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Can Phantom Limb Pain Be Prevented?

August 16th, 2010 · No Comments

Up to 72% of people undergoing an amputation develop phantom limb pain (PLP). This type of pain is quite difficult to treat with medications or injections. However we do know that mirror therapy achieves excellent results in reducing or eliminating this pain.

But how about preventing phantom pain?

Dr. Steven Hanling and others at the Naval Medical Center in San Diego had patients use mirror therapy prior to amputation in a small group of 4 men. The patients were young, active duty men, 3 having trauma due to explosions (IED’s) and 1 suffering a fall. They had experienced pain for 4-17 months prior to amputation. The patients used mirror therapy for 2 weeks prior to amputation. In mirror therapy, the painful body part, let’s say a hand, is put behind a mirror. The mirror is arranged so that it looks to the patient like he has 2 normal hands. While watching the reflected “good” hand in the mirror, the patient would do movements of either only the good hand or both hands.

It’s thought that by watching normal movement, the brain learns everything’s ok. In other words, the visual system is used to re-train the brain that movement is fine to do. Then, pain signals decrease.

In the study described above, 1 patient experienced no limb pain or phantom limb pain, 2 patients has mild limb pain and mild PLP, and the 4th patient had moderate limb pain with brief, moderate episodes of PLP. These are significant results and should encourage more studies of mirror therapy prior to amputation.

The study is: “Preamputation Mirror Therapy May Prevent Development of Phantom Limb Pain: A Case Series,” in Anesthesia and Analgesia, Vol 110, February 2010.

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