Loss of Sensation: Safety Tips
Loss of sensation means that you are unable to feel pain, heat, or cold. This can happen in one or more parts of your body.
Loss of sensation can be caused by a complication of diabetes called peripheral neuropathy. This is a type of nerve damage. Other conditions that may cause you to lose feeling are stroke, spinal cord injury, tumors, and infections.
When you have loss of sensation, you are more likely to hurt yourself and not know it. But you can take steps to protect your health and reduce your risk of injury.
Sensation loss makes injury more likely
Pain is a warning signal. It tells you that injury is occurring. A person feeling pain often reacts automatically by pulling away from the source of injury. For example, someone who puts a hand on a hot stove will pull the hand away immediately when they feel the pain. This reaction helps prevent severe injury. Loss of sensation, however, takes this warning signal away. If you have lost sensation, you may leave your hand on the hot stove. The resulting burn will be very severe.
Loss of sensation can also mean losing awareness of where your body is in space. For example, your arm may hang beside your wheelchair instead of resting in your lap. Unless you look right at your arm, you may not realize this. If you move the wheelchair and your arm gets caught in the wheel, you can get a cut or muscle tear.
Awareness helps prevent injury
Being aware of your body and the possible dangers around you can help keep you safe. In general:
When you are in a new place, look around for likely sources of injury. Always look for heat or cold sources, and sharp objects. Be careful not to touch them by mistake.
Check the position of your arms and legs often. Look to be sure they are not in danger of being hurt.
If you are in a wheelchair, check the position of your hands and feet before you move. This prevents them from getting caught or pinched.
Burns—from heat or cold—are a common source of injury. If you can't feel heat or cold, you are at greater risk for burns. To help stay safe, keep these tips in mind as you go about your day:
Use a thermometer to check the water temperature before you get into a tub or shower.
Cover your hands with thick oven mitts when cooking or using the stove.
Never place a hot plate directly on your lap or hold a hot or iced drink with bare hands.
Wear protective gloves and use care when handling products containing chemicals that can harm your skin, such as laundry bleach.
Apply sunscreen to avoid sunburn when outdoors. If you’re outside in hot weather, stay in shady areas when possible.
In cold weather, protect your hands with insulated gloves or mittens. Protect your feet with wool socks and boots.
Protect your feet
If you have lost sensation in your feet, you must take special care of them. Minor injuries can quickly get worse if not treated. To protect your feet:
Check your feet daily for wounds and other injuries. Check (or have your caregiver check) the top and bottom of your feet, your heels, and between your toes. It may help to use a mirror. Look for hot spots, blisters or sores, skin color changes, or cracks.
Wear socks and well-fitting, protective shoes. Don’t wear open-toed shoes or high heels. Never go barefoot.
Before putting on your shoes, check inside for any loose objects such as pebbles.
Ask if you need to see your healthcare provider for toenail, corn, or callus trimming.
Wash your feet with warm, not hot, water and soap. Don’t soak or scrub your feet.
Dry your feet well, especially between your toes.
Use lotion to moisten dry, cracked feet. But don’t use lotion between your toes.
Loss of sensation makes falls much more likely. Here are a few ways to help prevent falls:
Make sure rooms have proper lighting. That way, you can see where you’re going and avoid obstacles. Add night-lights to halls, bedrooms, and bathrooms. Put light switches at the top and bottom of stairs.
Keep floors and hallways clear of small objects that may make you trip. Remove any throw rugs. Tape down electrical cords so they are secure.
Use mobility aids such as a wheelchair, walker, or cane, as instructed.
Prevent pressure sores
Pressure sores (pressure ulcers) are open sores. They can form when there is too much pressure on your skin. Pressure sores are common in people who spend most of their day in a bed or a wheelchair. To prevent pressure sores, do the following:
Change positions often. Your healthcare provider can teach you the best ways to do this safely. If you’re seated or in a wheelchair, you may need to change positions and shift your weight every 20 to 30 minutes to relieve pressure. If you’re lying down, you may need to do this every 1 to 2 hours.
Use pressure-relieving aids. These can be prescribed or recommended by your healthcare provider. Special mattress pads and wheelchair cushions are available. Cushions can help protect your tailbone, back, and heels. These 3 areas are at high risk for pressure sores.
Check your skin daily. Look for redness, bruises, cuts, and other irritations, especially over bony areas. You or your caregiver should do skin checks as part of your daily routine.
When to call your healthcare provider
Contact your healthcare provider right away if you have any of the following:
A fall, even if you feel OK
A bruise, cut, burn, or sore in an area without sensation
A fever over 100.4°F (38.0°C)
Signs of a pressure sore (redness that doesn’t go away or skin breakdown)
January 01, 2018
Bluestein, Daniel. Pressure Ulcers: Prevention, Evaluation, and Management. American Family Physician, 10th ed. 2008 (78), pp. 1186-1194., https://www.uptodate.com/contents/approach-to-the-patient-with-sensory-loss?source=search_result&search=neuropathy&selectedTitle=5~150. UpToDate.
Fetterman, Anne, RN, BSN,Image reviewed by StayWell art team.,Jasmin, Luc, MD