Yes, chemotherapy can cause leg pain, a frequent side effect that can range from a mild ache to severe, persistent discomfort affecting mobility. The specific chemotherapy agent used, its dosage, and the patient’s individual health profile determine the risk and the type of pain experienced. Understanding the origin of the pain is important for effective management, which is often categorized into nerve damage, muscle and joint issues, or bone pain.
Chemotherapy Induced Peripheral Neuropathy
The most common neurological cause of leg pain during cancer treatment is Chemotherapy Induced Peripheral Neuropathy (CIPN), which involves damage to the peripheral nerves outside of the brain and spinal cord. Certain chemotherapy drugs, including taxanes (like paclitaxel and docetaxel) and platinum agents (like oxaliplatin and cisplatin), are known to be neurotoxic and can harm these nerve fibers. This damage often follows a “stocking-and-glove” pattern, meaning symptoms typically begin in the feet and hands before spreading further up the legs and arms.
CIPN symptoms in the legs are characterized by sensory disturbances such as tingling, numbness, or a feeling often described as “pins and needles.” Patients may also experience shooting, stabbing, or electric-like pain, along with a persistent burning sensation in the soles of their feet. In severe cases, the damage can affect motor nerves, leading to muscle weakness and difficulty with balance or walking. These neuropathic symptoms can begin during treatment or sometimes months after chemotherapy has been completed.
Musculoskeletal and Bone Pain Causes
Beyond nerve damage, chemotherapy can induce pain in the muscles, joints, and bones of the legs. Myalgia (muscle ache) and arthralgia (joint pain) are common side effects of certain chemotherapy regimens, particularly those involving taxane drugs. This type of pain is typically described as a generalized soreness, stiffness, or deep ache, which is distinctly different from the sharp, shooting pain of CIPN. The muscle and joint pain often manifests within a few days of receiving treatment and may resolve within a week, though it can sometimes persist longer.
Bone pain in the legs is also a concern, often linked not directly to the chemotherapy drug itself but to supportive medications given alongside it. Medications called Colony Stimulating Factors (CSFs), such as filgrastim or pegfilgrastim, are administered to stimulate the bone marrow to rapidly produce white blood cells. This rapid expansion of cell production within the bone marrow can cause an aching or throbbing sensation, particularly in the large bones like those in the legs and hips. This deep, pressure-like discomfort is a temporary side effect indicating that the medication is working as intended.
Recognizing Urgent Symptoms
While many causes of leg pain are manageable side effects, certain symptoms require immediate medical attention to rule out serious complications. Cancer and chemotherapy treatments significantly increase a person’s risk for developing Deep Vein Thrombosis (DVT), a blood clot that forms in a deep vein, most commonly in the leg. A DVT can be dangerous if the clot breaks loose and travels to the lungs, causing a pulmonary embolism.
Symptoms that should prompt immediate contact with the oncology team include sudden, severe pain in one leg, which may be accompanied by sudden swelling. The skin around the painful or swollen area may also feel noticeably warmer or appear red or discolored. New or worsening leg pain could also be a sign of disease progression, such as cancer metastasizing to the bones. Any uncharacteristic or persistent pain should be discussed with a doctor.
Managing Chemotherapy Related Pain
Managing chemotherapy-related leg pain involves a multifaceted approach tailored to the specific type of discomfort the patient is experiencing. For neuropathic pain from CIPN, the antidepressant duloxetine, a serotonin-norepinephrine reuptake inhibitor, is the agent with the strongest evidence for providing relief. Other medications used to calm overactive nerves include anticonvulsants, though not all show consistent benefit for CIPN. Topical creams or patches containing numbing medications like lidocaine can also be applied directly to the painful areas of the feet.
For muscle and joint aches, nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen can often help reduce discomfort, but these should be used under the guidance of a physician. Non-pharmacological strategies are also helpful for both nerve and musculoskeletal pain. Gentle exercise, such as walking or stretching, helps maintain muscle strength and flexibility, and physical therapy can address balance issues caused by numbness. Applying heat packs to muscle aches or using cold therapy for some forms of nerve pain can provide temporary relief.