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MIRRORS ARE NOT PROVEN TO EASE PHANTOM LIMB PAIN
Did You Know That A Mirror Is Used To Treat Phantom Limb Pain?
Researchers First Reported Setting It Up In The Middle Of A Box
Arm Amputees Placed Their Remaining Arm And Their Stump Inside It
The Reflection Gave The Illusion That The Missing Arm Had Returned
When They Moved Their Intact Hand The Phantom One Seemed To Move
For Some Of Them That Illusion Led To Less Pain
Mirror Therapy Is Thought To Restore Normal Visual Input To The Brain
How It Would Do That Is Still Not Well Understood
It Is Also Not Effective For Everyone Who Uses It
THIS NEWSLETTER IS FOR INFORMATIONAL PURPOSES ONLY. NOTHING IN THIS CONTENT CONSTITUTES MEDICAL, PSYCHOLOGICAL, OR PROFESSIONAL ADVICE. ALWAYS CONSULT A QUALIFIED HEALTHCARE PROFESSIONAL BEFORE MAKING ANY HEALTH RELATED DECISIONS.
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A MIRROR AND A MOTHER CLAPPING 👏
A Case Report From Boston Described A 24 Year Old Man
While Riding A Motorcycle He Collided With A Moving Car
He Was Thrown More Than 30 Meters Into The Air
His Entire Left Arm Was Lost Including The Shoulder
After 10 Weeks Of Hospital Care He Moved To A Rehabilitation Unit
Almost Immediately Phantom Limb Pain Became His Main Problem
He Kept Feeling That His Missing Left Fist Was Severely Clenched
Unable To Release It He Felt The Cramp Turn Into A Burning Pain
On Average He Rated The Pain 8 To 10 Out Of 10
It Was Suggested That Mirror Therapy Might Give Some Relief
His Mirror Stood Upright In A Frame Against His Chest
Sitting In A Chair He Watched His Right Arm Move In The Mirror
He Did Arm Curls And Opened And Closed His Right Fist
Each Day He Did At Least Two 15 Minute Sessions
His Mother Joined In By Clapping Her Hands
She Clapped In Time With His Hand Moving Toward The Mirror
That Gave Him The Illusion Of Seeing And Hearing Hands Clap
For The First Week And A Half His Pain Did Not Drop Significantly
By The End Of The Second Week He Reported Some Decrease In Pain
His Highest Pain Rating Was Then 6 Out Of 10
The Report's Authors Could Not Tell Whether The Mirror Alone Helped
It May Have Been The Mirror And The Clapping Together
The Authors Suggested A Controlled Trial Comparing The Two
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A MIRROR AGAINST A COVERED MIRROR 🧪
Controlled Trials Compare Mirror Therapy With Another Treatment
A 2023 Review Says A Good Comparison Is As Similar As Possible
It Says A Covered Mirror Is Classically Considered The Best One
An Opaque Sheet Covers The Mirror So The Reflection Cannot Be Seen
Everything Else Stays The Same As In Mirror Therapy
That Leaves The Reflection As The Only Difference
A 2007 Trial Tested Mirror Therapy On People Missing One Leg
Its Comparison Groups Used A Covered Mirror Or Mental Visualization
Mental Visualization Means Picturing The Phantom Limb Moving
In The 2023 Review Only This Trial Found A Specific Benefit
That Benefit Was Seen At Week 4 Compared With The Control Group
The Review Also Gave The Trial's Methods A Low Quality Score
A 2017 Trial Included Men With One Arm Amputated
Fifteen Of Them Came From Two Army Medical Centers
Nine Were Randomly Assigned To Mirror Therapy
Six Others Got A Covered Mirror Or Mental Visualization
Those Six Could Switch To Mirror Therapy After 20 Sessions
After 11 Sessions All Six Had Switched
A Lack Of Effect Or Increased Pain Were The Reasons
The Trial's Authors Found Mirror Therapy Effective In These Men
They Also Said With No Women Their Findings Cannot Be Generalized
Pain Dropped Significantly Within The Trial's Mirror Therapy Group
The 2023 Review Did Not List It Among Trials Comparing Two Groups
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WHAT FOUR REVIEWS CONCLUDED 📚
The 2023 Review Only Included Trials That Used A Placebo
Its Placebos Were A Covered Mirror Or No Mirror At All
Five Trials Met Its Criteria Including The 2007 And 2017 Ones
Together They Had 256 Patients
The Authors Could Not Conclude That Mirror Therapy Reduces The Pain
They Gave Two Likely Reasons For That Lack Of Strong Evidence
The Trials Were Low In Quality And Lacked Statistical Power
Those Authors Noted A 2019 Review Had A Similar Conclusion
Its Authors Examined Five Recent Trials Of Mirror Therapy
Mirror Therapy Did Not Appear To Reduce Pain More Than A Control
By Contrast A 2021 Review Reported A Significant Benefit
In That Review A Team Pooled Nine Trials With 372 Participants
Against Other Methods Mirror Therapy Had A Large Effect On Pain
In Four Comparisons The Other Method Was A Covered Mirror
That Team Found Fair Quality Evidence That Mirror Therapy Helps
The 2023 Authors Say The Effect Disappeared Against A Covered Mirror
On That Basis They Disagreed With The 2021 Conclusion
A 2026 Review Included Twenty Six Trials
Mirror Therapy Reduced Pain More Than Sensorimotor Therapy Did
The Reductions Were Small But Significant
Against Sham Treatments There Was No Significant Effect
The 2026 Authors Still Concluded Mirror Therapy Appears Effective
They Added That The Overall Quality Of Evidence Remains Limited
