Regaining Sensation After Stroke: Understanding Central Post-Stroke Sensory Syndrome

A ProVital Physiotherapy Guide

When someone experiences a stroke, most people focus on movement : the weakness, the walking, or the use of the arm and hand. But many stroke survivors notice something else that lingers long after strength begins to return: numbness, tingling, or strange sensations that just don’t seem to go away.

At ProVital Physio, we often meet stroke survivors who say:

“My hand feels like it’s there, but it doesn’t feel normal.”“I can walk again, but my leg still feels numb.”

What’s Really Happening: It’s the Brain, Not the Nerves

After a stroke, the part of the brain that processes touch, temperature, and body awareness can be affected. Even if the muscles regain their strength, the “feeling network” inside the brain may still be healing.

This condition is known as Central Post-Stroke Sensory Syndrome (CPS).

Unlike numbness caused by nerve injury in the arm or leg, CPS happens inside the brain, meaning the problem isn’t in your skin or nerves, but in how your brain interprets those signals.

Common Sensations People Experience

CPS can vary from person to person. You might feel:

• Tingling, pins and needles, or electric sensations

• Numbness or “heavy” feelings

• Burning, tightness, or temperature changes

• Pain or discomfort even from light touch (like clothing or water)

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These sensations can be uncomfortable or confusing, especially when your movement has already improved. But they’re actually a sign that your brain is still adapting and rewiring.

Can Recovery Happen?

Yes! with the right approach. Recovery often involves retraining the brain through neuroplasticity, the brain’s natural ability to re-learn and build new connections.

At ProVital Physio, our therapists use techniques such as:

• Sensory retraining (gradual exposure to different textures, temperatures, and movements)

• Mirror therapy to help re-map brain awareness

• Task-based activities to integrate sensation and movement

• Education and self-management to reduce fear and frustration

  
  

While recovery takes time, many patients notice gradual improvement when therapy is consistent and guided properly.

How to Explain It in a simpler term?

It’s important to understand:

“The nerves in my arm are fine — it’s my brain’s way of interpreting sensation that’s still healing.”

This helps shift the focus from frustration (“Why can’t I feel my hand?”) to motivation (“My brain is relearning; I just need to keep training it.”).

Family members should also know that these sensations are real and not imagined — even if the person looks “normal” on the outside.

Post-stroke recovery is more than just walking again. It’s about regaining connection with your own body. At ProVital Physio, we support stroke survivors through every stage of recovery, from strength and balance to the often-overlooked world of sensory rehabilitation.

If you or a loved one is experiencing unusual sensations after a stroke, don’t ignore them. They may be a sign that your brain is still healing — and with the right guidance, progress is possible.

References

Boivie, J., Leijon, G., & Johansson, I. (1989). Central post-stroke pain — a study of the mechanisms through analyses of the sensory abnormalities. Pain, 37(2), 173–185. https://doi.org/10.1016/0304-3959(89)90125-6

Bowsher, D. (1996). Central post-stroke (thalamic) pain: Further evidence on the therapy and a possible therapeutic mechanism. Pain, 67(1), 59–63. https://doi.org/10.1016/0304-3959(96)03072-8

Garcia-Larrea, L., & Peyron, R. (2013). Pain matrices and neuropathic pain matrices: A review. Pain, 154(Suppl 1), S29–S43. https://doi.org/10.1016/j.pain.2013.09.001

Klit, H., Finnerup, N. B., & Jensen, T. S. (2009). Central post-stroke pain: Clinical characteristics, pathophysiology, and management. The Lancet Neurology, 8(9), 857–868. https://doi.org/10.1016/S1474-4422(09)70176-0

Morioka, S., & Katayama, Y. (2016). Rehabilitation for sensory impairments after stroke: A review. Neural Plasticity, 2016, Article 7691026. https://doi.org/10.1155/2016/7691026

National Institute of Neurological Disorders and Stroke. (2023). Post-Stroke Rehabilitation Fact Sheet. Retrieved from https://www.ninds.nih.gov