Thursday, August 20, 2009

Not all mirror therapy is 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. The brain latches on to the pain message after an initiating event. The problem is the message remains when the event is over. The brain is what tells you there is pain 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. 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 or if the pain keeps returning I look for some underlying problem.
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 breath out twice as long as in for 15 minutes every day to activate the parasympathetic nervous system.
  • I have laser acupuncture, Yamamoto New Scalp Acupuncture and use self hypnosis.
  • 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.
  • I refer to my list of things that work for me when I have flare ups.

My plan was to persist until the symptoms of CRPS resolve. I am now in remission. My plan worked for me. I still eat smart and follow the plan when I have other pain.I've discovered that mirror therapy works for other types of pain.

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.

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