Mirror therapy for the alleviation of phantom limb pain following amputation: A literature review

Background/Aim: Phantom limb pain (PLP) is a debilitating condition that affects 50-85% of patients following an amputation and significantly diminishes their quality of life. Mirror therapy has been reported to have potential success for the alleviation of PLP. However, due to a lack of understanding of the mechanisms underlying PLP and the fact that no current consensus as to the effectiveness of mirror therapy exists, guidelines for treatment protocols are lacking. This review aimed to assess the current best evidence for using mirror therapy to treat PLP in patients with amputation. Methods: The authors conducted a systematic review of original research papers specifically investigating the use of mirror therapy in populations of patients experiencing PLP after unilateral limb amputation. Literature was sourced from PubMed, AMED, CINAHL and Google Scholar. The following search terms were used in combination: 'phantom pain'; 'PLP'; 'phantom limb'; 'phantom limb pain'; 'mirror'; 'mirror treatment'; 'mirror therapy'; and 'virtual limb'. All available studies were marked against predetermined inclusion and exclusion criteria. Results: Seven primary articles met the inclusion criteria, all of which reported significant PLP alleviation after using mirror therapy, with a trend for achieving phantom limb movement prior to pain relief. Conclusions: Mirror therapy is a promising intervention for PLP. Regular sessions of mirror therapy are required to maintain treatment effects. Causes of PLP and treatment pathways may be multifactorial; therefore, further well-conducted randomised controlled trials are required to identify best practice.