Rick Shory

Offering a little something you might not otherwise have

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Half-phantom pain

I was intrigued to learn about “mirror box therapy” for phantom limb pain. Say a man loses his left arm. He may feel pain in that no-longer-existing arm. That’s phantom limb pain. Where does the pain come from, since the arm is no longer there? More important, how do you make the pain go away?

The neuroscientist Vilayanur S. Ramachandran discovered that if the amputee used a mirror box, such that he was watching his still-existing right hand, but reflected in a mirror so it looked like his left hand, the phantom limb pain would go away. There’s more to it, but the basic idea was giving the brain another “information channel”, to re-calibrate itself and get things wired up correctly again.

I broke my ankle in year 2007, and was on crutches for some months. After it was over, there was still something wrong with that foot. It would cramp up and hurt. I’d had a titanium strap put in to repair the break, and later taken out when the bone was healed. The surgeon had explained he’d had to push aside a certain nerve, and that nerve was partially compromised.

I made the analogy with phantom limb pain. In amputation, the nerve is gone, along with the whole limb. In my case, the nerve was not completely gone, but pinched by scar tissue. When I touched the outer top of my foot, and the outer toes, they would feel “funny”. Somewhat numb. Like things weren’t wired right.

The mirror box “manufactures” a mental image of the missing limb, for the mind to work with. I didn’t need a mirror, since my foot was still physically there. But the mental image was not coming in correctly from the nerves. To give my mind another information channel, I used the simple expedient of just looking at my foot. I would watch it as I walked. I would direct it visually.

My foot was a bit off-angle, and something was subtly wrong with the gait. When I would take visual control, I could correct these small defects of motion, and direct the bad foot to match the good side. To my surprise, when I would do this, the pain would go away. This seemed a lot like the phantom limb pain cure.

Of course it’s something of a juggling act, to watch your feet, while still watching where you’re going. It took a couple weeks before it started to become a habit. I thought part of the problem might have been all that time on crutches. My foot had got wired to just hang limp, ignoring the nerve impulses for walking.

Whenever my foot started hurting again, I could just look at it, watch it, redirect it, and the pain would go. Eventually, I could do this even with boots on. By subtle cues of visual motion, I could “see” my foot through shoe leather.

It was a few years before this completely became an effortless habit. It was partly a matter of retraining whatever nerve sensation I still had, to “understand” and match the visual directions.

Anyway, it was quite rewarding to read an idea in a book, and find a way to use it in my life for rehabilitation and pain relief.

I couldn’t help wondering if these ideas might help other people with “mysterious” pains, pain where nothing is organically wrong. For example, fibromyalgia. Maybe the pain is just a disconnect of mental image from the body. Has anybody tried just looking at the painful area, directing it visually? It couldn’t do any harm, and it would cost nothing to try.