[HTML][HTML] Mirror therapy as an alternative treatment for phantom limb pain: a short literature review

FH Kiabi, MR Habibi, A Soleimani… - The Korean journal of …, 2013 - ncbi.nlm.nih.gov
The Korean journal of pain, 2013ncbi.nlm.nih.gov
Phantom limb pain (PLP), any painful sensation that refers to an absent limb, is frequently
found among persons who have experienced the loss of any body part through amputation
[1]. It is estimated that more than 80% of patients with total or partial loss of a limb develop
PLP [2]. It seems that PLP is more intense in the distal portion of the phantom limbs and can
have different qualities such as shooting, burning, throbbing or cramping pain [1]. In patients
with an amputation, PLP can be a distressing and enduring experience. Usually …
Phantom limb pain (PLP), any painful sensation that refers to an absent limb, is frequently found among persons who have experienced the loss of any body part through amputation [1]. It is estimated that more than 80% of patients with total or partial loss of a limb develop PLP [2]. It seems that PLP is more intense in the distal portion of the phantom limbs and can have different qualities such as shooting, burning, throbbing or cramping pain [1]. In patients with an amputation, PLP can be a distressing and enduring experience. Usually spontaneous resolution of phantom limb pain is very slow, taking many months and often years, and in many cases, the pain becomes chronic with a significant impact on the patient’s quality of life [3, 4]. The prevalence of limb loss in the United States was 1.6 million in 2005, which is projected to increase by more than double to 3.6 million by 2050 [5]. Given that the prevalence of limb loss is estimated to double in the next four decades, and the negative impacts of phantom pain in these patients, the importance of identifying accessible and cost-effective treatments for phantom pain is increasing [6]. The pathophysiology of PLP is still unknown and is not completely understood, therefore provides a challenge to those involved in the management and treatment of this pain [7]. It has been shown that a range of treatments such as pharmacological treatment, neuromodulation, physical treatment, nerve block and surgical treatment has been unsuccessful in treating PLP and any efficacious methods have yet to be proven [1, 8]. Mirror therapy, a non-pharmacological and alternative treatment strategy that has been proven successful in managing phantom pain, is a neurorehabilitation technique designed to remodulate cortical mechanisms of pain. With this technique, patients perform movements using the unaffected limb while watching its mirror reflection superimposed over the (unseen) affected limb, thus creating a visual illusion (and therefore positive feedback to the motor cortex) of movement of the affected limb. The visual illusion of movement of the affected limb generates positive feedback to the motor cortex, which might in turn interrupt the pain cycle [9].
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