FND Education Project

REFERENCE · RECOVERY TECHNIQUE

Skin, Pressure and Injury Protection

Page role: Additional injury-protection guidance. Develops skin, burn and pressure precautions from the original page; protective care is not a new sensory-restoration technique. See the collection index for the original technique groupings.

Most likely fit: Reduced sensation makes heat, cuts, pressure or footwear injury difficult to notice, including during temporary episodes. [Clinical safety adaptation; protection is supportive care rather than a proven sensory-restoration treatment]

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
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For the Person With FND

What this approach is for

Protection allows daily life to continue while sensation is unreliable. An area can be injured without giving the warning you expect. You can use safe routines and assistance even when rehabilitation is also under way.

A planned skin check is different from repeatedly testing whether sensation is normal. Look for injury; there is no need to poke, pinch or heat the area.

Terms in everyday language

Protective sensation helps warn of injury. Pressure injury can occur when sustained loading damages tissue, especially over bony areas. Shear occurs when skin and underlying tissues slide differently. Moving or transferring a numb limb also requires attention to joint position.

A practical example and flare adaptations

Keep hot-water bottles, heating pads and sharp sensory tests away from numb areas. Arrange a safe way to check washing-water temperature that does not rely on the affected skin. Use tools and kitchen arrangements that reduce contact with heat or blades.

Ask a clinician about skin inspection, footwear fit and pressure relief for your actual mobility. If you cannot inspect an area, an agreed mirror or supporter check may help. During a familiar flare, put down hot or sharp items, support the limb and accept assistance.

These are choices to discuss with your care team, not a required exercise schedule. Helpful activity, comfort and access matter even when sensation remains altered. The evidence and its limits are explained below. (Sources: 1, 2)

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
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For Family, Friends, and Other Supporters

Ask before inspecting skin or repositioning a limb. Explain what you see and protect privacy. Do not drag the person across bedding or pull on a numb arm to move them.

Help follow the assessed transfer and pressure-care plan. A person may still need protection when they appear to move normally or report a brief return of sensation.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For Clinicians and the Care Team

Selection and assessment

Assess protective sensation, skin, perfusion, diabetes or neuropathy where relevant, mobility, positioning, cognition, equipment and assistance. Evaluate actual pressure exposure rather than applying a universal turning interval or assuming functional symptoms carry little injury risk.

Explicit procedure

  1. Identify hazards in self-care, seating, bed, kitchen and transfers.
  2. Document sites requiring inspection and who can inspect them with consent.
  3. Arrange pressure redistribution and repositioning according to individual risk and local guidance.
  4. Review footwear, splints and supports for contact pressure and fit.
  5. Teach a safe routine for temperature and tool handling that avoids testing hazards on affected skin.
  6. Set escalation instructions for wounds, persistent redness, swelling or signs of infection and reassess equipment after functional changes.

Review, progression and stopping

Track skin integrity, comfort, safe participation and the feasibility of care routines. New wounds or circulation changes require review. Protective measures can continue indefinitely when needed; withdrawing them is not a way to demonstrate confidence in recovery.

The procedures are educational implementation examples requiring clinical adaptation, not validated standalone protocols. (Sources: 1, 2)

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

Research and Sources

These are individualized safety and access measures developed from rehabilitation care principles. They are not offered as a studied FND sensory-treatment protocol. More detailed wound, pressure and equipment care must follow the person’s assessed risks and relevant clinical guidance.

Citation Full citation
[1] Nicholson C, Edwards MJ, Carson AJ, et al. Occupational therapy consensus recommendations for functional neurological disorder. JNNP. 2020;91:1037–1045. FND-CIT-0011. Source
[2] Nielsen G, Stone J, Matthews A, et al. Physiotherapy for functional motor disorders: a consensus recommendation. JNNP. 2015;86:1113–1119. FND-CIT-0028. Source

Source check: September 15, 2026 · Occupational-therapy, physiotherapy, neurology, pain, equipment, lived-experience, supporter and accessibility review pending.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —