MIRROR VISUAL FEEDBACK THERAPY

Mirror visual feedback therapy was first described by V.S. Ramachandran for the relief of phantom limb pain. The principle of the mirror box therapy has been used to treat complex regional pain syndrome (CRPS), stroke, and other nerve related disorders of the limbs.

Dr. Ramachandran proposed the "learned paralysis" hypothesis of painful phantom limbs. The hypothesis was that every time the patient attempted to move the painful limb, they received sensory feedback that the limb did not move. To retrain the brain and eliminate the learned paralysis, Dr. Ramachandran created the mirror box.

Complex regional pain syndrome type 1 is characterized by pain, sensory disturbances, motor impairment, and sympathetic dysfunction. Visual feedback using a mirror box may be achieved. One of the theories of CRPS is a consequence of disruption of central sensory processing in that congruent visual feedback from the moving unaffected limb, as provided by a mirror, would restore integrity of cortical processing, thereby relieving pain and restoring function in the affected limb. The mirror reflection permits the patient to rehearse and practice movements of the affected limb without having to directly activate those parts of maladaptive central processes that typically produce pain.

Mirror box therapy, also known as mirror visual feedback therapy, has been used effectively for treating CRPS, stroke, and phantom limb pain. It may also be effective for peripheral limb pain or motor dysfunction.

Here at the Interventional Pain Management Center, Dr. Chopra has been using the Mirror Visual Feedback technique to help patients with CRPS (RSD), phantom limb pain and stroke.