Thursday, October 29, 2009
The House episode on mirror therapy was great in that it helped spread awareness of a non drug way of dealing with pain. However it's important to keep things in perspective. Mirror therapy is not a quick cure or the perfect treatment. It offers, in my opinion, a tool to add to others things that work for you. There is ongoing research which shows that some people can get a great result. It really helped me. In my opinion it has a better chance of working if you get it right. I would have much preferred to have been guided by a physiotherapist but there was none here at the time I began who knew about guided imagery and mirror visual imagery. In Australia now there are many therapists who have been trained in this area. NoiGroup has exceptional training for professionals in Australia and throughout the world. Their website has excellent resources for patients and professionals. David Butler and Dr Lorimer Moseley explain about this new treatment and the new understanding of the part the brain has to play in pain in free video on the NoiGroup site.. Dr Moseley and his team have a new website Body in mind which I recommend you visit and keep visiting. I recommend that you read the article Guided motor imagery is effective for longstand complex regional pain syndrome.
There is great cause for optimism with so much research current. It pays not to put all your chickens in one basket and not count on one thing, one drug one therapy as a fix. Looking out for ourselves, making a list of what helps, eating well, being mindful, remembering to breathe and keeping it real seems to me to be a good way to go. Stay safe and remember to take care of you.
Wednesday, October 28, 2009
I sat as you saw in the video with the mirror between my two feet. I moved my foot as I had done before but had this strange sensation, similar if not the same, as the sensation when I moved my painful foot and not my good foot whilst looking at the mirror image of my good foot.
I realized that I did not have the mirror positioned exactly centrally to my body. I also noticed that it was at an acute angle (smaller) instead of at right angles to my body. When I realigned the mirror all went well and no "strange sensation". It appears to me that the positioning/angle of the mirror such that the hidden foot is in the same position as the mirror image of the good foot is important in using this therapy and that having the position contry to the image could be causing a mismatch somehow.
I speculate whether the distance from the mirror might also be important.
If someone thinks videoing this might help others to understand please post a comment and I'll video what I did.
Phantom limbs make impossible moves.
Check out Dr Moseley and crew's new website Body in Mind
There is an excellent post about CRPS on Body in mind here.
Saturday, October 24, 2009
I injured my ankle on Wednesday. Today, Saturday, I can walk normally although with some discomfort. There is still some swelling and bruising but much improved. My treatment has been mirror therapy a few times a day, laser acupuncture on Wednesday and Friday in the area of injury and Yamamoto New Scalp Acupuncture. The YNSA specifically is to address autonomic dysfunction.
Body in mind has posted a comment by Dr Lorimar Moseley on a recently published letter in the New England Medical Journal. In the post he says, "it would be nice to see if pain reduction and motor improvement are related".
Well in my my case with this injury, function definitely improved with mirror therapy. I went from couldn't move toes or foot to being able to move them. I suspect that my inability to move my toes was because of pain. Mirror therapy eased the pain but also gave me visual input which created the illusion that my injured foot was moving. I don't pretend to understand this. I just know it works for me and for that I am very grateful. Before having this tool with which to help myself this would have been a different, much worse outcome for me involving ongoing extreme pain and loss of function for a long time.
Thursday, October 22, 2009
I was in extreme pain again and really struggled on the trip home. I was very nauseous from the pain and at a loss what to do as I lay on the bed with my leg raised. I struggled to bear the pillow under my foot. I could no longer bear to move my toes or move my foot up and down. I was told this was because of swelling but I had my doubts.
Still convinced this was not CRPS but just my injury I remembered that I'd eased acute mouth pain using my version of mirror therapy. I had nothing to lose so sat on the side of my bed and positioned myself so that I could only see the mirror image of my good foot. This time I used the recommended method of moving both feet in the same way. I knew I could not wriggle my toes on the injured foot so that is what I watched myself doing in the merror. I tried to move the injured foot's toes in the same way. To my amazement I was able to curl them a little. I continued do this for about 30 seconds and then tried to move my foot up and down while I watched my other food doing this. Again amazingly I was able to move my painful foot, not as much but I moved it. I continued for about 30 seconds. Then I put my foot on the ground while watching the mirror image of my good foot doing the same. I did this only for a few seconds.
When I lay on the bed the pain was less intolerable and I could more comfortably rest my foot on the pilows.
I repeated this a few hours later and again this helped reduce the pain.
Today I did the mirror trick again. It helped again and I can now place my foot on the floor and walk with the aid of a crutch.
The pain went from extreme to bearable with mirror therapy. Whether this pain has been wholly from the injury or from CRPS from the injury I don't know. What I do know is that mirror therapy helped. I'll make a video shortly to show you what I did and will continue to do.
I will have Yamamoto New Scalp Acupuncture again tomorrow and next Monday and Wednesday. I'm really hoping that this will again correct the dyautonomia that has returned.
My husband and I are going to Vietnam in 9 days. I was getting fit, walking heaps and planning a short trek in the Highlands above Sapa near the Chinese border. This is a bit of a setback but I am confident I can recover by then using mirror therapy and with my GP's laser acupuncture and remarkable YNSA.
Monday, October 19, 2009
In short - "you are not your past and you can shape your future".
Here you will find not just ideas but strategies to put them into place with relevant links.
Dr Sharp's last sentence says it all.
"So there it is; the past is history, tomorrow's a mystery, today is a gift...that's why they call it the present."
Sunday, October 18, 2009
Neuroscientist Christopher deCharms is helping to develop a new kind of MRI that allows doctor and patient to look inside the brain in real time -- to see visual representations of brain processes as they happen in order to help treat chronic pain with a kind of biofeedback. Being able to visualize pain can help patients control it.
Look to the left for a link to great information about CRPS..
Friday, October 16, 2009
There has been so much interest shown since this episode that CNN did a feature called
Brain mirror therapy CNN interviews Dr Sanjay Jupta.
This follows on from an earlier report For amputees an unlikely painkiller: mirrors.
At the Walter Reed Center for Veterans mirror therapy is now offered routinely. Dr. Jack Tsao, a Navy neurologist with the Uniform Services University says"this treatment has the potential to benefit amputees worldwide, and the best part is, no special training is required to do it. He gives interested parties instructions over the phone or by e-mail."
Thursday, October 15, 2009
Wednesday, October 14, 2009
The Happiness Institute in Sydney, Australia is now offering a series of free webinars. The last one was on "resilience", having the skills to cope with stressors in life. This one will be offered again so I'll post about it then.
This webinar Create the best job in the world - for yourself, is about maximizing the happiness and satisfaction the participants can gain from the time they are working
Presented by Professor Tim Sharp participants will learn how to:
- clarify your priorities, discover your purpose and paint a positive vision of the future
- approach whatever you do with enthusiasm and interact with whomever you need to work with positivity
- identify your inner strengths and attributes and utilise these effectively to enjoy what you do more and to be more successful
- and finally, be resilient, bounce back from adversity and stay on track once you've planned out your path
Wednesday, November 11 at 5.30 - 6.30 EST (that's Sydney, Australia time)
This world clock will help you find the time difference.
This is now over however this link will take you to a very good document Resilience - maintaining the happiness through the hard times
and for therapists this is a great resource Building resilience - using positive psychology to get through tough times. (slide show)
Monday, October 12, 2009
Since then research has shown that Complex Regional Pain Syndrome and other chronic pains can be relieved by looking at the mirror image of the corresponding painful body part.
In Australia there is a great deal of interest, with mirror therapy becoming more widely accepted as treatment for chronic pain, in particular for the treatment of Complex Regional Pain Syndrome.
In 2004 thirteen chronic CRPS Type I patients were given two weeks each of a hand laterality recognition task, imagined hand movements and mirror therapy. The results upheld their hypothesis.
In 2006 at Oxford University in the UK, Dr Lorimer Moseley was involved in a much larger study . Their conclusion was that Motor Imagery using mirrors reduced pain and disability in patients with Complex Regional Pain Syndrome Type I or phantom limb pain, but the mechanism, or mechanisms, of the effect were not clear.
Dr Moseley and David Butler have written an excellent book which examines this novel approach to pain management, "Explain Pain". The Neuro-orthopeadic Institute of Australasia, NOI Group, was formed to support therapists here, in the USA and in Europe. If interested go to the left of this blog and click on the link under crps/rsd related articles.
In the UK doctors, such as Dr Candy MacCabe of the University of Bath's School for Health, and Dr Ilan Lieberman, a Consultant Doctor specializing in Pain Medicine and Anesthesia at the University Hospital of South Manchester in England, have been able to alleviate the pain of Complex Regional Pain Syndrome using a simple mirror box.
In 2003 D MacCabe first described the use of this therapy for CRPS Type I. She showed that mirror visual feedback (MVF) relieved pain significantly, and normalized temperature changes in the affected limb. In 2006 in the Netherlands, a trial treatment of patients with Complex Regional Pain Syndrome Type I with mirror therapy was conducted with the aim to improve arm-hand function. The hypothesis of this study is that mirror therapy stimulates cortical representation of the upper extremity. The functionality of the upper extremity is expected to improve more than with only conservative therapy.
This "cortical" model of pain suggests that the brai's image of the body can become faulty, resulting in a mismatch between the brain's movement control systems and its sensory systems, causing a person to experience pain when they move a particular hand, foot or limb.
Researchers believe that this kind of problem could be behind a host of pain-related disorders such as Complex Regional Pain Syndrome and repetitive strain injury.
Look to the right of this blog for links to research under "mirror therapy links".
This video shows how easy it is to make your own box. mirrorboxtherapy.com and noigroup.com have collapsable boxes for sale.
Remember you can also use just a mirror so long as the problem body part is hidden behind the mirror and you can see the mirror image of the good part.
Thursday, October 08, 2009
It showed an episode of "House" in which in which Dr House successfully treats phantom limb pain using mirror box therapy.
crps/rsd related articles
- Nursing Patients with CRPS/RSD
- Vitamin c and CRPS 2010
- Cleveland Clinic link - twin research
- Complex Regionaal Pain Syndrome and identical twins.
- Familial occurance of CRPS.
- Headache a risk factor for CRPS.
- Ehlers Danlos Syndrome and CRPS
- Brain change in chronic CRPS -Neuron
- Vitamin c as preventative for CRPS - Netherlands study 2007
- Vitamin C and CRPS study ARC Bristol
- BestBETs Best Evidence Topics - Hydrotherapy for Comples Regional Pain Syndrome (CRPS) of the foot and ankle
- Neurotopian - Matthias Weinberger's fantastic blog.
- hope-4crpsrsd - a Christian support group
- podcast - Australian Native Fruits bear sweet antioxidants.
- Explain Pain - David Butler's blog
- CRPS/RSD and Dentistry
- HTCwP - brain control of movement is altered in CRPS - study
- HTCwP - Self Compassion or Self Esteem
- Neuromatrix Training Blog
- Neurodynamics - Physical and Neural Health Blog
- Explain Pain Blog
- JB & JS report - Can Vitamin C Prevent Complex Regional Pain Syndrome in Patients with Wrist Fractures?
- Matthais Weinberger's interview on "how to Cope with Pain" website.
- How to Cope with Pain - Ketamine Coma treatment for CRPS/RSD
- RSDHope - DVD set of three
- North Western University Feinburg School of Medicine "Old Memory Traces May trigger chronic pain."
- HOw to Cope with pain How Pain Affects Families -Tony's story.
- Prevention.com article -"Natural-Born Pain Killers"
- Brain control altered in movement with CRPS -How to Cope With Pain
- How to Cope With Pain - Asking for help.
- Hooshmand and Physical Therapy Part I
- Hooshmand and Physical Therapy Part II
- How to Cope with Pain on Recognize - Here's a way to get ready to move - with less pain.
- American Pain Foundation Booklet: Treatment Options - A Guide for People Living in Pain
- Preventing CRPS after surgery - International Research Foundation for RSD/CRPS
- How to Cope with Pain - great questions about Graded motor movements
- How to Cope with Pain - Recognize podcast
- How to Cope with Pain - Graded motor imagary
- How to Cope with Pain - Think & move & your pain will improve.
- How to Cope with Pain - CRPS - Can mirrors help?
- RSD Canada Online Survey Questionnaire
- For Grace web site
- For Grace Utube site
- How to Cope With Pain - Can mirrors help?
- Noi Group Australia
- Support groups help you cope with pain - HTCWP interview by National Pain Foundation
- How to Cope with Pain Mindfulness video from Utube.
- "How to Cope with Pain's" hilarious video.
- Jason's RSDS/CRPS News & Information blog
- BBC UK News - Vitamin C /crps study - "Mystery pain left me in a wheelchair"
- Dr Moseley's interview on How to Cope with Pain site.
- Virtual Reality as a Rehabilitative Technology for Phantom Limb Experience.
- UK mirror box therapy site.
- Ramachandran's mirror box video
- My interview on "How to Cope with Pain" website.
- Napp Pharmaceuticals donate mirror boxes - WebWire article
- How to Cope with Pain: A guide to coping with pain.
- Hooshmand and Physical Therapy Part II