The day following the devastating earthquake in Haiti, the queue for amputations was more than 1,000 patients long. Surgeons have therefore had to resort to “guillotine-style amputations, which increases the prevalence of phantom limb pain – the vivid impression that the limb is not only still present, but extremely painful.
Mirror box therapy developed by Dr. Ramachandran at the UCSD Center for Brain and Cognition is an excellent low-cost method to treat phantom limb pain. In mirror box therapy, a mirror is placed vertically on a table so that the mirror reflection of the patient’s intact limb is ‘superimposed’ on the felt position of the phantom. Double blind studies have shown the mirror box to be effective in reducing phantom pain in 89% of phantom pain patients. Psychophysical studies in normal subjects strongly support the notion that the mirror effect works by using vision of the intact or good limb to replace or drive proprioception in the affected limb.
We will be testing the use of acrylic mirror sheets over glass mirrors, as they may be superior for disaster stricken areas: they’re shatterproof so they won’t break in rough conditions, they’re much lighter making it easier for amputees to carry, and they’re much cheaper allowing us to bring more mirrors with us for the same amount of money. Each mirror will take the place of shipping a life time of pain medicine for the patient in Haiti, often not possible in disaster stricken areas. Not only are narcotics not effective in treating phantom limb pain, they leave a much larger carbon foot print than a single mirror.
We wish to bring mirror therapy to Haiti in an effort to reduce the number of individuals with phantom pain.