Mirror, mirror on the wall
Can you help my pain, after all?
Well, thatâ€™s a version of the rhyme that never made it into Snow White!Â But if you’re looking for painÂ relief (instead ofÂ finding out who’sÂ the fairest of them all :), mirror boxes might offer an answer.
Mirror image therapy is an exciting treatment for many pain syndromes.Â Today weâ€™ll look at Complex Regional Pain SyndromeÂ (CRPS), also called RSD.
CRPS is a neurological pain disorder with symptoms which include:
- pain out of proportion to any injury
- movement problems, e.g. muscle spasm, clumsiness
- temperature control problems, e.g. the affected area becomes cold or hot out of the blue, excessive sweating, pain increases with exposure to cold
Thereâ€™s a lot thatâ€™s unknown about CRPS, but we do know that the changes that occur in CRPS affect not onlyÂ the area where thereâ€™s pain, commonly a hand, foot, arm or leg.Â The changes also involve the spinal cord and brain.
The â€œbody mapâ€ hypothesis we looked at last week may also apply to CRPS.Â This hypothesis says that thereâ€™s an internal representation of your body in your brain.Â This pictureÂ helps youÂ know where your body isÂ in space, even with your eyes shut.Â It also helps you perform movements, without having to think about each little part of a complex movement.
In CRPS,Â the brainâ€™s map of the area where there’s pain may become distorted.Â Â It’s not clear if this distortion is a cause or a result of pain, but correcting this distortion can help.
In CRPS, movement often hurts and can make pain worse.Â But lack of movement means fewer normal sensations coming into the brain.Â This allows pain signals to get too much play in your brain, creating aÂ sort of spiraling feedback loop…
pain, which causesâ€¦Â Â you to move less, which causesâ€¦Â Â fewer normal movement sensations going to your brain, which causesâ€¦Â Â pain signals have less to compete with to get your brainâ€™s attention, which causesâ€¦Â Â PAIN,Â and weâ€™re back to the beginning
So where do mirror boxes come in?Â Letâ€™s say your right hand is affected by CRPS.Â You can put your right hand in the box so itâ€™s not visible.Â You then move your left hand, and your brain â€œseesâ€ the reflection as if your right hand is moving.Â And because your left unaffected hand is moving, the movements are easy and fluid.Â So it looks to your brain like youâ€™re right hand’s moving comfortably and easily.
It may be that â€œtrickingâ€ your brain into seeing that everythingâ€™s ok, lets pain begin to slowly decrease.
Now for the “be careful” section…
- It gets trickier to use a mirror if…
– both your right and left side are affected, i.e. thereâ€™s no pain-free part
-Â an area likeÂ your chest, back, or stomach is affected,Â where thereâ€™s not an obvious mirror image part
- Itâ€™s controversial if you can just start out using a mirror, or you need to build up to this kind of work, by graded motor therapy.
- Itâ€™s also controversial if you need toÂ move the hand or foot thatâ€™s in the mirror box, i.e. the affected limb thatâ€™s hidden from view.
Soâ€¦ if youâ€™re interested in mirror therapy, take a look at the websites below.Â Read some more on the treatment to educate yourself.Â And, most importantly, get some guidance from a medical practitioner â€“ MD, physical therapist, etc.Â – who’s informed about this treatment.Â Itâ€™s a very exciting option â€“ and one I want to make sure you use safely.
You can learn more as well as purchase a mirror with instructions for use:
And after we get this pain taken care of, we’ll move on to warts on the nose :)…
In my next post, weâ€™ll look a graded motor imagery computer program, Recognise.