Mirror Therapy For Amputees

Since the start of the war, more than 750 soldiers have returned home from combat in Afghanistan and Iraq as amputees. Walter Reed Army Medical Center has treated many of them. On any given day, 100 to 125 amputees are there, working to rebuild their lives. Most, a staggering 95%, suffer a type of excruciating pain that even pain medicine alone can't relieve, but one doctor has found a simple way to help them.

When Sergeant Nick Paupore's convoy was hit by a roadside bomb, Paupore lost his entire right leg. His whole life changed. The worst part was the pain. Sergeant Paupore tells us, "All of a sudden, it was just like someone kept turning on and off a taser and my whole leg started twitching and I sat up and I was holding on to my stump and it just wouldn't stop."

What he was feeling is phantom limb pain. , Navy Commander Dr. Jack Tsao at the Uniformed Services University, explains, "It's the sensation that the limb is still present … and phantom pain in particular is the sensation that the limb is experiencing pain of some form."

When it comes to war, traumatic amputation is nothing new, nor is phantom pain. The problem is that almost nothing works—not drugs, not therapy—and the pain is awful. Dr. Tsao says that 95% of the people who lose a limb have phantom pain. When asked if the source of the pain were nerves that were once present and are now cut in half, Dr. Tsao said, "There are a lot of different theories about where phantom pain is generated from. The thinking now is that it must be generated somehow in the brain in terms of how the brain interprets the signals from the pain pathways that are left."

So how do you trick the mind into believing the leg is still there? It's remarkably simple: a mirror can make it appear to Paupore as if he still has two legs, and that's exactly what the doctors want his brain to see. It's called mirror therapy, and Paupore started with fifteen minutes a day, four to five days a week. Within five months, he was pain-free. Dr. Tsao tells us that he was astounded by how well the therapy worked.

What the mirror actually does is to coordinate what the patient sees visually with what's known as "position." According to Dr. Tsao's study, coordinating these two things really helps to get rid of the phantom pain. This coordination makes it seem to the patient as if his amputated limb is still there.

Once a skeptic, Paupore is now a true believer. The mirror therapy has helped him reflect on all that's happening and perhaps given him a more positive view of how he'll deal with his future.

At Walter Reed, mirror therapy is now offered routinely to patients. Dr. Tsao says that this therapy has the potential to benefit amputees worldwide and the best part is that no special training is required to do it. It even gives interested parties instruction over-the-phone or via e-mail. It is already helping the country of Cambodia set up a similar program because of its large and growing amputee population due to abandoned land mines.

http://www.accenthealth.com/features/200808/