Stroke: Preventing Injury in Affected Limbs

Topic Overview

After a stroke, you may not feel temperature, touch, pain, or sharpness on your affected side. You may have:

• Feelings of heaviness, numbness, tingling, or prickling or greater sensitivity on the affected side.
• No sense of how your muscles and joints are operating together, which may affect your balance.

In stroke rehab, you can learn how to prevent injury on your affected side. For example, you might do exercises to gain more range of motion. Your team can also teach you how to position your limb to prevent pain.

If you cannot feel an object, you may be more likely to hurt yourself.

• If you have a tendency to clench your fist on the affected arm, keep your fingernails short and smooth so that you do not cut yourself.
• If you cannot feel sensations in your feet, cut and file your toenails straight across so that you do not scratch yourself.

Soaking your hands and feet may make your nails easier to cut. If you have diabetes, talk with your doctor about the care of your feet.

If you cannot feel heat on your affected side, you may be more prone to burns. Tips to prevent burns include the following:

• Test the temperature of bath water or dishwater using your unaffected side.
• Bathe and do dishes in lukewarm water.
• Use pot holders whenever you work near a stove.
• Turn pot handles away from you to prevent spills.
• Wear nonflammable clothes when you cook, and do not wear clothes with long sleeves or ruffles that could get caught in an appliance.

If you have poor muscle tone in an arm, you may be at risk for shoulder problems. The weight of an affected arm can cause the shoulder to dislocate (shoulder subluxation). You also may tend not to use the shoulder, which may cause pain and loss of motion (frozen shoulder). You can help prevent a frozen shoulder by:

• Positioning and supporting your affected arm. For example, wear an arm sling when sitting up or walking.
• Maintaining full movement (range of motion) of the affected joints either by moving your arm or having someone move it for you.
• Not overexercising your arm. This can cause pain and make exercising more difficult.

Swelling occurs when the affected arm or leg cannot move for a long period of time. A large amount of swelling:

• Causes reduced blood flow in the limb, which increases your chance of getting skin sores (pressure injuries).
• Limits movement of the limb, which increases your chance of having the joint stiffen (contracture).
• Causes pain and discomfort in and around the swollen tissues.

Some tips to prevent swelling in your affected arm or leg include the following:

• Elevate the affected arm or leg. If your arm hangs down at your side for long periods of time, you will have more swelling in the arm.
• Follow your doctor's advice about what daily exercises to do. There are exercises you can do to help drain fluid from the affected arm or leg.
• See a physical therapist. He or she can teach you how to do special massages that can help move fluid out of your arm or leg. You also can learn what activities would be best for you.
• Try compression stockings to keep fluid from building up in your arm or leg. Your doctor or therapist can help you know what size to buy.