A controlled pilot study of the utility of mirror visual feedback in the treatment of complex regional pain syndrome (type 1)

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BackgroundWe assessed mirror visual feedback (MVF) to test the hypothesis that incongruence between motor output and sensory input produces complex regional pain syndrome (CRPS) (type 1) pain.MethodsEight subjects (disease duration ≥3 weeks to ≤3 yr) were studied over 6 weeks with assessments including two controls (no device and viewing a non-reflective surface) and the intervention (MVF). Pain severity and vasomotor changes were recorded.ResultsThe control stages had no analgesic effect. MVF in early CRPS (≤8 weeks) had an immediate analgesic effect and in intermediate disease (≤1 yr) led to a reduction in stiffness. At 6 weeks, normalization of function and thermal differences had occurred (early and intermediate disease). No change was found in chronic CRPS.ConclusionsIn early CRPS (type 1), visual input from a moving, unaffected limb re-establishes the pain-free relationship between sensory feedback and motor execution. Trophic changes and a less plastic neural pathway preclude this in chronic disease.

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