Complex regional pain syndrome, a condition that generally affects individuals after an injury or traumatic incident, often causes prolonged pain in the arms or legs. While there are generally accepted treatment options like medication or nerve blocks, mirror visual feedback therapy may provide a noninvasive, highly approachable alternative to treating complex regional pain syndrome (CRPS).

Mirror visual feedback relies on a mirror box (diagram above), that is a a box with two mirrors in the center that was created by Vilayanur S. Ramachandran to help alleviate the symptoms of phantom limb pain after an amputation. Patients position their remaining limb through a hole in the box and lay it parallel to the mirror.

The reflected image mimics the missing limb and, by instructing the patient to release tension or move the limb even though the phantom limb felt paralyzed, Ramachandran was able to “coach” patients’ brains to release the painful feelings associated with the phantom limb.

Since CRPS has similarities to the sensations felt with phantom limbs, researchers undertook this method to see if they could use it to treat pain in an affected limb. 

In a study in the Oxford Journal of Rheumatology, researchers undertook mirror visual feedback to test their hypothesis that an incongruence with motor output and sensory input led to pain associated with complex regional pain syndrome. During their study, patients watched the unaffected limb move with a mirror showing how the affected limb should be moving and relaxing.

The researchers found that in early and intermediate stages of the disease, the use of mirror visual feedback had an immediate effect and helped reduce stiffness. After six weeks of treatment, mirror visual feedback therapy led to normal function and thermal differences in the limb due to CRPS. Treatment was not found to be effective for those individuals with long-term or chronic CRPS.

Researchers are still trying to understand the direct causes of complex regional pain syndrome, but new treatment methods can provide a clue as to what causes the pain in the first place and how to better treat the pain in affected individuals.

Mirror visual feedback may provide another noninvasive treatment option for CRPS with research showing strong indications of efficacy.  

Image via Wikimedia Commons


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