Neuropathy (Nerve Pain)

Among the side effects that head and neck cancer patients may deal with following treatment is nerve pain, or neuropathy.  About 14% of head and neck cancer patients will experience nerve pain and nerve damage. Neuropathy is a side effect that often doesn’t appear for years following treatment.

What Causes Neuropathy?

Nerve damage and nerve pain can be caused by cancer treatments, including radiation, surgery, and some chemotherapy drugs including cisplatin. The majority of nerve problems resulting from head and neck cancer treatment arise in the peripheral nervous system (PNS), which carries information back and forth from the body to the brain. Specifically, most head and neck patients have issues stemming from damage to the cranial nerves, which connect the brain to various regions of the head, neck, and trunk (torso). Occasionally, head and neck patients may also experience nerve pain and symptoms in other, more distant parts of the peripheral nervous system.


If the cranial nerves are affected, you may experience:

  • Difficulty speaking, including slurred speech, difficulty expressing oneself, or difficulty understanding speech
  • Difficulty chewing or swallowing
  • Changes in the voice
  • Numbness, tingling, or burning in your jaw, throat, or neck
  • Hearing loss or ringing in the ears (tinnitus)
  • Vision loss or other vision symptoms, such as blurred or double vision
  • Changes in taste and smell

Other peripheral nervous system symptoms that may occur in a smaller percentage of head and neck cancer patients could include:

  • General weakness or a lack of strength and coordination
  • Numbness, tingling, or burning in the hands or feet
  • Constipation or incontinence

Managing Neuropathy

Nerve damage and nerve pain is not always preventable, but it is manageable. The management techniques your doctor recommends will depend on your specific symptoms and the location of your nerve pain. Some options include:

  • Medications that treat peripheral nerve pain, including medicines for nausea and vertigo; certain antidepressants, like selective serotonin or norepinephrine reuptake inhibitors (SSRIs or SNRIs); or medications to treat nerve pain, including gabapentin or duloxetine
  • Nerve blocks and transcutaneous electric nerve stimulation (TENS)
  • Speech therapy to improve speech, chewing, and swallowing
  • Physical therapy to improve strength, balance, coordination, or mobility
  • Occupational therapy to maintain motor skills needed for daily activities