What Is Mirror Therapy for Phantom Limb Pain?

#mirrorboxtherapy #kneepain #functionalmedicine

What Are The Benefits For The Mirror Box For Phantom Pain?



Rose B talks about her care a Total Health and Wellness Center in Carol Stream, IL. She had lost her right foot below the ankle (Syme Amputation) at the age of 5. Syme amputation (SA) is a term used to describe an amputation at the level of the ankle joint in which the heel pad is preserved. It is performed for a number of indications in a pediatric population. SA is purported to hold the advantage of allowing weight bearing without a prosthesis.

The brain is the control center of the body, and has to process information coming from all five of the senses. One of the senses, vision, is often stronger than the others. Mirror therapy is a type of therapy that uses vision to treat the pain that people with amputated limbs sometimes feel in their missing limbs. Mirror therapy does this by tricking the brain: it gives the illusion that the missing limb is moving, as the person looks at the real, remaining limb in a mirror. This way, the brain ignores the fact that it receives no signal of movement from the amputated limb itself. Although very promising, mirror therapy has some limitations, and scientists are working to overcome these limitations so that mirror therapy can be used to address more complex movements or different kinds of pain.

Amputees sometimes experienced unpleasant sensations of tickling, spasms, or even pain in that amputated limb, even though the limb was not physically there anymore. The scientists proposed that this “phantom limb syndrome in which patients experience the sensation that their amputated limb is still present. These patients can also feel pain or cramping in the missing limb.” phenomenon was due to a miscommunication problem in the brain. Neurons (nerve cells) that had previously commanded muscles in the phantom (amputated) limb still exist in the brain, and can still send out signals, such as a request to move the limb. When these signals are sent, the brain expects signals in return, like the feelings of movement or touch, to indicate that the command was carried out. However, because the limb does not exist anymore, the brain signals never reach their destination (the muscles), and the limb cannot send sensory information back to the brain. This miscommunication creates a conflict that the scientists call negative feedback. To bypass this negative feedback, the scientists devised a plan to trick the brain of people with an amputated hand/arm into perceiving sensations, simply by looking at the other (real) hand/arm. In the original experiment, people placed both their amputated (phantom) and intact limbs in a box with a mirror on one side. The amputees were instructed to move their existing fingers while looking in the mirror on the side of the phantom limb. With just 15 min of practice per day for 3 weeks, people were able to “feel” movement in the phantom limb, and more than half of the amputees were relieved of their phantom pain. In this study, the mirror therapy created an illusion of movement that broke the negative feedback loop.

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Dr. Jinaan Jawad
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DR. JINAAN JAWAD
D.C., DACNB, FACFN, FIAMA, CFMP

Dr. Jawad is a Board Certified Chiropractic Neurologist and Acupuncturist. In addition, a Diplomat for the American Chiropractic Neurology Board, Fellow of the American College of Functional Neurology as well as Fellow of the International Academy of Medical Acupuncture. He is a Certified Functional Medicine Practitioner.

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