Can multimodal exercise and physical therapy help with chemotherapy-induced peripheral neuropathy?

Chemotherapy-induced peripheral neuropathy (CIPN) is nerve damage from cancer drugs. It can cause numbness, tingling, pain, weakness, and balance problems. Drug options for CIPN are limited, so exercise and physical therapy have become important non-drug tools ²⁷. The short answer is yes: research generally supports exercise and physical therapy as helpful add-ons for CIPN, especially for symptoms, balance, strength, and quality of life ²⁷⁹. The evidence is not perfect, and the best exact program is still being sorted out ⁷⁹.

What the research says

A 2025 systematic review of 26 randomized trials looked at exercise and physiotherapy for CIPN ⁷. Nineteen trials tested exercise (aerobic, resistance, balance, sensorimotor, yoga, or mixed programs). Seven tested physiotherapy methods such as manual therapy, light therapy, electrical stimulation, and others ⁷. Both approaches improved sensory and motor symptoms, balance, muscle strength, and quality of life, and adherence was high, ranging from 70% to 95% ⁷. A separate 2025 narrative review reached a similar conclusion: non-drug options, including multimodal exercise and physical therapy, are promising adjuncts, while drug choices remain limited, with duloxetine the only guideline-recommended drug for established painful CIPN ².

What to ask your doctor

• Which type of exercise (balance, resistance, aerobic, or a mix) is safest and most useful for my neuropathy and my cancer treatment?
• Should I see a physical therapist for a supervised program, and what precautions apply to me (for example, fall risk or bone issues)?
• How will we track my symptoms, balance, and strength over time, and what changes would mean adjusting the plan?
• What drug options exist for painful CIPN, and how do they fit with exercise and physical therapy?