Mirror Box Therapy, a relatively new treatment for severe or abnormal pain in a limb, is currently being provided at Shaughnessy-Kaplan's Peabody outpatient clinic. Therapists Elizabeth Hearne, OT and Valerie Murphy, PT have used this treatment with some of their patients and have seen how this tool has helped ease the pain for them. Hearne, who is also a Certified Hand Therapist (CHT), says 'I have seen rapid improvement in mobility with my patients who have severe hand pain after using the mirror box. They are usually shocked at how much motion they gain while looking at the reflection of their hand.'
The Mirror Box itself is a simple device. It consists of what its name states: a box with a mirror on the outside. It is lightweight, reasonably inexpensive and portable. To use the mirror box, a patient places the injured limb inside the box and the good limb outside, facing the mirror. While doing symmetrical exercises with both limbs, the patient watches the reflection of the good limb. Elizabeth Hearne describes the process as "instead of seeing the limited motion of the injured hand, the patient sees the full motion of the reflected hand, but it actually feels like the injured hand is moving that well." When the patient sees their good limb moving, it sends visual feedback to the brain giving it the illusion of movement in the bad limb. According to Hearne, when the brain "sees the bad limb moving without pain the brain will 'relax' enough to allow exercise and the patient can recover."
Mirror Box Therapy can be used to help a broad spectrum of people with limb pain. It is used in rehabilitation for people with Phantom Limb Pain or severe hand, wrist and foot pain due to Complex Regional Pain Syndrome (CRPS), but it is not limited to those populations. Without the use of drugs, this therapy can also improve the mobility of a limb after a stroke, or following a hand or foot injury.
The idea of Mirror Box Therapy at Shaughnessy Kaplan-Peabody came to Valerie Murphy, when a patient was referred to her from Brigham and Women's Hospital for this specific treatment. The patient had CRPS in her leg and foot and Murphy worked with the patient using a regular standing mirror instead of the box. The patient now has an improved range of motion in those areas. Hearne began using mirror box therapy with her own patients, following Valerie's lead, and has seen rapid improvement in their mobility.
Currently, there are quite a few studies and research on Mirror Box Therapy, especially with its effect on Phantom Limb Pain. Studies have shown a decrease in pain for amputees over a period of time as a result of mirror therapy.
"The best thing about it is it is very inexpensive, about $35 and "low tech" says Hearne "patients can easily do it at home, so those needing long term therapy for these severely painful conditions don't have to be depending on a therapist or a machine in a clinic to boost the effectiveness of exercises at home."
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