Wednesday, December 03, 2008

What's in a name? - Not all mirror therapy's the same.

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 you 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 inflammation, 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 mirror image of the body part opposite to the one that hurts moving, the brain gets visual stimulus of a moving pain free limb. The brain is being retrained. 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. I do it again and again. 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. When the pain stops, it is gone for good. If the pain is in the same place again, I know something has triggered it and follow the same process again.
Mirror therapy isn't the whole answer.

  • I do physical therapy every day in small amounts throughout the day. Physical therapy is essential to regain lost function. I try not to over do it (very hard).
  • I do mirror therapy for one sided flare ups. I do it for a short time and several times a day until pain resolves.
  • I breath out twice as long as in for 15 minutes every day to activate the parasympathetic nervous system. I've changed this to alternate nostril breathing with out breath longer than in. I do this for 5 minutes about 5 times a day.
  • I have laser acupuncture and use self hypnosis. I sometimes have Yamamoto New Scalp Acupuncture which stops migraine, settles tendinitis and normalizes the autonomic nervous system.
  • I eat foods high in antioxidants (prunes are highest) to deal with the free radicals caused by stress of coping with CRPS. I "tweaked" my diet so that I have more antioxidants especially Vitamin C. Vitamin C demolishes the free radicals involved in inflammation.After a knee injury I took 1000mg of vitamin C as well as an increase in vitamin rich foods.
  • 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. CRPS symptoms, specially dysautonomia had resolved earlier this year. However I had an accident in which I injured my knee. Immediately dysautonomia returned as did other problems. However as I took vitamin C immediately and continue to do so, I have no CRPS in the injured knee.

If interested look through my blog under archives to see explanations of what I do and photos. Click on tags under posts to bring up other posts on that topic.

1 comment:

Barbara K. said...

It is inspiring to read in one post what you do to get control over your brain and body. When I have a pain episode, it's so easy to go right to misery and forget what I can do to help myself. Thanks

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