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Swollen Arm After Stroke: How to Manage This Common Side Effect

best ways to treat a swollen arm after stroke

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 sustain 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 lymph.

Lymph is a clear 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 helps move lymph throughout the body to help the lymphatic system get rid of toxins. When muscles become difficult to move after stroke, it impairs the flow of lymph and leads to fluid buildup in the affected tissue.

This fluid buildup 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
  • Infection
  • Hot and humid weather

In the hospital after stroke, the medical team can notice and treat edema. When 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

therapist holding stroke patient's swollen arm for passive exercise

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 exercise helps 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. 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 effortful movement 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 work their way up.

3. Exercise the Non-Swollen Side (New Recommendation)

therapist helping stroke patient exercise arm

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 increased 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.

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 exercise.

5. Wear Compression Garments

stroke patient with compression sleeve on arm

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.

This is another compensation technique, but can still be helpful. For best results, combine your favorite compensation techniques with consistent rehabilitation 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.

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.

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See how Susan is recovering from post-stroke paralysis

“I had a stroke five years ago causing paralysis on my left side which remains today.

I recently began using FitMi.

At first it was difficult for me to be successful with a few of the exercises but the more I use it, the better my scores become.

I have recently had some movement in my left arm that I did not have before.

I don’t know if I can directly relate this to the use of the FitMi but I am not having occupational therapy so I conclude that it must be benefiting me.

The therapy modality motivates me to use it daily and challenges me to compete against my earlier scores.

I heartily recommend it!-Susan, stroke survivor

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