The Mirror Box Theory

The mirror box technique developed by leading neurologist, Vilayanur Ramachandran is both as simple as it is effective. Using a mirror arranged in such a way as to give precise visual feedback, the tequnique tricks the brain.

The technique was developed during Ramachandran's studies of cortical remapping, and phantom limb pain. The mirror box technique uses a box which is halved by a mirror. The participant in the experiment  can only see one half of the box. Once the participant puts his "good" arm (or leg) into the box, the mirror produces a "sterioisomeric image " of the other limb. For example, if the participant had an amputated lower right arm, he would put both arms on opposite sides of the mirror and then the right half would be covered. The mirror mimics the left arm's actions and the participant perceives this manipulated reflection as his right arm. When participants kept their eyes open, in Ramachandran's studies, 4 out of 5 amputees claimed that they felt relief from being able to move their once-phantom limb in or out of positions. This would imply that the phantom limb is a creation of the brain and that relief can come from satisfying the brain by maneuvering the image and making oneself believe that the phantom limb actually exists.

What does this have to do with BPI?
The overwhelming majority of people who have a TBPI suffer from pain which has been compared to that suffered by amputees.  There is a theory that this type of pain derives from a 'hardwiring' of the brain to expect sensory input from all parts of the body. When this sensory input is missing due to nerve damage for example, the same sensory input is generated by spontaneous generation within the brain. The most acute sensation is that of pain. The theory is that the visual stimulus resulting from using the mirror box, temporarily reinforces the natural hardwired image and therefore reduces the pain level.
I haven't been able to find any results of any studies of people using this technique regularly for pain caused by a TBPI , this is probably because so few people have tried it. In the abscence of any other methods of non-surgical or drug free pain control, it seems worth a try.

If anyone else is using this method for pain relief we would love to hear from them.

Rekha has very kindly given us permission to upload pictures of her using the mirror box created by her son.

Rekha is using a mirror placed in the box to reflect her non-affected arm in

such a way that it appears that the other (affected) arm is there.

Rekha performs simple tasks such as unclenching of the fist or tapping the

fingers on the mirror The visual stimulus as a result of using this method

temporarily reinforces the natural hardwired image and, theoretically, should

over time dampen the pain.

Temporary respite from pain may be only for as long as the mirror

box is in use, if at all. From what I have read, the box needs to be

used around 20 minutes a day, the theory being that perhaps with

prolonged and co-ordinated use the pain may subside without the

mirrored effect.

                              And here is how to make your own mirror box


Phantom Limb Pain

The Gaps between Science and Behavior in Understanding Phantom Sensations
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