Rheumatology 2003; 42: 97-101
© 2003 British Society for Rheumatology
A controlled pilot study of the utility of mirror visual feedback in the treatment of complex regional pain syndrome (type 1)
The Royal National Hospital for Rheumatic Diseases in conjunction with The Department of Medical Sciences and The Department of Pharmacy and Pharmacology, University of Bath, Bath BA1 1RL,
1 School of Psychology, University of Cardiff, PO Box 901, Cardiff CF10 3YG and
2 Centre for Neuroscience Research, Hodgkin Building, King's College, London SE1 1UL, UK
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 
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.
Results. The 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.
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.
KEY WORDS: Complex regional pain syndrome, Mirror visual feedback.
Correspondence to: C. S. McCabe, The Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath BA1 1RL, UK. E-mail: candy.mccabe{at}rnhrd-tr.swest.nhs.uk
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