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Balance when numbness, full or partial is present.

Nige

Balance becomes a new skill after a stroke. It is more complicated when there are numbness sensation issues. Feedback from the feet,body and eyes gives the brain the detail it needs to maintain balance. It is much harder to balance when you close your eyes.
What further complicates balance is the lack of sensation from your weaker foot/leg, whether full of partial.
You may not know you are against something or precisely where your leg is in relation to your body.

Partial sensation can feel very odd. If feeling is just in your toes but no where else in the foot, it will feel like you are on tip toes even if your foot is flat on the floor. You may feel like you are falling backwards if just your heel has feeling.

Nige

Got to say, this partial feeling/numbness is hard work.It completely mucks up steadiness. The favouring of one side for standing is much more marked. If the body perceives danger on the weaker side, it wants to get that weaker side away from danger asap.
Imagine you have stood on something sharp (rather than something cold or cool here) your body lifts the foot away as soon as it possibly can. No critical thinking needed, you don’t have the time. That move of weight to one side at very quick speed is hugely difficult, it’s grab onto whatever is in reach.
It’s going to catch me out one day for sure.

EmeraldEyes

Nige Try standing upright with your feet together and eyes closed. That would eliminate some of external data process the brain has to process, allowing it to focus more on the act of staying upright 😉

https://stroke.logicalmodel.net/flarum/public/d/202-balance

Nige

EmeraldEyes I am finding that moving in the dark where it is really dark, is harder than ever. Feels like you are totally reliant on feedback from the feet.
In my case, that might be just my left toes, next ten mins it might switch to the heels. Next time I try it might be the left hand side of my left foot. In turn, that feels like stood on tip toes one min as that’s all I can feel on left side, falling backwards, falling sideways.

So you can imagine, closed eyes, feet together or apart, it’s just getting harder and harder as the sensations just become more varied.

EmeraldEyes

Nige But to me, that’s all the more reason to be doing balance exercise with your eyes closed. To retrain that brain of yours and awaken those connections. It was the same for me in the beginning, no sense of where my foot was. The foot placement, as well as the foot drop were my biggest issue post stroke, and I had a few painfully stubbed toes getting around in the dark.
Are all those sensations painful?
Could the be bearable for 5 minutes here and there throughout the day. Stand a few inches away with your back to a wall and you stick in hand if need be ’til you progress.

DeAnn

I suppose that’s one of the good things about being somewhat blind. It is actually easier for me to roam around in the very dark. No I can’t feel my left foot but something in my mind remembers the way without my toes to feel it. I have them cut my foot on dog bones and such a time or two, however I did not know until it was light again or someone else noticed.

Nige

EmeraldEyes the thing for me was I got pretty good at that post stroke and the walking one foot in front of the other. The only way I can improve currently is to only concentrate on the feedback from my good foot and try to discount completely the feeling from the weaker one. Which I guess is what we are hoping to train.
I suspect my deterioration will only be addressed by surgery. Yesterday I suffered some of my worst pain so far.
I had my weaker hand out the bed holding my phone, so hardly the artic but that temperature difference was enough. Fingers felt like ice, the cold alarm went off and didn’t reset for two hours.
Stuck in bed thinking I wouldn’t be able to make the pain management programme, how ironic, can’t come, in too much pain …
Fortunately it died down after 2 hours in bed.

There must be something in the story which is trotted out. Marathon runner can push through pain, barely impacted but come the end of the race after resting, can barely walk. Why can the brain ignore pain (that it has created/interpreted) but then not ignore it. Why does running or a distraction actually trump pain - one of the most obvious things the body would need to react to ?

EmeraldEyes

Nige

Nige There must be something in the story which is trotted out. Marathon runner can push through pain, barely impacted but come the end of the race after resting, can barely walk. Why can the brain ignore pain (that it has created/interpreted) but then not ignore it. Why does running or a distraction actually trump pain - one of the most obvious things the body would need to react to ?

That’s the adrenaline that builds up in your body, help push you through that you are in the moment, so to speak. Once the “emergency” is over, you are out of the fight or flight situation. Your body crashes. Don’t know if you remember the mountaineer Aron Ralston who had to cut off his own arm when he got it trapped in a canyon in 2003. It was the buildup of adrenaline in his system that got him through that. Same goes for women going through natural child birth. Your body gets you drugged up to such a high that, even though you are aware the pain is there, you are on enough of a high to not care. Bit like drug addicts and wino’s, only there’s are not the natural highs of adrenaline. The adrenaline junkies are the ones who’ll go for the more extreme sports and don’t fear pain.

Adrenaline comes from the adrenal gland situated at the top of your kidney. Might be a direction for you to explore. Also, consider looking into how those with spinal injuries manage chronic pain.
https://www.spinal.co.uk/
https://www.healthdirect.gov.au/adrenal-glands

Another avenue to be considered/explored, if not already, is hypothyroidism as it can cause chronic pain too

‘hypothyroidism may cause: Muscle aches, tenderness and stiffness. Joint pain and stiffness, particularly in the hands and knees in adults.’

https://pubmed.ncbi.nlm.nih.gov/32621001/

How deeply/thoroughly was your chronic pain investigated? It’s easy, and less expensive on NHS, just to conclude its the result of your stroke and you’re just going to have to live with it. But have they even tried to track it down, the pain has to stem from somewhere in the body doesn’t? Is it because the brain signalling to the thyroid or adrenal gland or elsewhere causing something to malfunction.

For instance, I have a little “thin” pain just down a section of my outer thigh, a couple inches long, it came on immediately after my stroke and it’s relatively constant. I can live with it and comfortably ignore it but I know its there. I think I mentioned it to physio at the time but never bothered with the doctor as there were more pressing issues at the time, my speech for one.
I just assumed it was the stroke effect! But now, 4yrs on, with my physical fitness regime, the pain is not as great as compared to the beginning. I can not pin point exactly where it stems from and it’s coming from the hip. I can actually switch on and off just by turning my leg certain ways. That in turn, tells me its osteoarthritis; I’ve had it in the left hip and had that replaced but the right hip, my stroke side, isn’t bad enough for that yet. Like I said, its easy to assume otherwise, and cheaper on the NHS.

I can only wish that yours could be that easy, but you are far worse off than I ever was ☹

Nige

EmeraldEyes oddly I do know a bit about adrenal glands as I had an underlying condition of Conn’s syndrome which led directly to my stroke. One of my glands had a tumour on it, boy was I happy when it was suspected (since confirmed) of being benign.
It was enough though to get that gland to perform in a dangerous way. Its a condition where the adrenal glands produce too much aldosterone, a hormone that regulates blood pressure by balancing potassium and sodium level. Tried to control it with medication and have since had an Op to remove it.
Oh if only I had chosen that before ….. 5 BP medicines are now down to 2 and possibly reviews to come.
I am going to ask as part of my pain medicine course if I can have a 1 to 1 with the physio and see if she can tell if there is a physical element to this.
The pain appears to move around but I suspect part of it is muscles or tendons pulling on areas which fires off nerve signals. The thalamus which was partly blown up with the stroke is possibly incorrectly routing some of those sensations to the pain receptors.
The toe next to my big toe is being pulled sideways so that must be some sort of shortening. My previous physio couldn’t find anything and felt it was all sensation issues.
What ever it is it really hurts. It was so bad Tue I was having to do breathing to try to control it. I thought I was going to miss the pain management programme. How ironic, can’t come, in too much pain. Fortunately after 2 hours of warmth in bed it eased.

Nige

EmeraldEyes it does seem there is no formal test for cpsp. Its one of those where they rule out other conditions, including Parkinsons and it’s what I was left with as a diagnosis.
My extreme pain the other day was as a result of my weak hand being out of bed. Hardly the artic and it triggered the whole left hand side. Won’t forget a glove next time. Once that pain alarm goes off, it’s a right sod to turn it off again. Even if the trigger for it, is long gone.

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