Phantom Limb Pain

Phantom limb pain treatment. These client sessions were filmed as part of an ongoing development project in conjunction with a university research team and associated clinicians.

These web pages have five complete mirror therapy sessions that were professionally filmed in a studio.  All patients were volunteers, of whom four had upper limb amputation and one lower limb amputation.

Schedule an online consultation with Andrew T. Austin here.

*New addition: 90-minute presentation on the mirror box and a demonstration of suggestion and metaphor in the treatment of PLP. Filmed live in Winter Park, Colorado in 2009.

*New addition: Over 3 hours of lecture material from the presentation, "Effective Assessment and Treatment of Phantom Limb Pain." Recorded in London 18th June 2014.

Lecture Material Contents

Part 1. Assessment of the patient
00.01  Introduction and background
04.00  Amputations in hospital, patient experience of visual representation and feedback
05.50  Patient experience of kinaesthetic representation and feedback
06.50  The mirror box, the rationale for the choice of style and construct
08.25  Vilayanur Ramachandran, Phantoms in The Brain
09.25  Phantom limb pain case study/example (edited to remove confidential details)
12.30  Ramachandran, change the picture
12.57  Assessment of patient (PTSD)
23.10  Assessment of patient (delayed organic depression)
26.24  Assessment of patient (dysmorphic distress)
32.10  Assessment of patient (secondary depression and anxiety)
36.45  Assessment of patient (pre-morbid conditions)
46.42  End

Part 2. Assessment of the phantom 
00.01  Trapped in relationships
00.50  Assessment of the phantom (remapping phenomena)
09.09  Assessment of the phantom (eliciting the phantom image)
13.00  Assessment of the phantom (position of phantom, contractures)
15.45  Demonstration of repositioning phantom
19.12  Assessment of the phantom (mobility of phantom)
21.30  Congruity and incongruity between image and kinaesthetic representation
24.19  Overlap between phantom and physical pain
25.48  Question and demonstration of testing amputee for remapping
37.57  Demonstration with brachial plexus injury patient
44.55  End

Part 3. Phantom limb pain treatment structure 
00.01  How to use the mirror box
08.30  First non-amputee experimentation with the mirror box
12.18  Second non-amputee experimentation with the mirror box
13.20  Getting results, expectations, time pressures on appointment duration
15.25  What to do with the prosthetics when using the mirror box
25.15  Treatment session structure
30.00  Considerations of limb transplants
32.30  Patient expectation management
34.55  Instructions to patient
37.00  Question from audience about medication for pain relief
38.50  The stages of the treatment session (1. Expectation and anticipation)
40.49  The stages of the treatment session (2. Focus)
42.00  The stages of the treatment session (3. Reaction)
43.00  The stages of the treatment session (4. Emotional reunion with limb image)
44.05  The stages of the treatment session (5. Abreactional states)
45.55  The stages of the treatment session (6. Fascination and Exploration)
48.18  The stages of the treatment session (7. Fatigue)
49.00  Results and effect of mirror box session (telescoping phenomena)
50.40  Demonstration with upper limb amputee
73.50  End

Part 4. Patient demonstrations 
00.01  Demonstration with a hand injury
09.39  Questions from the audience
15.16  Demonstration with brachial plexus injury, pre-amputation
28.00  Questions about demonstration and discussion
39.31  End

Also featured on this website are:

- comprehensive assessment of phantom limb pain
- application of the mirror box to alter phantom limb perception
- pain relief using the mirror box
- sensory remapping (phantom hand to face)
- some of the more unusual phenomena with phantoms (telescoping, the illogical positioning of the phantom)
- use of IEMT to deal with memories of trauma

If you would like access to these videos, please email your credentials and request to Andrew T. Austin at:

*Patients (UK only): We are actively seeking patients with phantom limb pain and related phenomena for a number of brain scanning studies and also for filmed treatment sessions.  Please get in contact if you would like to participate.

*Post Traumatic Stress Disorder (PTSD): The PTSD treatment website can be found here.  It's only £9.99 and is available to any interested person. Please see:  

Access to the Mirror Visual Feedback website is free and available only to registered health care professionals and university-affiliated researchers and clinicians.

Schedule an online consultation with Andrew T. Austin here.

phantom limb pain treatment

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