Sunday, December 16, 2007

Mirror Box Therapy - Part VII


This section tries to cover any question you might have and should serve as an additional resource so that the experiences people have with this kind of therapy can be recorded and shared.

1) Are there any known side effects?

None have been reported yet.
Things that can happen - depending on the condition are:
Lorimer Moseley reported a patient that was so distressed seeing the amputated limb move again that he had to withdraw from treatment.
Another interesting phenomenon is Dysynchiria - if you touch the unaffected limb and watch the reflection pain is felt in the affected limb.

2) How long should the sessions last?

Since you have to focus your attention on the treatment 10 minutes at a time are sufficient. Try to repeat it several times a day for a few weeks.
There are huge differences between individuals regarding how fast they respond.

3) Are there commercial suppliers of mirror boxes?

Yes - you can order them here and here for example.
Or you can make your own by following these instructions.

4) What do I do during the session?

If you have pain in your arms, hands or fingers try moving them in any way possible. Pick things up, count coins, do whatever you can. Vary the movements from simple to complex. And above all: watch what works best for you.
Jeiseas Blog is a great resource - see how she uses it. What works for her might also be good for you.

5) Which therapist should I see for mirror box treatment?

This is a tough one.
The treatment was developed by a Neurologist and is used (and expanded) by Physiotherapists, MD's, Psychologists and other professions.
In effect the treatment belongs to you - the person in pain.
Any attempt to bring it under the domain of only one profession is - in my view - completely nuts!
By explaining it in this series I hope you are able to give it a try yourself.

6) Which conditions can be treated?

First the obvious ones: phantom limb pain, CRPS, RSI.
Then the not so obvious one: central pain in paraplegia.
And last but not least those problems that can be treated by applying the principles of feedback therapy: low back pain, tinnitus, anorexia (?!), fibromyalgia.


aurelia said...
This comment has been removed by a blog administrator.
The Physiotherapist said...


Just wondering how mirror therapy can be used in management of low back pain? means how would the mirror be placed?

Matthias Weinberger said...

You would not use a mirror. :-)
We did a study in our clinic where we used a webcam and a laptop so that the patient can see his low back on the screen.

Piloot said...

A friend of mine has one amputated leg and was suffering phantom pain, restricting his life style a lot. After showing him the TED talk he starting using a mirror and had instant great results. He used it for a year or so, but after that the effect was wearing out. And the phantom pain is coming back gradually, the mirror doesn't seem to trick his brain anymore. Do you know of this effect, or better do you know a way to counter it? Thx,


Matthias Weinberger said...

Hi Emile,

sounds like a strange case.
As mirror therapy is still a very new form of treatment there aren't any long term studies available.
I haven't heard of cases where it worked for some time and then stopped doing so.

If the phantom pain is triggered by something going on inside the stump then that may explain it not being effective this time.
It would be interesting to see if sensory discrimination training on the stump would provide relief.