Changes to touch and sensation

Feeling touch differently and having strange sensations can be a surprising change after a stroke. In this article, the StrokeLine team covers why this can happen and what can help.

We have touch receptors in our skin. When we are touched, the receptors send out signals. Mostly, it’s up to our brains to make sense of these signals. All being well, we know where we are being touched, and what kind of touch it is. We know if something is hot or cold, rough or smooth, sharp or blunt. If things are working as they should, when we experience a sensation, there’s a reason. We have pins and needles, for example, because a part of our body has been in an awkward position.

We also have sensations that come from our muscles. These sensations tell us if we are moving or resting, and what position we are in.

After a stroke, all this can be disrupted. Stroke can change your brain’s ability to process and understand information from your senses.

Parts of your body may feel touch less or be numb. If you have a loss of sensation in your hands, you may drop things or have trouble brushing your teeth. Getting back to a craft or hobby may be difficult. Less sensation may mean you don’t notice things like shoes being tight.

It can also affect relationships. You may not know if someone has touched you affectionately as they walk by, and sex may feel very different.

You can also feel touch more. A light touch can feel like much more than it is, to the point of being irritating or painful. Again, this can affect you throughout your day, and it can change how you experience affection and sex too.

You may feel hot and cold less. This is an important one, as feeling temperature accurately keeps us safe. You may not know water is too hot, or that you are sitting too close to a heater.

You may have pins and needles, tingling or other strange sensations. Some sensations can be unpleasant, like burning or feeling like something is running over your skin.

Finally, you may not always know where your hand or foot is. You may not know it is in a funny position or you may feel like it is heavy or stiff when it actually isn’t.

So, what can be done? First, remember sudden changes such as numbness or paralysis in the face can be signs of stroke, so if it’s come on suddenly, call triple zero (000).

If you’re experiencing sensation changes, speak with your doctor. Your doctor can:

• Make sure you have a diagnosis.
• Make sure there are no health or medication issues causing the changes.
• Refer you to specialists and allied health therapists if needed.

Therapy aims to improve sensation, and to help you adapt to changes.

Improvement relies on neuroplasticity, which is our brain’s ability to change and adapt. After a stroke, pathways in the brain can change so that undamaged parts of the brain can take over the jobs of damaged areas. Repetitive training is needed to help the brain build new pathways.

Sensory retraining is a therapy that aims to retrain sensory pathways and get unused pathways working. Exercises create an association between seeing and feeling touch, or between seeing and sensing where your limbs are. They can include:

• Touching differently textured objects.
• Having someone touch you in the same spot with your eyes closed and then open.
• Applying a cold face-washer and then a warm one to your skin.
• Practising sensing where your hand or foot is with your eyes closed and then open.

These training sessions need to be specifically prescribed to you by an occupational therapist or physiotherapist. For sensory retraining, you will need to see a therapist who has experience working with people with neurological conditions, including stroke. Some therapists have special training in sensory retraining.

Working with a therapist will make sure the exercises you are doing are safe and effective. You will also need to do them repeatedly to help the brain build new pathways. Your therapist will give you exercises to do between sessions.

Ask your doctor about the best way to access an appropriate therapist. Community rehabilitation may be a good option for you. You may also be able to see a therapist using Medicare-subsidised sessions. In this case, Occupational Therapy Australia or the Australian Physiotherapy Association can help you find one. StrokeLine can also help with finding a therapist.

Adapting to changed sensation is also best discussed with your therapist. Again, this needs to be specifically tailored to you to be effective.

Occupational Therapy Australia: Visit otaus.com.au or call 1300 682 878.

Australian Physiotherapy Association: Visit australian.physio or call 03 9092 0888

StrokeLine’s health professionals provide information and advice on stroke prevention, treatment and recovery. Our StrokeLine team can help you find the support and services you need, whether you are a stroke survivor, carer or family member.

Call StrokeLine on 1800 787 653, Monday to Friday 9am to 5pm, Eastern Standard Time.