Mirror Therapy for Chronic Complex Regional Pain Syndrome

Complex regional pain syndrome type 1 is characterized by pain, sensory disturbances (e.g., pain evoked by light brushing of the skin [allodynia]), motor impairment (e.g., weakness), and sympathetic dysfunction (e.g., edema). Pain in this syndrome may be induced by a mismatch between proprioceptive feedback and motor action. Visual feedback as a substitute for inappropriate proprioceptive feedback may reduce pain.

Visual feedback may be achieved with mirror therapy, which was originally used to treat phantom pain. However, the use of mirror therapy and therapy involving imagery of movement in patients with chronic complex regional pain syndrome type 1 (lasting 6 months or more) remains controversial.

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Our results indicate that, unlike imagery therapy, mirror therapy effectively reduces pain and enhances motor function in the arm of patients with stroke and chronic complex regional pain syndrome type 1 in the arm. The traditional view that in patients with stroke, chronic complex regional pain syndrome type 1 in the arm is refractory to mirror therapy needs to be reconsidered.

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