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Beth Darnall, PhD, develops self-treatment tool for phantom pain

Mirror therapyPhantom pain is often a chronic, debilitating condition that affects about 80 percent of people who have lost a limb. Of those who acquire phantom pain, as many as 85 percent report continued phantom pain 2 years after amputation; and for some people, it may persist for decades.

Beth Darnall, PhD, Assistant Professor, Department of Anesthesiology and Perioperative Medicine, has developed an instructional DVD to enable amputees to self-treat their phantom pain. Do It Yourself Mirror Therapy teaches patients how to use this evidence-based treatment at home, making it a cost-effective non-pharmacologic treatment for phantom pain.

“When mirror therapy is practiced, the brain is exposed to the image of the intact limb repeatedly and receives the message that both limbs are intact and functioning,” said Dr. Darnall. “When mirror therapy is used consistently over the course of one month, phantom pain may lessen or even resolve.”

Functional MRI studies show that positive results from mirror therapy are related to cortical restructuring in the brain. It is thought that a remapping of the body map in the brain reduces or eliminates any distortion that may have been created when the brain tried to reconcile the amputation.

“Our study findings are promising, and self-treatment is especially important where access to pain care is severely limited,” said Dr. Darnall. She is currently working with a global non-profit organization called End the Pain Project to bring mirror therapy tool kits to amputees in Vietnam and Cambodia. HealthSaas has made it possible to evaluate their progress from Portland.

Dr. Darnall recently presented an instructional session on mirror therapy to amputees and caregivers at the national conference of the Amputee Coalition of America. In October, an OHSU N.L. Tartar Trust Fellowship will fund her travel to the annual conference of the Egyptian Society for the Management of Pain where she will present her findings on self-delivered mirror therapy. While she is in Cairo, Dr. Darnall will also meet with researchers at Al-Ahzar University to discuss a collaborative comparative effectiveness study of phantom pain treatments that will include mirror therapy.

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