Perineural Electrical Dry Needling and Neural Mobilization for Chemotherapy-Induced Peripheral Neuropathy: Case Report

TL;DR

This case report explores the use of perineural electrical dry needling and neural mobilization to reduce pain and improve function in patients with chemotherapy-induced peripheral neuropathy.

Contribution

The study provides preliminary evidence that PEDN and NM may be effective for managing chronic neuropathic pain caused by chemotherapy.

Findings

Three patients showed clinically meaningful improvements in pain and function after 4–8 sessions of PEDN and NM.

Patients A and B exceeded the minimum clinically important difference in primary and secondary outcome measures.

Patient C showed improvements in most measures but only clinically meaningful changes in pain and function.

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) affects 20–85% of individuals exposed to neurotoxic chemotherapeutic agents. Perineural electrical dry needling (PEDN) and neural mobilization (NM) interventions may be beneficial in the management of chronic neurogenic pain; however, there is a paucity of research on the efficacy of both interventions for CIPN. Methods: Three patients were referred to an outpatient physical therapy clinic with chronic neuropathic pain associated with CIPN. Each underwent PEDN and NM twice weekly until goals were met or progress stalled. The primary outcome measure was the Numeric Pain Rating Scale (NPRS). Secondary outcomes included the Global Rating of Change (GROC) and the Lower Extremity Functional Scale (LEFS). All outcome measures were assessed at evaluation and discharge. Results: At discharge, patients A and B exceeded the minimum clinically important difference (MCID) for the primary and secondary outcome measures, indicating decreased neuropathic pain and improved lower extremity function. Patient C improved in all outcome measures but only experienced clinically meaningful changes in the NPRS and LEFS, not the GROC. Conclusions: Following 4–8 sessions of PEDN and NM, three patients with CIPN demonstrated clinically meaningful improvements in chronic lower extremity neuropathic pain and function. PEDN and NM may be beneficial in the management of patients presenting with chronic neuropathic pain secondary to CIPN.

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