Arm and hand function

Upper limbs, that is your arms and hands, are affected as frequently by stroke as are legs, but they often have a bigger impact on your daily life. Regaining useful function can be more difficult in upper limbs.

Usually, one side of the body is affected, and which side it is depends on where in the brain the stroke happens. Nerves from each side of the body cross over when they enter the brain, so a stroke in the left side of the brain affects the right side of the body, and vice versa.

The most common type of stroke is an ischaemic stroke, and the most common ischaemic stroke is a blockage in the middle cerebral artery. This occurs more frequently on the dominant side. So if you’re right-handed, you’re more likely to have a stroke that affects your right hand and arm.

Common changes to arm and hand function include:

• Weakness and paralysis
  Your shoulder, elbow, wrist or hand may be weak, or you might not be able to move them. Hemiparesis is when you have weakness all the way down one side of your body. Hemiplegia is when one side of the body is paralysed.
  
• Sensation
  You might lose feeling in your arm or hand, and experience numbness or ‘pins and needles’. Alternatively, you might have hypersensitivity or increased feeling, which can make even light touch painful. For more information, see our page on Sensory changes.
  
• Coordination
  If your arm doesn’t move in the way you want it to, you may have apraxia (also known as dyspraxia). This is when you have difficulty planning or coordinating movements.
  
• Swelling
  Fluid might build up in your hand or arm when it doesn’t move as well as it used to. This is called oedema (also spelt edema).
  
• Muscle tone
  High muscle tone, called hypertonia or spasticity, makes your muscles stiff or tight. Low muscle tone, or hypotonia, makes your muscles floppy or loose.
  
• Subluxation
  The shoulder joint can become partially or incompletely dislocated. This happens when weakness or low muscle tone causes the top of your arm to drop out of its socket.
  
• Contracture
  Muscle shortening due to weakness or high tone can make joints less flexible, or even become fixed in one position.

It is difficult to predict how much your arm will recover, or how long it will take. Recovery is usually most rapid in the first six months after a stroke. But you can continue to see improvement for years, especially if you keep active and continue rehabilitation.

Talk to an occupational therapist or physiotherapist for an assessment of how much you can use your arm. They will help figure out the most effective treatment and exercise program for you, as well as strategies and aids to help you in your daily activities.

For more information

There are many possible treatments for arms and hands. To find out more, see the Stroke Foundation fact sheet on Upper limb management.

See also our pages on Exercise and Pain management.