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


METHODS
Eight subjects (disease duration > or =3 weeks to < or =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.


RESULTS
The control stages had no analgesic effect. MVF in early CRPS (< or =8 weeks) had an immediate analgesic effect and in intermediate disease (< or =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.


CONCLUSIONS
In 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.
McCabe
C S
CS
The Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath BA1 1RL, UK. candy.mccabe@rnhrd-tr.swest.nhs.uk
Haigh
R C
RC
Ring
E F J
EF
Halligan
P W
PW
Wall
P D
PD
Blake
D R
DR
D000328:Adult; D001831:Body Temperature; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D009068:Movement; D017288:Pain Threshold; D010865:Pilot Projects; D012019:Reflex Sympathetic Dystrophy / Q000523:psychology / Q000628:therapy*; D019455:Self Psychology; D014796:Visual Perception