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Mirror therapy is a pioneering, non-invasive treatment for the management of chronic pain. As the term implies, the primary tool of this therapy is a mirror from which the patient receives visual feedback in order to train the brain to configure a new “body map.” This so-called map is simply the hard-wired mental representation that allows a person to be aware of where each component of the body is at all times, even in complete darkness. This built-in diagram also permits one to move in complex ways without having to consciously focus on each step to perform.
The ultimate goal of mirror therapy is to correct misrepresentations in the body map that develop when an injury or loss of limb occurs. In fact, this is what is thought to cause phantom pain associated with losing an arm, leg, or other body part, particularly if the part was affected by pain before its removal. The theory is that the brain records or remembers the pain in that specific area and continues to send out nerve signals, fully expecting to receive some back in return. In other words, in the absence of experiencing true physical sensations in the area, the brain resorts to “filling in the blanks” based on the misperception that the missing body part is still intact.
Mirror therapy has also shown to be effective in relieving discomfort associated with non-specific pain disorders, such as Complex Regional Pain Syndrome (CRPS), or Reflex Sympathetic Dystrophy (RSD). Again, in these cases, it’s possible that the brain’s body map has become distorted. However, instead of compensating for a missing body part, the brain overreacts to stimuli, such as external temperature, pressure, muscle spasms, or simple movement.
While practicing mirror therapy, the patient places the affected limb in what’s known as a mirror box, which keeps the injured part out of view. The corresponding and unaffected limb is then positioned in front of the mirror. An alternative setup is to have the patient sit at a right angle before a mirror so that only one side of the body is reflected back. In either case, the idea is to then move both limbs in a coordinated manner so that they mimic the movement of the other. Studies have shown that the majority of patients typically experience sensations in the hidden limb very quickly after starting this exercise.
Obviously, adaptations must be made during mirror therapy to account for missing limbs and body parts not paired, such as the torso. However, this therapy appears to offer equally effective results for such patients. In addition, mirror therapy may hold promise as an effective treatment for other conditions. For instance, it is being explored as a potential treatment to facilitate the recovery from stroke, surgery, and repetitive strain injuries.
There are some published studies that support the use of mirror therapy (4 RCTs and a number of case studies), so I do not think the comment is accurate that there is "virtually no clinical evidence".
Mirror therapy is a component of graded motor imagery.
Like most therapies, neither mirror therapy or graded motor imagery work for everybody, but considering the lack of harmful side-effects, I think they are well worth trialling.
There is virtually no clinical evidence to support the claim that mirror therapy is effective as a stand alone therapy. In Feb. 2012 Lorimer Mosely and Herta Flor (two of the world most respected pain researchers) co-authored an article In Neurorehabilitation and Neural Repair in which they concluded that clinical trials of mirror therapy have produced conflicting results.
There are approaches to treating phantom limb pain such as graded motor imagery and sensory discrimination training that appear to be much more effective than mirror therapy.
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