquo;That will help with range of motion, strength and desensitizing.&rdquo; Rolling a tennis ball back and forth along the floor while seated or standing with support is another good exercise with multiple benefits. Tissue mobilization Massage can be a great way to mobilize tissue in arms and legs affected by chemotherapy. By completing these exercises themselves, patients can add mental benefits that may aid in their physical well-being. &ldquo;We need the brain and body to connect, so it&rsquo;s most effective when you do it to yourself,&rdquo; Hock says, adding that patients should start slowly and gently and begin at the end of their fingers or toes, working their way up their hands or feet. Hock recommends doing a variety of exercises for five to 10 minutes, two or three times a day. &ldquo;You can do it while you&rsquo;re watching TV or you&rsquo;re the passenger in a car.&rdquo; All the physicians at the OSUCCC &ndash; James are aware of CIPN and closely monitor their patients during all phases of their treatment for symptoms. Hock and her team of specially-trained physical therapists have facilities at The James, the Stefanie Spielman Comprehensive Breast Center and the Martha Morehouse Medical Plaza. If you would like to speak with an oncology rehabilitation specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.