How do you feel days after a mini stroke?

The Days and Months After a Stroke

There are many problems that may happen after a stroke. Most are common and will improve with time and rehabilitation.

Common physical conditions after a stroke include:

Weakness, paralysis, and problems with balance or coordination.
Pain, numbness, or burning and tingling sensations.
Fatigue, which may continue after you return home.
Inattention to one side of the body, also known as neglect; in extreme cases, you may not be aware of your arm or leg.
Urinary or bowel incontinence.
Speech problems or difficulty understanding speech, reading, or writing.
Difficulty swallowing.
Memory problems, poor attention span, or difficulty solving problems.
Visual problems.
Depression, anxiety, or mood swings with emotional outbursts.
Difficulty recognizing limitations caused by the stroke.

Right vs. Left Side of the Brain

Common problems when a stroke happens on the right side of the brain versus the left side of the brain:

Right Side of the Brain

Left-side weakness
Impulsive behavior
Overconfidence in abilities
Vision problems

Left Side of the Brain

Right-side weakness
Speech and language problems
Slow behavior

Special Problems

You may need focused treatment to address certain other conditions.

Shoulder/hand syndrome

Shoulder/hand syndrome happens when the loss of a muscle group causes the shoulder to detach from its socket.

The secondary disability may include:

Tingling
Varying feelings of hot and cold
Changes in sensation

Preventing and treating the syndrome is critical in the rehabilitation process. It can be addressed with range of motion exercises.

Learned non-use

A phenomenon often seen in people after having a stroke is “learned non-use.” This occurs when you accept the loss of function of a particular muscle or muscle group and only uses your “good side.”

Treatment for this condition consists of advanced therapy that allows the brain to “re-wire” connections to help regain function and movement.

Spasticity

Spasticity is a frequent outcome of stroke.

Your limbs may change position; your neck, arms, or legs can get stiff, painful, or shorten, limiting mobility and interfering with activities of daily living.

With specialized and individualized treatment at the UPMC Rehabilitation Institute, quality of life can be improved.

In addition to traditional medicines, we offer treatments for spasticity, including:

Phenol: A type of alcohol proven to prevent the transmission of excess nerve impulses when used in small amounts. It can allow for excellent spasticity control, especially in the elbow and thigh muscles.
Lioresal (baclofen): This medicine can be very effective in severe cases of spasticity. It’s most effective when given through a surgically implanted pump, which allows for very low doses and minimal side effects.
Botulinum toxininjections:This can be very successful for treating spastic muscles, when used in small amounts.

Communication Problems After a Stroke

Communication problems after a stroke may involve:

Speech disorders
Language disorders
Cognitive-linguistic deficits
A combination of any or all of the above

The speech-language pathologist at the UPMC Rehabilitation Institute evaluates and provides treatment for these problems.

Speech Disorders

Dysarthia — A collective term used to describe speech changes caused by any of the following:

Muscle weakness
Incoordination
Increased muscle tone
Presence of involuntary movements
Muscle stiffness

Jaw
Lips
Tongue
Soft palate
Vocal cords

Language Disorder

Aphasia — A disorder of language processing that happens because of damage to the brain. Aphasia can be very frustrating for you and your caregivers. It’s like trying to learn and use a foreign language when living in a foreign country.

Aphasia affects your abilities to:

Understand spoken and written words and sentences
Recall words
Formulate sentences

Level of intelligence
Ability to think
Ability to hear

Cognitive-Linguistic Deficits

Deficits may include:

Attention
Memory
Social skills
Thinking
Visual processing abilities

Depression and Emotional Changes After a Stroke

Depression is a frequent problem after a stroke.

Physical and psychological symptoms can include:

Sudden mood changes
Feeling anxious, worried, pessimistic, or hopeless
Having thoughts of death
Loss of energy
Increase or decrease in appetite
Difficulty sleeping or sleeping too much
Difficulty concentrating, remembering, thinking, or making decisions
Headache
Digestive problems
Sexual problems

Talk your doctor if you have concerns about depression. Antidepressant medicine may be available, or it may be better to get a referral for a psychologist or psychiatrist.

Increasing the amount of socialization with other stroke patients may also help improve mood.

Looking for.

Inpatient Rehabilitation.
Outpatient Physical, Occupational, or Speech Therapy.
Rehabilitation Doctors.

Fatigue and tiredness

Fatigue affects the majority of people who have a stroke or transient ischaemic attack (TIA or mini-stroke). It can have a big effect on your life. This page looks at the causes and impact of fatigue and suggests practical ways you can help yourself and seek support.

The information on this page can be accessed in the following formats:

Download this information as a pdf or large print document.
Order a printed copy from our shop
To request a braille copy, email helpline@stroke.org.uk

What is post-stroke fatigue?

Fatigue is different from normal tiredness, as it doesn’t seem to get better with rest. It can happen after any type of stroke, big or small. It can also happen after a transient ischaemic attack (TIA, or mini-stroke).

The signs of fatigue vary between individuals, but you may feel like you lack energy or strength, and are constantly tired, physically and mentally. It can be mild or more severe.

It’s not always caused by being more active or working harder. You might need to rest or sleep more than normal. Fatigue could make it difficult for you to take part in everyday activities. It can also affect your recovery and rehabilitation.

If you think you have fatigue, it’s a good idea to speak to your GP or therapist. They may be able to help to find out if something like a medication or infection is causing the fatigue, or if it’s more likely to be due to the stroke. They may also be able to suggest ways to manage your fatigue.

You can find out how to understand the triggers for your fatigue, and how to manage it. Fatigue can get better over time, and you can help to improve your recovery by getting support and trying techniques for managing fatigue.

Who can get post-stroke fatigue?

Fatigue can happen after any type of stroke, and you can have severe fatigue after a relatively mild stroke or a TIA. Even if you have made a full physical recovery, or your stroke was some time ago, fatigue can still be a problem. It can start soon after a stroke, and often improves over time, but it can also appear some time later.

Many people describe fatigue as the most difficult and upsetting problem they have to cope with after a stroke. You may not feel able to engage fully in rehabilitation because you feel so tired. It can affect your ability to regain your independence in day-to-day life, and it can be difficult to return to work or to socialise and enjoy everyday activities. It can also affect your quality of life and relationships, as family and friends may not understand how genuinely exhausted you feel on a daily basis.

Why do I feel so tired?

Both physical and emotional factors can contribute to fatigue after stroke.

Physical effects of stroke

The physical impact of the stroke on your brain and body can trigger fatigue. In the early weeks and months after a stroke, your brain and body are healing.

The rehabilitation process can involve trying to do things in a completely new way, or learning and doing exercises which can be very tiring.

You may have lost some of your fitness and strength while in hospital, or as a result of the stroke. If you’re not able to move around much, this can also lead to feelings of fatigue.

If you have muscle weakness after your stroke, walking and other movements could take up much more energy than they did before your stroke.

Emotional changes

Although fatigue shares some of the signs of depression, such as feeling low, having anxiety, sleep problems and tiredness, it’s not the same thing.

But it isn’t always easy to tell the symptoms of fatigue apart from depression. People can have both at the same time, and fatigue may cause low mood and anxiety.

Talk to your GP and explain what you are going through. Discuss the treatment options available, and what would work best for you. You are the expert on your own situation, and you might feel sure that your symptoms are due to the stroke rather than emotional changes.

You can ask if there is a local fatigue management service. There may be help available with healthy eating, being more active and increasing your fitness and strength, such as physiotherapy or a cardiac rehabilitation programme.

If you feel that emotional changes play a part in your fatigue, you can ask about treatment for depression, including medication and counselling. Find out more in our ‘Emotional changes after stroke’ page.

Other factors

Sleep problems

Sleeping problems such as insomnia and sleep apnoea (interrupted breathing) can make you feel sleepy during the day. You might have trouble sleeping due to muscle stiffness or joint pain.

Diet

If you have trouble with swallowing or chewing, this could affect the amount of energy and nutrients you gain from your food.

Health problems

Some health conditions such as anaemia (low levels of iron in the blood), diabetes or an underactive thyroid gland can also make you feel tired.

Pain

If you have pain after stroke such as muscle pain or headaches, this can also affect your energy levels.

Medication side-effects

Some common medications have fatigue as a side effect, such as beta blockers for high blood pressure, epilepsy drugs and antidepressants.

If you think your medication is causing side effects, your GP or pharmacist can give you help and advice. You may be able to try different types of medication. Don’t stop taking your medication without speaking to your GP.

Managing your fatigue

Although there isn’t a clearly defined treatment for post-stroke fatigue, there are some practical steps that you can take to reduce and manage your fatigue.

It is important to get individual advice from a GP or other health professional, to ensure that you have identified any underlying health problems. They can also help you to get the right support with your fatigue.

Find out the cause of your fatigue

Try to find out if there are any treatable causes for your fatigue. Your GP or stroke nurse can check if you have any medical conditions that could be making you feel tired.

Ask the GP for a review of your current medication. If your fatigue is at least partly caused by side effects of your medication, it usually improves with time or once you start a new medication. Never stop taking your medication suddenly, and ask your GP for advice if you have any problems with side effects.

Help others understand your fatigue

Your tiredness may not be obvious to other people so they may not understand how you feel. This may be frustrating for you. Show your family and friends this guide to help them understand what you are going through. They can offer you support with your recovery and dealing with tasks.

Pace, plan and prioritise (the ‘three Ps’)

Try thinking about the ‘three Ps’ to help you form your own coping strategies. Fatigue can follow a pattern, and learning to understand this can help you make the most of your energy.

Pace: thinking about how you can take things step-by-step at a manageable speed, without triggering your fatigue.
Plan: working out what you want to do, and planning when and how you can do it.
Prioritise: deciding which activities are important to you, and which ones you can leave or get some help with.

Don’t make it hard for yourself by trying to do all the things you used to do. You might need to slow down to save your energy. It can be helpful to lower your expectations of what you can achieve for a while, so you can build up stamina and strength again slowly.

Don’t push yourself to do too much if you’re having a ‘better day’. Although it is tempting, it may leave you exhausted for the next day or two.

Take proper breaks before or after doing things. Even gentle activities like talking with friends, a car journey and eating a meal can be tiring.

For more about the three Ps, and practical tips on managing daily life with fatigue, visit the Royal College of Occupational Therapists website.

More tips for reducing and managing fatigue

Give yourself plenty of time to recover from your stroke. It can take many months before post-stroke fatigue starts to lift. Accepting that it takes time to improve can help you to cope better.
Find out how much you can do in a day and stick to it. For example, if you can achieve about four hours of activity a day (with rests in between) without being too tired then that is the right level for you. If you do too much, you will probably soon realise as you will need to rest more or have to spend a day in bed to recover.
Keep a written or visual diary of what you are doing, even if it’s just a few notes or a photograph each day. Over time this really helps to remind you of the progress you’ve made. It will help you understand how much activity you can cope with, and what triggers your fatigue.
Celebrate your successes. Many people feel frustrated by what they can’t do and forget to feel good about what they can do.
Rest and sleep: you might need to rest or nap during the day. But if you are having trouble sleeping at night, avoid sleeping during the day. Look for other ways to sleep better such as comfortable bedding and cotton sheets.
Start to wind down during the evening and get into a bedtime routine.
Build up stamina and strength slowly or you may well feel you are going backwards if your fatigue worsens. Increase your activity gradually. For ideas and advice see our ‘Getting active after a stroke’ resource page.
Try to do some exercise, as this may help to improve fatigue. Start gently, for example, a very short walk or a few minutes on an exercise bike, and slowly build up without overdoing it. Ask a physiotherapist for help with this.
Eat healthily. Carbohydrates such as bread and pasta are good sources of energy. Try to eat at least five portions of fruit and vegetables each day. If you have trouble swallowing or eating after a stroke, you will need support from a dietician to help you eat the right types of food. Ask your GP to refer you for help.
Seek support. Your GP or occupational therapist can put you in touch with different types of support, for example, stroke clubs, counselling, relaxation programmes, exercise groups or alternative therapies. Contact us for details of stroke clubs and other support in your area.

Self Care Measures after a Stroke

Medically reviewed by Drugs.com. Last updated on May 1, 2023.

What are self-care measures?

Self-care measures are ways to help yourself manage the physical, mental, and emotional effects of a stroke. The effects of a stroke depend on where the stroke happened in your brain and how much damage occurred. You will learn self-care measures during stroke rehabilitation (rehab) sessions. Rehab is a program run by specialists who will help you recover abilities you may have lost. Specialists include physical, occupational, and speech therapists. They will help you develop a plan to care for yourself at home and at work.

What can I do to manage physical effects?

You may have balance or walking problems. You may have numb areas or trouble moving your arm or leg. You may have weak muscles, spasms, or contractures (muscles stay in one position).

Take your medicines as directed. Medicines will help you manage pain and problems with movement.
Stretch and do range of motion exercises to prevent a contracture. Contractures limit movement of a joint, such as your wrist, elbow, shoulder, or ankle. Contractures can start to develop as soon as 1 week after your stroke. Your healthcare provider may show you or your caregiver how to stretch and do ROM exercises.

Prevent falls. Remove objects from walkways in and around your home. Install devices to prevent falls, such as handrails or a raised toilet seat. Use assistive devices when you walk, such as a cane or walker. Wear nonslip shoes or socks at all times.

What can I do to manage mental effects?

You may have trouble paying attention, thinking clearly, or remembering facts. You may lose track of the date or not know where you are. It may be hard to find a familiar object.

Calendars and planners can help you remember events and important dates. A calendar on an electronic device can be programed to alert you about an upcoming event. You may want to use a paper calendar so you can cross off days or circle important events.
A medicine organizer can help you remember to take your medicine each day. Organizers can also blink or sound an alarm when it is time to take the medicine. Someone may need to help you program the organizer to remind you at certain times of the day.
Lists can help you remember events or activities you need to do each day. Choose a kind of list that makes it easy for you to add new items and delete or cross off items that are done. It may help to put a list in a place you will see it often. An example is on the refrigerator. You may want to keep lists on a computer, tablet, smart phone, or other electronic device.
Timers can help you remember to do a task, such as brushing your teeth.
Labels can help you recognize items and remind you what they are for. Labels can include words or pictures.

What can I do to manage emotional effects?

You may have trouble controlling emotions after the stroke. This may be caused by damage to the brain. It may also be caused by the loss of body functions or independence. Depression is common after a stroke. You may also feel sad, irritable, or hopeless. You may have anger, frustration, or anxiety. Your moods may change quickly. You may laugh or cry, even if it is not the right emotion.

Therapy or counseling may help you manage depression or anxiety after a stroke. Therapy or counseling may also help you control emotional outbursts or inappropriate emotions. Ask your healthcare provider how you can receive therapy or counseling.
Medicine may be needed to treat depression, anxiety, or problems controlling your emotions.
Support groups will allow you to talk about your feelings and concerns with others who have had a stroke. It may be helpful to hear from others who have gone through stroke rehab. You may learn ways to cope with your feelings and emotions.

Talk to your healthcare provider if you have depression that continues or is getting worse. Your provider may be able to help treat your depression. It may also help to talk to friends and family members about how you are feeling. Tell your family and friends to let your healthcare provider know if they see any signs of depression:

Extreme sadness
Avoiding social interaction with family or friends
A lack of interest in things you once enjoyed
Irritability
Trouble sleeping
Low energy levels
A change in eating habits or sudden weight gain or loss

What can I do to manage bladder or bowel problems?

A stroke can make it hard to control when you urinate or have a bowel movement. You may feel like you have to urinate even when your bladder is empty. You may have constipation or trouble emptying your bladder.

Bladder and bowel movement training helps you control when you urinate and plan for bowel movements. This training can help your skin stay clean and dry, and help prevent skin breakdown. Your program may include using the bathroom at certain times each day, even if you do not feel the need.
Medicines can help prevent urine leakage. Medicines such as stool softeners can help prevent or treat constipation. Some medicines are available without a prescription.

What can I do to manage energy and sleep problems?

You may feel tired during the day. You may not have the energy to do activities or spend time with others. It may be hard to fall asleep at night or to stay asleep.

Talk to your healthcare provider about your medicines. Some medicines can make you feel tired or groggy. Your provider may make changes to your medicine or when you take it.

Work with healthcare providers to create an exercise plan. Exercise can help increase your energy level during the day. Exercise can also help you sleep better at night. A short nap during the day can also help you manage fatigue.

Schedule rest periods. You may need to rest after exercise or other activities. A short nap can help increase your energy. A nap can be for 15 to 30 minutes during the day. Do not nap for longer than 1 hour. Long naps can make it harder to fall asleep at night.
Create a sleep schedule. Go to bed and wake up at the same times each day. This will help you develop healthy sleep patterns. Do activities that help you relax before bed. Read a book, take a warm bath, or listen to music.
Limit liquids for 2 hours before bed. This helps prevent nighttime waking to empty your bladder. You may need to stop having caffeine in the afternoon if it affects your sleep.
Talk to your healthcare provider about sleep apnea. This is a condition that causes you to stop breathing for 10 seconds or more while you are sleeping. A stroke increase your risk for sleep apnea. Treatment can also lower your risk for another stroke.

Call your local emergency number (911 in the US) or have someone call if:

You have any of the following signs of a heart attack:
- Squeezing, pressure, or pain in your chest
- You may also have any of the following:
  - Discomfort or pain in your back, neck, jaw, stomach, or arm
  - Shortness of breath
  - Nausea or vomiting
  - Lightheadedness or a sudden cold sweat

You have any of the following signs of a stroke:

Numbness or drooping on one side of your face
Weakness in an arm or leg
Confusion or difficulty speaking
Dizziness, a severe headache, or vision loss

You have trouble breathing.
You have a seizure.

When should I seek immediate care?

You fall and hit your head or get injured.
You have new symptoms, or your symptoms are getting worse.
You have pain that does not go away, even after you take pain medicine.

When should I call my doctor?

You feel depressed or anxious.
You have a sore on your skin that does not go away.
You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Self Care Measures after a Stroke

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Hemorrhagic Stroke

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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