Can You Lift Weights with Peripheral Neuropathy? Exercise and Safety Explained
Updated: Oct 14
Written by Rosy Allan, BSc (Hons), ANutr
Registered Associate Nutritionist | Level 3 Personal Trainer | Level 4 Cancer Exercise Rehabilitation Specialist
Peripheral neuropathy can make activities that once felt straightforward surprisingly difficult.
For someone who enjoys strength training, changes in grip, sensation or balance can be particularly frustrating. Holding a dumbbell, standing comfortably during an exercise or even feeling where your feet are positioned may become more challenging.
But does having peripheral neuropathy mean you need to stop lifting weights?
Not necessarily.
For many people, resistance training and other forms of exercise can remain an important part of maintaining strength, mobility and physical confidence. However, the exercises and equipment used may need adapting.
Let's explore how peripheral neuropathy affects movement, what the research tells us about exercise and how strength training can be approached safely.
What is peripheral neuropathy?
Peripheral neuropathy occurs when nerves outside the brain and spinal cord become damaged or function abnormally. These nerves help transmit information about sensation, movement and certain automatic bodily functions.
Peripheral neuropathy has several possible causes, including diabetes, certain medical conditions and some cancer treatments. This article focuses primarily on chemotherapy-induced peripheral neuropathy (CIPN), although some of the practical exercise considerations may also be relevant to people with neuropathy from other causes.
Certain chemotherapy medicines, including taxanes, platinum-based drugs and vinca alkaloids, can damage peripheral nerves. Symptoms vary considerably between individuals and according to the medicines received (Loprinzi et al., 2020).
How can peripheral neuropathy affect exercise?
Chemotherapy-induced peripheral neuropathy commonly affects the hands, feet and lower legs. Symptoms may include:
Numbness or reduced sensation
Tingling or pins and needles
Burning or shooting pain
Increased sensitivity to touch or temperature
Reduced grip strength or hand coordination
Difficulties with balance and walking
Muscle weakness
These symptoms can affect everyday activities such as fastening buttons, carrying shopping
or walking on uneven surfaces (Macmillan Cancer Support, n.d.).
In the gym, they can create additional challenges. For example, someone with reduced hand sensation may struggle to judge whether they're holding a dumbbell securely.
Someone with numbness in their feet may find standing exercises more difficult because they receive less sensory information about their position and movement.
The aim of adapting exercise isn't simply to make it harder. It's to find a way of training that remains effective without introducing unnecessary risk.
Can resistance training help?
Resistance training can support muscular strength and physical function, including for people living with and beyond cancer.
The American Society of Clinical Oncology recommends appropriately adapted aerobic and resistance exercise during active cancer treatment with curative intent because of its benefits for fatigue, fitness, strength and physical functioning (Ligibel et al., 2022).
However, there is an important distinction between:
Improving strength and physical function in someone who has neuropathy.
Treating or reversing the underlying nerve damage.
These are not the same outcome. An individual may become stronger and more confident with movement even if some numbness or altered sensation persists. Whether exercise can directly reduce chemotherapy-induced neuropathy symptoms is an area of continuing research.
What does the research say about exercise and chemotherapy-induced neuropathy?
A 2025 systematic review and meta-analysis examined 12 studies involving 928 participants with chemotherapy-induced peripheral neuropathy. The exercise interventions varied and included resistance training, aerobic exercise, balance activities and combined programmes.
Five studies were included in a meta-analysis using a common neuropathy symptom scale. The pooled results favoured exercise, with a standardised mean difference of 0.50, suggesting improvement in reported neuropathy symptoms among participants undertaking exercise interventions (Amarelo et al., 2025).
A separate 2024 systematic review of 20 studies involving 1,308 participants also reported a small overall improvement in chemotherapy-induced neuropathy symptoms associated with exercise (Khmethong, Hawsawi and Schneider, 2024). These are encouraging findings.
However, the studies differed in their exercise programmes, participant characteristics and outcome measures. Many involved relatively small groups.
We therefore cannot conclude that a particular exercise programme will reverse nerve damage or benefit every individual. The 2020 ASCO guideline on chemotherapy-induced peripheral neuropathy did not make a recommendation for exercise specifically as a treatment for established neuropathy because the evidence available at that time was insufficient (Loprinzi et al., 2020).
More recent reviews provide additional support for exercise as a potentially useful intervention, but important questions remain about the most effective type, intensity and duration.
The evidence supports exploring appropriately supervised exercise as part of rehabilitation, not treating it as a guaranteed cure for neuropathy.
How can you lift weights if your grip strength is reduced?
One of the most frustrating effects of peripheral neuropathy can be losing the ability to grip weights comfortably and securely. You may still have the strength to perform an exercise, but reduced sensation, pain or weakness in your hands can make holding the equipment difficult. This is something I've experienced personally following chemotherapy, and it's also a challenge I've encountered when working with clients recovering from cancer treatment.
Over time, I've explored several ways of adapting resistance exercises to reduce reliance on grip strength.
The following approaches are examples I've found useful in practice. They aren't suitable for everyone, and the choice of equipment should always reflect the individual's sensation, coordination, balance and medical circumstances.
1. Weightlifting straps
Weightlifting straps can be particularly useful when grip strength becomes a limiting factor.
They're commonly used during pulling exercises, such as rows and deadlifts, to help secure the weight and reduce the demand placed on the hands.
For someone experiencing neuropathy, straps may make it possible to continue certain exercises that would otherwise be difficult because of reduced grip strength or discomfort. I've found these helpful personally and when adapting training for clients.
However, straps do not eliminate the need for grip control. Someone with significant numbness, poor coordination or an inability to release equipment safely may be better suited to a different exercise. The load, strap arrangement and ability to control and release the weight should always be assessed before use.
2. Weighted cuffs
Weighted cuffs are another option I've used when traditional dumbbells are difficult to hold.
Depending on their design, cuffs can be secured around the wrists or ankles, allowing resistance to be added without relying on a conventional hand grip.
For example, wrist cuffs may be useful during certain upper-body exercises, while ankle cuffs can provide resistance during appropriately selected lower-body movements. The advantage is that the individual can sometimes continue strengthening exercises without needing to hold a weight throughout the movement.
However, cuffs need to fit securely and comfortably.
Particular care is needed when someone has reduced skin sensation, fragile skin, swelling, lymphoedema or circulatory problems. The equipment should not create excessive pressure, friction or discomfort, and wrist cuffs should only be used where appropriate for the person's treatment history.
3. Weighted backpacks
I've also used weighted backpacks as a practical way of introducing additional resistance without requiring someone to hold dumbbells. A properly fitted backpack can distribute resistance across the trunk, potentially making certain exercises more accessible when grip strength is reduced.
Depending on the individual's capabilities, this might include controlled sit-to-stands or other suitable lower-body strengthening movements. This can be particularly helpful when someone has sufficient lower-body strength but finds gripping external weights difficult.
However, backpacks change the body's loading and balance demands.
They may be unsuitable for people with significant balance difficulties, spinal problems, fragile bones or certain cancer-related complications, including bone metastases.
The load should be secured, kept manageable and introduced only when the individual can maintain control of the movement.
4. Supported resistance machines
Resistance machines can also provide an effective alternative to free weights.
For example, a seated leg press allows the lower-body muscles to be challenged without requiring someone to hold heavy dumbbells.
Some machines provide additional trunk support or reduce the coordination demands associated with free weights. This can be valuable when neuropathy affects grip, stability or balance.
However, equipment selection should still be individualised, and the person must be able to operate the machine safely.
5. Bodyweight and supported exercises
Not every strengthening exercise requires external resistance. Sit-to-stands, supported calf raises and other controlled bodyweight movements can provide a useful starting point, particularly when someone is rebuilding confidence.
For individuals experiencing significant neuropathy, developing control, balance and movement confidence may be more appropriate initially than increasing resistance.
My approach to adapting strength training
From my own experience of cancer treatment and from working with clients, I've learned that exercise rehabilitation often involves finding creative ways to work around physical limitations. Sometimes a relatively simple equipment adjustment can make an exercise more accessible.
A person may have the muscular strength to perform a movement but struggle because neuropathy affects their ability to hold the weight. In those circumstances, lifting straps, weighted cuffs or a properly fitted weighted backpack may provide useful alternatives.
These are practical adaptations rather than proven treatments for neuropathy itself. Their effectiveness and safety depend on the individual, and they should not be used to push through pain, significant sensory loss or instability.
The aim is not to avoid challenging the muscles. It's to find an appropriate way to challenge them while respecting the effects of cancer treatment. This is why I believe cancer exercise rehabilitation should be individualised. Two people may have received similar treatments but require very different approaches to exercise.
Why balance training matters
Peripheral neuropathy can interfere with the sensory information needed to maintain balance. Reduced sensation in the feet may make it harder to detect changes in the surface beneath you or adjust your position quickly. This can increase the risk of trips and falls.
Macmillan Cancer Support recommends seeking advice from the healthcare team when neuropathy affects balance or coordination. Physiotherapists and cancer exercise specialists may be able to help people select appropriate activities (Macmillan Cancer Support, n.d.).
Depending on the individual's needs, a programme might include supported weight shifts, controlled stepping exercises or other supervised balance activities. The aim is to improve movement confidence and physical function while minimising fall risk.
Someone who is particularly unsteady may initially be better suited to seated exercises or activities that provide reliable external support.
Is it safe to exercise during chemotherapy?
For many people, physical activity remains beneficial during chemotherapy. However, the intensity and type of exercise should be adapted according to symptoms, treatment effects and clinical circumstances.
ASCO guidance supports appropriately prescribed aerobic and resistance exercise during active cancer treatment, but the recommendations do not mean every activity is safe for every person (Ligibel et al., 2022).
Particular precautions may be needed if someone is experiencing:
Severe neuropathy or loss of sensation
Significant balance problems
Fever, infection or feeling acutely unwell
Severe fatigue or anaemia
Low platelet counts or increased bleeding risk
Bone metastases or increased fracture risk
Significant pain or other treatment complications
People receiving chemotherapy should report new or worsening neuropathy symptoms to their oncology team. In some circumstances, worsening neuropathy may affect medical decisions about treatment. Those decisions belong to the prescribing oncology team, not an exercise professional (Loprinzi et al., 2020).
What should you do if neuropathy makes exercise difficult?
If numbness, pain or poor coordination is affecting your ability to exercise, it's worth reviewing the situation before attempting to increase the intensity. A sensible approach may involve:
Assessing the symptoms
Consider whether the main limitation is reduced grip, altered foot sensation, pain, weakness or balance. These difficulties may require different exercise adaptations.
Reviewing the equipment
A different exercise or piece of equipment may allow the same muscle groups to be trained more safely.
Adjusting the resistance
A lighter load or a more supported movement may be appropriate, particularly when coordination is affected.
Monitoring the response
Persistent or worsening pain, increased numbness, significant instability or new weakness should prompt reassessment.
Seeking specialist input
An oncology physiotherapist, occupational therapist or appropriately qualified cancer exercise rehabilitation professional may be able to help. Physiotherapists can assess movement and balance difficulties, while occupational therapists can support practical challenges with everyday activities and equipment (Macmillan Cancer Support, n.d.).
Will exercise make neuropathy disappear?
Unfortunately, exercise cannot currently be described as a reliable cure for chemotherapy-induced peripheral neuropathy. Some people experience improvement in symptoms after treatment ends, while others continue to have difficulties for months or years. Clinical guidelines recognise that management can be challenging.
For established painful chemotherapy-induced neuropathy, ASCO identifies duloxetine as a medication that clinicians may consider, although its benefits are limited and it is not suitable for everyone (Loprinzi et al., 2020).
Exercise may offer additional benefits for physical function, balance, strength and possibly neuropathy symptoms, but it should not replace medical assessment or appropriate treatment.
For many people, rehabilitation is about improving what they can do, even when some symptoms remain.
Final thoughts
Peripheral neuropathy can make resistance training more complicated, but it doesn't automatically mean strength training must stop. The most appropriate approach depends on the individual's symptoms, treatment history and physical capabilities.
Research suggests that exercise programmes incorporating resistance, aerobic and balance activities may provide benefits for people experiencing chemotherapy-induced neuropathy.
However, exercise should be adapted carefully, particularly when grip strength, sensation or balance is affected.
The goal isn't to find a way to lift the heaviest possible weight. It's to find a way of rebuilding strength that is safe, manageable and appropriate for your body.
At ROSY, I provide specialist cancer exercise rehabilitation coaching for people living with and beyond cancer, including personalised online support throughout the UK.
The focus is on understanding individual treatment effects, adapting exercise appropriately and supporting gradual improvements in physical function and confidence.
Disclaimer: This article is intended for general educational purposes and does not replace personalised medical or physiotherapy advice. Peripheral neuropathy has several possible causes, and exercise recommendations should be adapted to individual circumstances.
Anyone experiencing new or worsening numbness, muscle weakness, pain or balance difficulties should seek appropriate medical assessment. People undergoing cancer treatment or living with significant treatment complications should discuss exercise suitability with their oncology or rehabilitation team before making substantial changes to their programme.
References
Amarelo, A. et al. (2025) 'Effects of physical exercise on chemotherapy-induced peripheral neuropathy: A systematic review and meta-analysis', Pain Management Nursing, 26(2), pp. 212–221. Available at: https://doi.org/10.1016/j.pmn.2024.12.011
Khmethong, U., Hawsawi, S. and Schneider, J.K. (2024) 'The effects of exercise on symptoms of chemotherapy-induced peripheral neuropathy in cancer survivors: A systematic review and meta-analysis', Oncology Nursing Forum, 51(5), pp. 426–444. Available at: https://doi.org/10.1188/24.ONF.426-444
Ligibel, J.A. et al. (2022) 'Exercise, diet, and weight management during cancer treatment: ASCO guideline', Journal of Clinical Oncology, 40(22), pp. 2491–2507. Available at: https://doi.org/10.1200/JCO.22.00687
Loprinzi, C.L. et al. (2020) 'Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: ASCO guideline update', Journal of Clinical Oncology, 38(28), pp. 3325–3348. Available at: https://doi.org/10.1200/JCO.20.01399
Macmillan Cancer Support (n.d.) Peripheral neuropathy and cancer: Symptoms and support. Available at: https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/peripheral-neuropathy (Accessed: 13 October 2026).
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