Cold sensation in the back still lingers 3 years after a stroke

Three years ago (at age 79), I had a mild stroke. I was in and out of the hospital during the same day, but I soon reverted to normal. However, two mysterious side effects did remain:

First, although my right shoulder still works well (I can do weight lifting and pushups), it feels as if I am continuously being tightly grasped by someone. Second, after the stroke, my brain started telling me that my back was seriously cold from top to bottom, even though it felt like a normal body temperature to my touch.

The only relief from this maddening coldness is when I lean my back against a chair or sleep on my back. I can live with the damaged shoulder, but three years of sharing space and time with a back that feels neurologically cold is beginning to get me down.

— H.D.

A stroke is caused by the death of cells in the brain or spinal cord. This commonly causes weakness if the stroke is in a part of the brain that controls movement; speech problems when it is in one of the main speech centers; loss of balance; deafness or blindness; and changes in the ability to think clearly.

One less-common stroke syndrome is when the stroke affects the sensoryprocessing areas of the brain. This commonly results in numbness or pain, but other symptoms — such as the cold sensation you're feeling, but also dryness, tingling, itching and burning sensations — are possible. They can even be incredibly debilitating. I am pretty sure that your back coldness is a sensory stroke manifestation, and I'm pretty sure the symptom in your shoulder is, too.

The central nervous system has some capacity to adapt to changes, and we often see improvement in patients who have weakness after a stroke. My limited experience, along with the medical literature, tells me that sensory changes after a stroke do not tend to get much better, especially a year following the stroke.

A visit with the neurologist is called for. I have read suggestions that some chronic-pain medications can sometimes help with cold and pressure sensations, but you need the opinion of an expert who has seen more than I have.

Recently, you wrote a column about dry nose conditions. I have found a simple fix with COVID masks. I wear one at night and sometimes in the day. As a result, the moisture that normally escapes when breathing stays trapped in the nasal area, so moisture is retained.

I could not take baby aspirin due to nosebleeds in the past. I can now take them, as moisture retention has prevented nosebleeds.

— M.B.

I appreciate you writing in. I often recommend nasal sprays and gels, but you are absolutely right that a mask will keep the air you breathe in warm and humid. I've never had a patient do anything but note the downsides of wearing a mask (such as skin rashes and fungal and bacterial infections in people who need to wear masks professionally), but masks do have an upside in this particular case.