A swollen arm after stroke often happens to stroke patients with hemiplegia or hemiparesis (paralysis or weakness on one side of the body). Lack of movement in the affected limb is often the primary cause of swelling, although other causes should not be ruled out.
It’s important to talk to your doctor if you notice any swelling after stroke. A doctor can help diagnose the cause and provide next steps for treatment.
This article will help you understand the causes and treatment methods for swollen arms and hands after stroke. We hope it helps you have an informed conversation with your doctor.
What Causes a Swollen Arm After Stroke?
Swelling in the arm or hand is often the result of excessive fluid buildup in the muscles. The fluid of particular concern is lymphatic fluid, also known as lymph.
Lymph is a clear or slightly yellowish sticky fluid that contains infection-fighting white blood cells. The lymphatic system is responsible for pumping lymph throughout the body to help get rid of toxins.
Normally, muscle and joint movement help move lymph throughout the body to help the lymphatic system get rid of toxins.
When muscles contract, it increases the strength of pumping in lymphatic vessels, allowing the fluid to move faster. Lymph moves through lymphatic vessels and eventually reaches lymph nodes, where it is filtered. Most lymph nodes are near your joints and are compressed and able to work faster when you move your joints. When muscles and joints become difficult to move after stroke, it impairs the flow of lymph and leads to fluid buildup in the affected tissue.
This fluid buildup in the arms or legs is called peripheral edema. While there are many other causes of peripheral edema, one-sided weakness is the most common cause in stroke patients. However, it’s not the only cause, so it’s important to talk to your doctor if you’re experiencing this side effect.
Other causes of edema after stroke include:
- Physical inactivity
- Side effects of new medication
- Being overweight
- High sodium intake
- Blood clotting
- Hot and humid weather
In the hospital after stroke, the medical team can notice and treat edema. If a swollen arm occurs after discharge from the hospital, it’s important to proactively seek medical attention.
How to Reduce Arm Swelling After Stroke
There are numerous ways to manage arm and hand swelling after stroke. Talk to your doctor or therapist to see which options will work best for you.
Here are methods commonly used to treat a swollen arm after stroke:
1. Passive Arm Exercises
Movement is the first line of defense against edema after stroke. Not only does movement help get tissue fluids moving, but it also helps rewire the brain through neuroplasticity.
Consistent, therapeutic rehab exercises help stimulate neuroplasticity to improve one-sided weakness like hemiparesis and hemiplegia long-term. As mobility increases, the swelling should decrease as a result.
If you struggle with post-stroke paralysis, it helps to start with passive range-of-motion exercises. These exercises involve someone else, such as a trained caregiver or therapist, to move your arm for you. They can also be done independently using your unaffected arm to move your affected one. This helps get the lymph moving and activate neuroplasticity.
2. Active Arm Exercises
When there is partial control over the swollen arm and hand, then the patient can benefit from active arm exercises for stroke patients. This also helps stimulate lymph circulation and neuroplasticity.
Active exercise differs from passive exercise by requiring you to independently complete effortful movement of your affected arm or hand without help. Active exercise helps stimulate neuroplasticity even more than passive exercise. Patients that cannot do active exercise can start with passive ROM exercises and progress to active movement when able.
3. Exercise the Non-Swollen Side (New Recommendation)
Most therapists encourage stroke patients to exercise the swollen arm to help reduce edema. However, an interesting study showed that exercising the non-swollen side can still help reduce swelling on the affected side.
In the study, stroke patients opened and contracted their non-swollen hand for 20 seconds. This was found to increase both the speed and volume of blood flow in the swollen hand, too. This has positive implications for stroke patients with paralysis.
Even if it’s not possible to exercise the affected hand or arm yet, this study shows that any movement is helpful to manage swelling in the affected arm or hand.
4. Elevate Your Arm
When your arm is down at your side, gravity pulls lymph to the lowest point, which can contribute to swelling in the arm or hand. A simple way to help reduce this type of swelling is to elevate the arm, bringing it above the heart if possible.
Elevation encourages the lymph to flow evenly. This is a compensation technique, which means it’s a short-term solution. The best long-term solution is regular exercise and use.
5. Wear Compression Garments
Compression garments are another compensation technique for swollen limbs after stroke. Tight-fitting compression gloves and sleeves can help push fluid back into circulation.
If you’re interested in trying compression garments, talk to your therapist. They can help size you and provide recommendations.
6. Massage the Swollen Limb
Massage helps stimulate fluid circulation, which can help reduce swelling in the arm. Ask your caregiver to massage your affected arm, or try to do it yourself using your non-affected side. Massage from your fingers upward toward your armpit rather than downwards, as massaging downward pushes fluid into your hands and fingers, where it gets stuck as it has nowhere else to go.
This is another compensation technique, but can still be helpful. For best results, combine your favorite compensation techniques with consistent rehabilitative exercise.
Where to Look for Help
If you notice swelling after stroke, make an appointment to talk with a medical professional. Although swelling is generally easy to treat and not worrisome, it can also be caused by serious conditions like blood clotting.
Typically, a combination of treatments is the most effective way to manage swelling. Ask your therapist for recommendations for compression sleeves and exercise programs. Most physical and occupational therapists have a general knowledge of how to treat post-stroke swelling. However, if you have extremely persistent or severe swelling, ask your doctor or therapist if there is a certified lymphedema therapist in your area who will provide you with more specialized care.
Many therapists recommend FitMi home exercise for stroke patients. It encourages high repetition of therapeutic exercises which are necessary to rewire the brain and improve movement after stroke.
For more tips on stroke recovery, check out the free ebook below.