Monday, June 25, 2007

What's in a name? Mirror therapy again.

If you google "mirror therapy" you come up with a range of therapies all calling themselves "mirror therapy". Some mirror therapy has been developed to combat body image problems and involves face on examination of yourself in a mirror and "telling yourself" that this or that body part is OK. This, I believe, is a form of training and psychologically based.

It is not the same as the mirror therapy which was invented by Vilayanur S Ramachandran (see link to left of page) to help alleviate "phantom limb" pain. Further studies in the UK and in Australia have proven this type of mirror therapy to help allieviate the pain and symptoms of complex regional pain syndrome. Just as the brain keeps responding with pain messages in the case of phantom limb so too does the brain send pain and pain response messages in the case of CRPS. These messages are not in response to something being wrong (eg dropping a hammer on your foot). The messages are brain driven or created in the brain in the same way as the brain creates the message to tell your heart to beat. You cannot consciously tell your heart to stop beating any more than you can tell yourself to stop the pain. It isn't just pain messages that the brain sends out in CRPS, it's protective messages because of pain eg inflamatiom, swelling, sweating, vascular messages, colour and temperature changes. These things are under the control of the autonomic nervous system - out of our conscious control.

It hurts and our learned behaviour is to protect the hurting part by stopping things touching it and moving less or resting. This is the best thing to do if the pain was from an injury but it's not. I know that I need to override the normal pain response and move normally and not protect the hurt part. It isn't easy. That's where the mirrors come in. The brain message is wrong. I cannot take pain medicine but even if I could I'd only be treating the symptoms of pain not the cause. The cause is these false messages. By looking at the moving mirror image of the body part opposite to the one that hurts, the brain gets visual stimulus of a moving pain free limb. I do this for a very short time, usually less than a minute.
I do it again and again.
A therapist explained what I do this way.


Do less - but do it regularly.
The brain needs to be reminded over and over again - but by doing short "training sessions" habituation doesn't set in and the movement is always new and interesting.

For me there is usually no instant difference. About 10 minutes after I've finished I notice that I don't feel quite as bad. It takes effort and I need to keep doing it for several days or weeks. I treat each flare up immediately before it spreads (as it very quickly does for me). Doing this gives the best result.

Mirror therapy isn't the whole answer.

I do physical therapy every day in small amounts throughout the day. I try not to over do it (very hard).

I breath out twice as long as in for a five minutes five times a day every day to activate the parasympathetic nervous system. I used to do this breathing once a day for 15 minutes. There is UK research that supports doing this to control blood pressure.

I eat foods high in antioxidants (prunes are highest) to deal with the free radicals caused by stress of coping with CRPS. I have changed my diet so that I have more Vitamin C. Remember Vitiman C demolishes the free radicals involved in inflammation. My "eat smart" plan includes eating a range of high antioxidant foods. Antioxidants become free radicals when they neutralize another free radical. By having a range of antioxidants a balance can be maintained.

I refer to my list of things that work for me when I have flare ups.



My plan is to persist until the symptoms of CRPS resolve. I take one day at a time. If interested look through my blog under archives to see explanations of what I do and photos. I'm posting new links now. See CRPS/RSD related articles to the left of the blog.

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