It is intuitive to examine the most prevalent therapy in the treatment of phantom limb pain, in an attempt to elucidate the mechanisms responsible for the experience. Mirror therapy, first introduced by Ramachandran and Rogers-Ramachandran (1996) is arguably one of the most common treatments for phantom limb pain. It involves a simple process of carrying out a range of movements with the intact limb in a mirror, to simulate the experience of movement in the missing limb. The efficacy of this type of therapy has been demonstrated in a number of studies (Chan et. al., 2007; Lamont, Chin, & Kogan, 2011; Ramachandran & Altschuler, 2009; Ramachandran & Hirstein, 1998). The following video demonstrates how mirror therapy is undertaken.
Although efficacious, mirror therapy does little to resolve the question of what mechanisms cause phantom limb pain. Weeks et. al.(2010) and Ramachandran and Hirstein (1998) argue that primarily the effects of mirror therapy work by reducing the visual-proprioceptive dissociation. This is consistent with the learnt paralysis and pain memory hypotheses in that phantom pain is reduced by providing visual feedback to the cortex that the limb is no longer paralysed or in pain. However, the efficacy of mirror therapy could just as easily be attributed to the reversal/prevention of cortical reorganisation by maintaining the representation of the missing limb in the cortex, and it has also been associated with the mirror neuron hypothesis (Lamont, Chin, & Kogan, 2011). Hence, it is clear that rather than elucidating a single mechanism involved, Mirror Therapy could be considered consistent with any one of a number of theories. NEXT
Phantom Limb Pain 