Question to Tari: One of my cancer survivor students is experiencing has numbness in her toes and feet from the chemo. What can yoga offer that other approaches can’t?
Answer from Tari: Your student is experiencing a common side effect of chemotherapy: Chemotherapy Induced Peripheral Neuropathy or CIPN. It’s one of the more common — and frustrating — side effects of certain cancer treatments, and it deserves more attention than it usually gets in yoga spaces.
What Is Peripheral Neuropathy?
Peripheral neuropathy refers to damage to the nerves outside the brain and spinal cord — the network that carries sensory and motor signals throughout the body. When chemotherapy disrupts those signals, the result can be numbness, tingling, burning pain, or a strange sensation of wearing socks or gloves when you aren’t. It can affect balance, coordination, and the ability to feel pressure or temperature in the feet and hands.
There are three types of nerves involved:
- Autonomic nerves — which regulate involuntary functions like heart rate and digestion. Autonomic involvement is less common but can occur.
- Sensory nerves — which transmit touch, temperature, and pain signals. Damage here causes numbness, tingling, or hypersensitivity.
- Motor nerves — which control muscle movement. Damage can cause weakness, clumsiness, and balance problems.
CIPN is typically caused by specific drug classes — taxanes, vinca alkaloids, platinum-based agents, and proteasome inhibitors are among the most common. Effects can appear during treatment or weeks to months afterward. For many people, symptoms gradually improve once treatment ends, though the timeline varies and some effects can persist.
Why Massage Alone Is Limited
Foot massage feels intuitive, but its primary mechanism — improving circulation — isn’t what’s needed here. CIPN is a nerve signaling problem, not a circulation problem. That said, gentle massage and bodywork can provide sensory input that helps maintain body awareness, which is valuable. Qi Gong can offer similar benefits — cultivating attention to the body and breath — and I wouldn’t discourage it.
What I would add — and where yoga can contribute something specific — is balance training and proprioceptive awareness.
What Yoga Offers
When the nerve signals from the feet are disrupted, the brain loses some of its real-time information about where the body is in space. That’s what makes neuropathy a fall risk. Yoga practices that build balance, ground the feet, and engage conscious attention can help compensate for that loss — not by repairing the nerve damage, but by training the nervous system to work with what it has.
Research supports this approach. A randomized controlled trial by Bao and colleagues found yoga to be safe and promising for improving CIPN symptoms and fall risk in breast and gynecologic cancer survivors. Other exercise reviews similarly support balance-focused movement for survivors with neuropathy symptoms.
Practically, I focus on:
Simple, supported balance work. I always make a wall available during any standing or balance pose, and I introduce it as standard — not as a modification for those who “need” it. For neuropathy students, it’s not optional. Start with the most accessible version of every pose and build slowly. The goal is sensory-motor confidence, not challenge for its own sake.
Toe and foot activation. Spreading the toes, pressing through the ball of the foot, and consciously engaging the arches are small actions that generate feedback to the nervous system. These don’t require elaborate sequences — even a few minutes of mindful foot work at the start of class can be meaningful.
Standing tall with props. Standing on a yoga block — with support nearby — creates a slightly unstable surface that asks the foot and ankle to engage and respond. Done carefully, this kind of graded weight-shifting is exactly the kind of stimulus that can help rebuild sensory-motor awareness over time.
Breath and visual focus. Directing the gaze to a fixed point (drishti) and syncing breath with movement gives the nervous system additional anchors during balance work. These simple tools make a real difference when proprioceptive feedback from the feet is unreliable.
More suggestions provided in Tari’s book – Yoga for Cancer.
What to Watch For
Neuropathy can accumulate during active treatment, so monitor your student’s symptoms over time. Encourage her to report any changes to her oncology team — especially if symptoms worsen. If she’s still in active treatment, be more conservative; if she’s post-treatment, there’s generally more room to progress gradually.
Also be mindful of:
- Extended time weight-bearing on numb feet — pressure and pain signals are reduced, which can mask injury
- Prolonged time in one position — neuropathic discomfort can increase with sustained pressure
- Transitions — moving slowly and deliberately between poses reduces fall risk significantly
The Larger Picture
CIPN won’t resolve on its own timeline according to a yoga practice, and it’s important to be honest with your student about that. But what yoga can offer is a way to stay embodied, maintain confidence in movement, and reduce the fear that often accompanies balance changes. That matters — not just physically, but psychologically.
