Clear effect of mirror therapy on trigeminal neuralgia pain

Introduction: Trigeminal neuralgia (TN) is one of the most excruciating pain conditions. Mirror therapy (MT) is effective in several chronic pain conditions and with a reversing set-up has been described as effective for facial pain with ongoing benefit five years later. Case presentation: a middle-aged lady was offered MT for her long-standing TN. She experienced pain relief repeatedly and reliably after 10 minutes of massage applied by others and subsequently also on self-application of the massage. However, after several selfapplications, which entailed significant strain of the massaging arm, MT suddenly and completely ceased to show effect. Discussion: The significant and on occasions complete pain relief, albeit only temporary, with no side effects experienced, is promising. Whether the reported pain relief is reproducible in further patients, and whether a spoilt illusion can be restored, needs to be investigated. Conclusion: The reliable pain reduction seen here suggests further use of MT for TN. The benefit of the illusion appears to have been lost through the strain or the vision of the self administering arm on the pain-free side of the mirror reflection. Therefore self-administration should be avoided. If this treatment proves effective, a breakthrough in pain relief for chronic unilateral facial pain may be achieved.