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The pain caused by surgery is usually of a transient nature, however the perception of pain in an amputated limb often persists. This prolonged pain, which is often refractory to pain-killing medication, nerve block and surgical treatment may severely affect the patient's quality of life. The phenomenon of phantom limb pain has been investigated using neurological, neurophysiological and psychopathological approaches. However exact cause of phantom limb pain is still a mystery. In this study we analysed the role of mirror therapy for treatment of phantom limb pain in below knee amputation. Material and methods: 96 patients who had phantom limb pain after below knee amputation were included in this study. They had to visit the hospital four times a week for a 15-minute treatment period. They performed movement of unaffected limb while watching its mirror reflection and thus creating a visual illusion of movement of affected limb. The degree of pain relief was measured on visual analog scale (VAS). Results: 70 patients out of 96 reported an improvement of 4 or more degrees of VAS score after 6 months of the treatment. The result was statistically significant. Conclusions: Mirror therapy improves pain sensation of the amputated part when other treatment modalities fail. This therapy works on the principle of mirror neuron system. A mirror neuron fires either when a person acts or when a person observes same action performed by another. The mirror image of the normal body part helps reorganize and integrate the mismatch between proprioception and visual feedback of the removed body. This reorganization decreases the sense or emotion of phantom limb pain in the amputated part.

Role of Mirror Therapy for Phantom Limb Pain in Below Knee Amputees