Eliminating Numbness After A Stroke: Effective Strategies And Rehabilitation

how can you eliminate numbness from a stroke

Numbness is a common secondary effect of a stroke, causing a loss of sensation in the affected areas. This can be complex and is often accompanied by other sensory issues such as pain, tingling, and hypersensitivity. The good news is that there are ways to eliminate numbness and improve your quality of life. In this article, we will discuss the causes of numbness after a stroke, the impact it can have, and effective treatments to help you regain sensation and functionality.

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Seek medical advice from a therapist or doctor

Numbness after a stroke is a common secondary effect, and it is important to seek medical advice from a therapist or doctor. They will be able to advise on the best course of treatment and rehabilitation to promote the return of sensation.

Firstly, a doctor will be able to diagnose the cause of numbness. A stroke occurs when blood flow in the brain becomes disrupted, leading to brain cells becoming deprived of oxygen-rich blood and dying. This tissue damage in the affected areas of the brain causes a loss of function, including sensory issues such as numbness. The area of the brain affected by the stroke will determine the secondary effects that occur. For example, if the thalamus, parietal lobe, or occipital lobe are affected, this can result in numbness or other sensory impairments.

Once a diagnosis has been made, a doctor or therapist will be able to advise on the best treatment methods. There are a variety of rehabilitation methods available to promote the return of sensation, and these can be done at home or with the help of a therapy team. These treatments are based on the concept of neuroplasticity, which refers to the brain's ability to reorganise itself and learn new functions. Through neuroplasticity, functions in areas of the brain that were damaged can be rewired to healthy, unaffected areas.

One of the most effective ways to fix sensory issues after a stroke is with sensory reeducation. This involves sensory retraining or sensory reeducation exercises to teach the brain how to interpret senses. For example, a patient can be asked to identify objects of different textures without looking at them, or to practise temperature differentiation by alternating between touching warm and cold objects.

Another rehabilitation technique is mirror therapy, where the patient places a mirror in front of their affected limb and engages in repetitive movements with their unaffected limb. This helps activate mirror neurons in the brain and encourages neuroplasticity.

Functional electrical stimulation is another treatment option that delivers a shock to the muscles to activate nerves. While there is currently limited research on its effectiveness in reducing numbness, it has demonstrated good results in some patients.

It is important to seek medical advice to determine the best course of treatment and to ensure safety during daily activities. Numbness can affect a patient's everyday life and safety, so it is crucial to work with a therapist to address numbness and take extra precautions to prevent injuries.

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Try electrical stimulation therapy

Electrical stimulation therapy can be used to address many issues that may arise after a stroke. It involves placing electrodes on the skin over a muscle and activating them to send electrical currents to the muscle, causing it to contract. This can be especially helpful for those with neuropathy or central post-stroke pain, as it helps to engage neural pathways between the brain and limbs, reducing painful symptoms and improving quality of life.

There are several types of electrical stimulation therapy:

  • Functional Electrical Stimulation (FES) is often used to restore function to a paralysed limb.
  • Electrical Muscle Stimulation (EMS) and Neuromuscular Electrical Stimulation (NMES) provide stimulation to muscular tissues via electrical impulses.
  • Transcutaneous Electrical Nerve Stimulation (TENS) is used to address chronic or acute pain management by encouraging the body to produce more endorphins.
  • EMG Triggered Stimulation (ETS) is used for stroke survivors who have some movement in the affected limb. The device detects the patient's movements and provides stimulation based on them.
  • Electromyogram-Triggered Stimulation (EMG) is a combination of biofeedback and stimulation, using the patient's own movements to provide stimulation.
  • Reciprocal EMG Triggered Stimulation (RETS) is used for patients with increased tone or difficulty relaxing the muscles in the affected limb.

It is important to note that electrical stimulation therapy may be contraindicated for certain individuals, such as those with pacemakers or decreased sensation. It is also important to perform a skin check after using an electrical stimulation unit to ensure there are no adverse reactions.

Combining electrical stimulation with massed practice of repetitive functional exercises can lead to the best results.

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Try mirror box therapy

Mirror box therapy is a rehabilitation technique that can help individuals improve mobility in the hand, arms, and sometimes even legs. It is especially useful for stroke survivors with extremely limited mobility or post-stroke paralysis.

The therapy involves placing a tabletop mirror over the survivor's affected hand, with the non-affected arm resting on the table next to the mirror, ensuring that it is fully in view in the reflection. The survivor then practices various hand therapy exercises with their non-affected hand while watching its reflection in the mirror. This helps activate mirror neurons in the brain and encourages neuroplasticity, which is the brain's ability to heal and rewire itself.

The more you practice mirror therapy exercises, the more your brain will rewire itself, and the higher the chances of restoring hand and/or arm function. Mirror therapy can also be combined with other treatments such as electrical stimulation therapy or sensory retraining exercises to further improve numbness and sensory issues after a stroke.

  • Spend a few minutes observing the reflection and getting accustomed to the optical illusion.
  • Think of the mirror as a window instead of a reflection to further "trick" your brain.
  • Practice simple hand therapy exercises such as touching your thumb to your fingertips, making a fist and then opening the hand, or turning your palm up and down.
  • Complete these exercises for at least 10 minutes, working your way up to half-hour sessions, keeping your eyes on the reflection in the mirror the entire time.
  • Be strategic and repetitive with your exercises. Practicing specific hand exercises repetitively will help activate neuroplasticity.
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Practise sensory re-education exercises

Practising sensory re-education exercises is a rehabilitation technique that can help stroke survivors regain their sensory function by retraining the brain to process sensory signals. This involves practising touch-based exercises that stimulate the brain and encourage sensory processing.

Tabletop Touch Therapy

  • Place a variety of objects with different textures, such as soft scarves, rough sandpaper, fluffy cotton balls, rough Velcro, and cold cutlery, on a table.
  • Pick up the items and feel them without looking at them. Try to differentiate between the textures by taking your time and being deliberate.
  • Bury various tactile objects, such as cotton balls, marbles, coins, and Velcro strips, in a bowl of uncooked rice. Insert your hand into the bowl and try to find and identify the objects without looking.

Texture Recognition

  • Have someone place different objects in your hand with your eyes open. Feel the textures of these items and practice describing them using adjectives like rough, smooth, or bumpy.
  • Repeat the exercise with your eyes closed. Focus on the sensations associated with each object to help your memory remember the link.

Temperature Differentiation

  • This exercise is especially helpful for patients with stroke who have problems sensing or differentiating between heat and cold.
  • Soak two cloths—one in cold water and the other in warm but not hot water. Have someone place the cold cloth on your arm and notice how the experience differs from what it was before the stroke.
  • After 30 seconds, swap the cloths and try to distinguish the temperature difference.
  • Close your eyes and have someone place one of the cloths on your arm. Try to identify whether you are experiencing heat or cold.
  • Continue alternating between the hot and cold cloths. If you don't have an assistant, use your unaffected hand to place the cloths on your arm, being mindful of the temperature to prevent burns.

Touch Localisation

  • Close your eyes and have someone place their hand somewhere on your arm. Then, indicate where you believe they touched.
  • If you don't point to the correct area, have them move your hand to the correct location. Open your eyes to visually absorb the information.
  • Repeat this exercise at least ten times. Once you become proficient, increase the difficulty by having your assistant touch you with different textured objects, such as a Q-tip or metal spoon.
  • Keep your eyes closed during the exercise, and if you perform it incorrectly, open them once someone touches your finger to help your brain process the input.

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Be cautious of safety hazards

Numbness after a stroke can be dangerous, so it's important to be cautious of safety hazards and take extra care to prevent injuries to the affected limb. Here are some ways to be cautious of safety hazards and ensure your safety:

  • Be aware of your surroundings: Pay close attention to your surroundings, especially in the kitchen or when dressing. For example, if you're cooking, make sure you're aware of your affected limb's position to avoid accidentally brushing against a hot stove or boiling water, which could cause burns.
  • Check clothing and footwear: Ensure your clothes and shoes are not too tight, as this can lead to skin breakdown, abrasions, wounds, and infections. Always check the fit of your clothing and footwear to prevent any restrictions in blood flow, which could further damage the affected area.
  • Monitor water temperatures: If you have reduced sensitivity to temperature, be cautious when showering or washing up. Test water temperatures with your unaffected hand to avoid scalding or burning yourself.
  • Practice extra caution with food: Be cautious when heating up food, especially if you have tingling sensations or numbness in your hands. This will help prevent accidental burns or injuries.
  • Wear shoes when walking: If you have impaired sensation in your feet, always wear shoes to protect your feet from potential hazards and injuries when walking.
  • Seek help from a therapist: Work closely with an occupational therapist or physiotherapist to address sensory retraining and improve your safety during daily activities. They can provide tips and techniques to maximise your safety and minimise risks.
  • Be mindful of potential skin damage: Numbness can make it difficult to detect pressure or tightness on your skin from clothing or shoes. Check your skin regularly for any signs of rubbing, damage, or wounds, especially in areas where numbness is present.
  • Be cautious with sharp objects: If you have reduced sensation in your hands or arms, be extra careful when handling sharp objects such as knives or scissors. Always pay close attention to your movements to avoid accidental cuts or injuries.
  • Keep your environment well-lit: Ensure your home or workspace is well-lit to help you better visualise your surroundings and identify potential hazards. This is especially important if your stroke has affected your vision or perception.
  • Use assistive devices: There are various assistive devices available, such as orthotics or adaptive equipment, that can help improve your safety and functionality. These devices can provide support and protection for your affected limbs, reducing the risk of injuries.

Remember, it is crucial to be vigilant about your safety and well-being during the recovery process. By following these precautions and working closely with your therapy team, you can effectively manage the safety hazards associated with numbness after a stroke.

Frequently asked questions

Numbness after a stroke can be eliminated through spontaneous recovery, which occurs in the first few months for some survivors. For others, specific rehabilitation methods are needed to promote the return of sensation. This includes sensory retraining exercises, electrical stimulation, and mirror therapy.

Sensory retraining exercises involve practicing with objects of different textures, temperatures, and shapes to help the brain interpret senses. For example, you can gather objects with different textures and try to distinguish between them without looking. Another example is the rice bucket exercise, where you place different objects in a bucket of rice and try to identify them by touch.

Electrical stimulation uses electrical impulses to improve sensory function and reduce tingling sensations. It can also help engage neural pathways between the brain and limbs, reducing painful symptoms.

Mirror therapy involves placing a mirror in front of the affected limb. The patient then performs repetitive movements with their unaffected limb while watching their reflection, giving the brain the impression that the affected limb is moving. Over time, this helps rewire the brain and decrease numbness.

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