|Mailbag: Mirror Therapy
As a mother of a 12-year-old afflicted with CRPS, I’ve found mirror therapy to be our saving grace. The pain docs and PTs I know and have worked with haven’t been aware of this therapy. The PTs have been excited to hear about it.
We all know that CRPS is a problem with the central nervous system—after a surgery or injury, the brain began sending pain signals to an immobile limb, trying to get it to answer back. This is in the same category as phantom limb pain and post-stroke pain. The central nervous system needs a chance to be rewired. Anesthesiologists (pain doctors) are very frustrated by it. There was a big "what do we do with CRPS?" conference in LA a year ago.
My daughter’s CRPS started after an ankle sprain in a soccer game last fall. Nothing would touch it, until I learned that mirror therapy can be effective for phantom limb pain. We tried it. It successfully "tricked" her brain into "seeing" her completely disabled foot as a working foot. After one session (and an evening of watching funny movies), she went from terrible pain and no blood circulation to "that’s ticklish" when it was time for PT. We’ve used mirror therapy twice since then when she’s had recurrences with the smallest of injuries (it hit hard and fast last week, but the mirror shut it down again).
Don’t be fooled by her quick recovery—her brain is young and plastic, and she’d only had the syndrome for 4 to 6 weeks. Studies describe using this therapy for weeks before getting results. But hey—it’s free, easy to do, and low-risk!
For more information, search on "mirror therapy" on the net. For studies and case descriptions, search on PubMed (www.pubmed.gov).
Here’s a quick "how-to" mirror therapy example:
For a foot, sit with a mirror between the "good" and "bad" feet. The mirror needs to be big enough that you can look down and see a full reflection of the "good" foot and lower leg. The "bad" foot is fully hidden behind the mirror. We picked one up at a thrift store that was tall enough that it could lean against her knee on her "bad" side.
Move the "good" foot. Keep it moving. Watch it intently as it moves. Do this for several minutes at a time. Meanwhile, the "bad" foot moves with it. (In pain-free people, keeping the hidden limb still while moving the reflected limb has been shown to confuse the brain and cause tingling and pain. So make every effort to move it.) In my daughter’s case, she couldn’t move the "bad" foot, so we had her picture it moving in her mind.
We also make a point of never using "bad" or "good" foot with her, since that kind of "factoring out" of the injured foot is what contributed to the CNS dysfunction in the first place. Instead, we’ve had her name each foot as though they are puppies she dearly loves!
Kathe Gallagher, MSW
RSDSA Review. Spring 2008.