Evidence-Based Treatment of Pain in Chemotherapy-Induced Peripheral Neuropathy

Curr Pain Headache Rep. 2023 May;27(5):99-116. doi: 10.1007/s11916-023-01107-4. Epub 2023 Apr 14.


Purpose of review: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and often painful condition that occurs after administration of chemotherapeutic agents. The primary objective of this systematic review was to appraise the literature on conservative, pharmacological, and interventional treatment options for CIPN pain.

Recent findings: There is level I evidence supporting modest to moderate improvement in CIPN pain from duloxetine treatment, as well as short-term modest improvement from physical therapy and acupuncture. Although opioid and cannabis administration may provide short-term modest improvement, administration is commonly limited by side effects. Generally, most studies reported no clinical benefit from yoga, topical neuropathic agents, gabapentinoids, and tricyclic antidepressants. Evidence is currently equivocal for scrambler therapy and transcutaneous electrical nerve stimulation. Finally, evidence on neuromodulation options is limited to mostly case reports/series and one observational study highlighting moderate improvement with auricular nerve stimulation. This systematic review provides an overview of conservative, pharmacologic, and interventional treatment modalities for CIPN pain. Furthermore, it provides a level of evidence and degree of recommendation based on the United States Preventive Services Task Force (USPSTF) criteria for each specific treatment modality.

Keywords: Cancer; Chemotherapy; Chronic pain; Neuromodulation; Peripheral neuropathy; Systematic review.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Humans
  • Neoplasms* / chemically induced
  • Neoplasms* / drug therapy
  • Neuralgia* / drug therapy
  • Neuralgia* / therapy
  • Observational Studies as Topic
  • Pain Management
  • Transcutaneous Electric Nerve Stimulation*


  • Antineoplastic Agents