Category Archives: Mirror Therapy

Mirror Therapy for Relief from Phantom Limb Pain Inspired By Professor Ramachandran

Feature Image of Professor Ramachandran sourced from: 

Thanks to Professor Ramachandran’s inspiring research into mirror therapy, the world is now a better place for many amputees with phantom limb pain and other patients!

For related blog posts, see:

Dear Pain Matters blog readers,

This blog post discusses:

  • A clinical trial involving mirror therapy;
  • Two (2) amputees who had successful mirror therapy for phantom limb pain; and
  • Professor V.S. Ramachandran’s ground-breaking research into mirror visual feedback via mirror therapy.

Phantom pain affects at least 90% of all amputees.  It includes a myriad of painful sensations including the following:

  • The limb feels frozen in an awkward position;
  • Burning;
  • Stabbing;
  • Shooting; or
  • Electrical shocks.

The good news is that mirror therapy (aka mirror visual feedback) may offer a cheap and effective treatment option for some amputees with phantom limb pain and other pain sufferers.


Sgt. Wallace Fanene’s Story  

Sgt. Wallace (‘Wally’) Fanene, a 25-year old Samoan in California, was severely injured on September 8, 2007, while serving in Iraq.  He lost both his right arm and his right leg in an improvised explosive device (IED) blast.  At first, Wally did not feel any pain, although he had a burning sensation in his injured legs.  In his words,

‘I knelt down on a landmine;  I sat on it.  I knew my leg was gone right when I was hit, but I didn’t feel any pain, and I didn’t know about my arm.’

Things got even weirder at the hospital when Wally asked his wife to scratch his bandaged right hand to relieve itching.  What Wally did not realise was that his lower right arm was also missing!

[My wife] told me my arm was gone. We argued about that for five minutes. I mean, I could feel it.’

It was at the hospital when the pain kicked in big time, even affecting his sleep.  There were nails in his phantom toes as well as needles and a knife-like pain in his missing leg.

Wally added,

‘It was the most excruciating pain in my life.’



Enter Mirror Therapy  

Not knowing what to expect, Wally enjoyed immediate pain relief as soon as he started mirror therapy.  

In Wally’s words,

‘I was sceptical at first, but then I said, what the heck. So we tried it and [mirror therapy] worked right away. The pain just stopped. Four hours later the pain came back again, and again the mirror helped right away … 

… The pain still comes back, but it’s nowhere as bad as it was.  It comes back several times a day.  But if [the phantom limb pain] starts to bother me, I use the mirror.’


Wallace Fanene, double amputee, and his wife



Inspired by Professor Ramachandran’s ground-breaking research into mirror visual feedback in the mid-1990’s, Jack Tsao, Neurologist, offered mirror therapy for his patients who suffered phantom limb pain.

Soon after, Tsao set up a clinical trial involving mirror therapy for phantom pain at the Uniformed Services University in Maryland.

Specifically, 22 lower limb amputee patients with phantom pain from Walter Reed Army Medical Center (WRAMC) were randomly allocated to 1 of 3 groups.  Four (4) patients were unable to complete this study.

The 1st group (N=6) received mirror therapy.  The remaining 2 groups underwent covered mirror treatment (N=6) and mental visualisation (N=6).

Each group was instructed to do their assigned therapy for 15 minutes daily for 4 weeks.

This study found that ALL 6 amputees in the first group who received mirror therapy enjoyed reduced phantom limb pain after one month!  Some even experienced complete relief from phantom pain after mirror therapy.

In comparison, half of the 2nd group who received covered mirror treatment and 2/3 of the 3rd group who performed mental visualization exercises had increased pain after 1 month.

Nine (9) amputees from the 2nd and 3rd groups were subsequently re-assigned to classical mirror therapy for 4 weeks.  Eight (8) of these 9 amputees (89%) enjoyed less pain thereafter.

The first group performed 4 additional weeks of mirror therapy, totalling 8 weeks.  This resulted in further improvements for all 6 participants.  

Jack Tsao, Neurologist, said that the results ‘astounded me … I didn’t expect [the results] to be that good.’

Mirror therapy is now available at 3 US military amputee centres including WRAMC as well as other locations for amputees and patients with other painful conditions (Chan et al, 2007; Dobyns, 2008).

Nick Paupore, Amputee and Participant in Above Trial

Nick Paupore (32), a participant in the aforementioned trial, enjoyed significant relief from excruciating phantom pain following mirror therapy.

Nick lost his lower right leg in Iraq when a roadside bomb hit his vehicle.  While he felt a burning sensation in the back of his legs, Nick did not feel any pain.  Unfortunately, the blast tore out a chunk of his leg including 15cm to 20cm of an artery that almost caused him to bleed to death.

At the hospital, Nick suffered excruciating phantom pain in his missing leg 5 – 6 times an hour, with each bout of pain lasting up to a minute.  As he screamed and dry-heaved, the searing shock raced from the missing sole in his foot up the back of his phantom calf and into his thigh.

Quoting Nick,

‘I was laying in bed and it just, all of a sudden, it felt like I was getting shocked.  I called the nurse, ’cause I was like, ‘What’s going on?’  

The nurse told Nick that it was likely his phantom pain.

Nick continued,

‘All of a sudden, it was like someone kept turning on and off the Taser, and my whole leg started twitching. … I sat up, and I was holding on to my stump, and it just wouldn’t stop.’

‘It was like sticking my finger in a light socket. … getting electrocuted.’

‘… the [phantom] pain was driving me insane.’

And now for the good news:

Nick was almost pain-free after mirror therapy for a month.  Furthermore, he no longer needed pain medication 5 months later.

Jack Tsao

Jack Tsao, Neurologist, with Nick Paupore during mirror therapy

Quoting Tsao, Neurologist,

‘The difference is like night and day … To see him walking, he’s able to drive his car; he works downtown; I mean, that is incredibly gratifying!’ (Burgess, 2008; Young, 2008).



Professor Ramachandran did research in the mid-1990’s based on amputees who had lost their limbs many years earlier.  His studies led to mirror therapy as a pain treatment option for phantom limb pain and other painful conditions.


Neuroscientist V.S. Ramachandran


Many ground-breaking research findings were reported by Ramachandran including:

(1) An amputee named ‘D.S.’ lost his left arm 9 years ago.  His phantom arm felt as if it was ‘frozen … in a cement block’.  Ramachandran offered mirror therapy involving bilateral mirror-symmetric movements.  During this therapy, D.S. felt movement in the muscles and joints of his phantom arm while looking at his intact arm in the mirror.

When Ramachandran removed the mirror, D.S. was no longer able to feel his phantom arm move.  In his words, ‘It feels frozen again.’   

This experiment demonstrates the importance of visual feedback via mirror therapy in restoring movement in ‘frozen’ phantom limbs.  This movement may even be a prerequisite before phantom limb pain can be reduced or eliminated altogether.

(2) A left arm amputee known as ‘R.T.’ (55) suffered a paralysed phantom arm.  His left hand often had clenching spasms with ‘fingernails digging into the palm’.

Mirror visual feedback was done to provide an illusion of a restored left arm.  The reflection of his intact right arm in the mirror provided the visual feedback that R.T. desperately needed before he could finally ‘unclench’ and ‘move’ his paralysed phantom arm in a mirror-symmetric manner.

(3) Five patients suffered painful ‘clenching spasms’ in their phantom hand.  Following mirror therapy, 4 of 5 patients were finally able to ‘open’ their phantom hand leading to relief from painful spasms.

Mirror therapy may lead to new connections in the brain.  This may include novel and/or reactivation of pre-existing neural pathways between both cerebral hemispheres (Ramachandran & Hirstein, 1998).

Graded Mirror Therapy vs Traditional Mirror Therapy

A male patient (43) suffered deafferentation pain in his right arm following brachial plexus avulsion due to a traffic accident 23 years ago.  Specifically, he endured severe tingling pain including numbness in his right fingers (pain rating of 10/10).

Traditional mirror therapy for 4 weeks failed to offer pain relief.

Graded mirror therapy, on the other hand, ultimately led to complete relief from pain.

Graded mirror therapy comprises 5 steps, being:

  1. Observing the mirrored reflection of the unaffected side without imagining any movements in the amputated limb;
  2. Observing the mirrored reflection of the 3rd and 4th fingers while slowly moving them from a flexed position to an extended position;
  3. Observing the mirrored reflection of the unaffected side during passive movements;
  4. Motor imagery of the affected fingers while observing the mirrored reflection of the unaffected side; and
  5. Motor imagery of the affected fingers without a mirror.

Graded mirror therapy involving the aforementioned 5 steps was done for 3 – 4 weeks.

The good news is that during graded mirror therapy, pain levels decreased and finally disappeared altogether.  The patient was also able to imagine finger movement both with and without a mirror (Mibu et al, 2016).

Possible Mechanisms

Although there is no shortage of possible explanations, no one really knows why mirror therapy may work better in some patients than in others.

Professor Herta Flor, Neuroscientist, believes that both peripheral input and central changes may be involved in phantom limb pain (Perur, 2014).

Competitive interaction may arise between the two brain hemispheres in stroke patients (and presumably also in amputees).  This can lead to abnormal interhemispheric inhibition (IHI) and weakened motor function.

In stroke patients, mirror therapy and motor training could increase the excitability of the stroke-affected primary motor cortex (M1).  Specifically, mirror visual feedback training could alter the excitability of the transcallosal pathway and restore IHI back to normal.  This could in turn strengthen motor function in the stroke-affected side.

Thus, mirror visual feedback training may help normalise IHI and restore the hemispheric balance between the stroke-affected (or amputation-affected) M1 and the healthy M1 (Avanzino et al, 2014).

Another study reported that mirror visual feedback via a mirror led to improved motor function in 2 patients who had callosal disconnection.  Based on this, they concluded that mirror therapy that leads to improved motor performance does not affect interhemispheric interaction via corpus callosum (Nojima et al, 2013).  Whether this also occurs in amputees is unknown.

See 5-minute TED-Ed Animations video called ‘The fascinating science of phantom limbs’ by Joshua Pate.

Some Questions to Ponder

Could an amputation lead to abnormal IHI and a hemispheric imbalance between the amputation-affected M1 and the healthy M1?

If yes, could this contribute (in part or in full) to ‘painfully frozen limbs’, ‘paralysed phantom limbs’ and phantom limb pain in amputees?

If so, could mirror visual feedback training using mirrors reduce phantom limb pain and other symptoms in some amputees?

Another Question

In my blog post called:

A Doctor and a Nurse who can Literally Feel Pain in Other People,

we learn that Dr Joel Salinas, a neurologist, has mirror touch synesthesia.  This means that he can literally feel his patients’ pain and tactile sensations.  Automatically triggered by sight, he said that, for example, when he sees someone’s right arm being touched, he also feels a touch on his own left hand – just like in a mirror.

Could Dr Salina’s experience with mirror touch synesthesia offer certain insight into why mirror therapy may offer relief from phantom limb pain in many amputees? 


Mirror therapy including graded mirror therapy may be a very effective treatment option for amputees with phantom limb pain and other chronic pain sufferers.

Benefits derived from mirror therapy vary from one patient to the next.  According to Professor Christoph Maier, while some amputees are pain-free after only 1 mirror therapy session, others may need to do mirror therapy for the rest of their lives to reduce phantom pain (Liebling, 2010; translated from German).

Who would have thought that a humble mirror could offer relief from excruciating phantom limb pain for some amputees??

Sabina Walker

Blogger, Pain Matters (in WordPress)



Patient Stories

(1) Dobyns, Stephen. Certain San Diegans feel their missing limbs. San Diego Reader (9 July 2008).

(2) Saundra Young. For amputees, an unlikely painkiller: Mirrors. CNN (19 March 2008).

(3) Burgess, Lisa. Mirrors helping amputees fight phantom pain. Stars and Stripes (2/2/2008).

(4) Colapinto, John. Brain Games – The Marco Polo of Neuroscience. The New Yorker (11 May 2009).

Peer-Reviewed Science Papers

(5) Chan BL et al. Mirror therapy for phantom limb pain. N Engl J Med (22 Nov 2007); 357: 2206-2207.

doi: 10.1056/NEJMc071927 

(6) Uniformed Services University of the Health Sciences. Phantom Limb Pain May Be Reduced By Simple Mirror Treatment. Science Daily (24 November 2007).

(7) Ramachandran VS & Hirstein W. The perception of phantom limbs. Brain (1998); 121: 1603-30.

(8) Avanzino et al. Training based on mirror visual feedback influences transcallosal communication. Eur J Neurosci (Aug 2014); 40(3): 2581-8.

doi: 10.1111/ejn.12615.

(9) Nojima et al. Mirror visual feedback can induce motor learning in patients with callosal disconnection. Exp Brain Res (May 2013); 227(1): 79-83.

doi: 10.1007/s00221-013-3486-4

(10) Perur, Srinath. The mirror man. mosaic (7 July 2014).

(11) Mibu et al. Successful Graded Mirror Therapy in a Patient with Chronic Deafferentation Pain in Whom Traditional Mirror Therapy was Ineffective: A Case Report. Pain Practice (April 2016); 16(4): E62-E69.

Non-Fiction Book

(12) Ramachandran VS & S Blakeslee. Phantoms in the Brain – Human Nature and the Architecture of the Mind. HarperCollins Publishers (20 May 1999); pages 1 to 352.

ISBN 9781857028959

(13A) Ramachandran VS. The Tell-Tale Brain – A Neuroscientist’s Quest for What Makes Us Human. W.W. Norton & Co (5 April 2012); pages 1 to 357.

ISBN: 9780099537595

(13B) V.S. Ramachandran’s Tales Of The ‘Tell-Tale Brain’. NPR (14/2/2011).

Medical Articles (in German) 

(14) Mit der Spiegeltherapie sind Schmerzen “verlernbar”. Ärzte Zeitung online (22.02.2010).

(15) Liebling, Patricia. Spiegeltherapie hilft gegen Phantomschmerzen. Aachener Zeitung (27 Feb 2010).

(16) Hawlik, Michaela. Leben mit Phantomschmerz. My Handicap (1/2011).

Other Medical Articles (not discussed in this blog post)

(17) Peterzell, David H. Psychophysical investigations into Ramachandran’s mirror visual feedback for phantom limb pain: video-based variants for unilateral and bilateral amputees, and temporal dynamics of paresthesias. 2016 Society for Imaging Science and Technology (Feb 2016).

doi: 10.2352/ISSN.2470-1173.2016.16HVEI-093

(18) Timms, Jason & Carus, Catherine. Mirror therapy for the alleviation of phantom limb pain following amputation: A literature review. International Journal of Therapy and Rehabilitation (March 2015); 22(3): 135-145.

(19) Datta & Dhar. Mirror therapy: An adjunct to conventional pharmacotherapy in phantom limb pain. J Anaesthesia Clin Pharmacol (Oct-Dec 2015); 31(4): 575–578.

(20A) Ol, Ha Sam et al. Mirror therapy for phantom limb and stump pain: a randomized controlled clinical trial in landmine amputees in Cambodia. Scandinavian Journal of Pain (3 July 2018); 18(4): 603-610.

doi: 10.1515/sjpain-2018-0042

(20B) Ol, Ha Sam et al. Mirror therapy: Curing phantom pain in landmine victims. Science Discoveries (26.10.2018).



A Phantom Leg And Frozen Fingers Treated By Mirror Therapy

‘Disability is only a state of mind.’

Bryan Wagner, Amputee 

Feature Image showing mirror therapy sourced from:

For related blog posts, see:


Dear Pain Matters blog readers,

Phantom limb pain (PLP; phantom pain) is a terrible affliction that affects up to 90% of all people who have lost a limb, or part thereof, due to trauma, injury, disease or surgery.

Mirror therapy may be an effective and inexpensive pain treatment option for patients with phantom pain, complex regional pain syndrome (CRPS), pain and lost motor function after stroke, hand immobility and pain caused by spinal stenosis and other conditions.

Mirror therapy is sometimes called mirror visual feedback or graded motor imagery.


Bryan Wagner, Amputee and War Veteran  

Bryan Wagner (23) lost his lower right leg in an improvised explosive device (IED) explosion on 17 December 2007 while serving in Baghdad.  Thereafter, Bryan suffered phantom pain in his missing toes and in the arch of his heel.  The pain included knife-like stabbing pain between his toes and poker-like pain.

Mirror therapy is offered to patients just like Bryan at the Walter Reed Army Medical Centre (WRAMC).  This therapy is done 15 minutes a day, 5 days a week, for 8 consecutive weeks.  If necessary, this cycle is repeated.

During mirror therapy, Bryan stated:

‘It … really feels like you are moving your [missing] foot … It feels like your foot is there …’

If you look very closely at the video below, you will see Bryan’s stump actively participate in all the foot exercises at the same time as the good leg.

It is as if the residual stump is doing all the exercises that the missing foot would be doing, if it were to still exist.  Thus, the stump is acting in lieu of the missing foot!  I don’t know about you but I find this very fascinating!

In other words, the leg stump (that is 100% hidden from Bryan’s view) is moving in complete harmony and unison with the foot’s reflection.  Could it be that optimal results from mirror therapy are possible when this occurs?  (Go to 1:28 minutes.)

Mirror therapy enables the brain to finally ‘feel movement’ again in the (phantom) limb.  Using mirror therapy to restore movement in a missing limb (and in a stump) may be key to reducing phantom limb pain.

Treating Phantom Limb Pain with Mirror Therapy 

Above, a 2-minute YouTube video and narrative by UPIVideo dated 27 July 2009.  NB The narrative may only be available if you open the video in a separate window.



Bob McKeefery, a long-time fisherman, has spinal stenosis (i.e. tightening or narrowing) of the spinal canal.  Spinal stenosis can lead to compression and ‘pinching’ of the spinal cord and nerve roots.  This can cause pain, cramping, weakness and numbness as well as abnormal signalling between the brain and the body.

Bob suffered ongoing pain and limited mobility in his right hand following several surgeries over a year ago.

In his words,

‘I could move my right arm, but I couldn’t move my right hand.  So 3 of my digits, the last 3, were like ‘frozen shut’ and 2 were frozen open.’

The good news is that mirror therapy led to immediate benefits including complete pain relief for Bob!  

Quoting Bob,

‘All my pain, a year’s worth of pain, went away in one day!’

After only 1 week of mirror therapy, Bob was finally able to use muscles and do movements that he had long given up on.

Bob said,

‘It was impossible last week for me to do this.  I could not ‘palm up’. …’ 

As Bob continued with mirror therapy, 10 minutes each session, several times a day, he has one goal that keeps him going.

Quoting Bob,

‘[My goal] would be to pick up my grandchildren … because I’m not allowed during this crisis … and they are 1 and 3.’

Thanks to mirror therapy, Bob is now one step closer to his goal!

For more details, watch Mirror Therapy Helps Patients Reduce Pain, Gain Mobility in Limbs, by NJTV News (30 April 2015).


I hope that these stories will inspire others to try mirror therapy for their phantom pain and other painful conditions.  After all, there is no downside in trying mirror therapy.

Sabina Walker

Blogger, Pain Matters (in WordPress)




* Tibia bone – One of 2 bones in the lower leg.


Mirror Therapy For Phantom Limb Pain – ‘What Your Eyes See IS Reality’

‘What Your Eyes See Is Reality’

Erez Avramov, Life Rebuilder

Feature Image of Erez Avramov and the mirror box was sourced as a still frame from the YouTube video dated 8 July 2013 (below).

For related blog posts, see:


Dear Pain Matters blog readers,

Phantom limb pain (PLP; phantom pain) is a terrible affliction that affects up to 90% of all people who have lost a limb, or part thereof, due to trauma, injury, disease or surgery.

Mirror therapy may be an effective and inexpensive pain treatment option for some patients with phantom pain, complex regional pain syndrome (CRPS), pain after stroke and other pain conditions.


Erez’s Traumatic Life Events 

Erez Avramov, Life Rebuilder, survived 3 serious motor vehicle accidents (MVA) and a serious heart attack.  Sounding more like an action thriller story than an enriched life story, Erez is a perfect example of ‘what doesn’t kill you, makes you stronger’.


During his first accident, Erez was involved in a serious head-on crash with a semi-truck after his vehicle hit black ice and spun out of control near Merritt, BC, Canada, in November 2010.  He suffered many injuries including fractures to the sternum, hand and ankle, a crushed rib cage as well as a leg that was broken in 17 different places.

Several years and multiple surgeries later, Erez opted for elective amputation to improve mobility of his MVA-injured right leg below the knee (ADV Pulse, 2014)

Erez holds the honour of being the first amputee ever to enter the Dakar Rally race in South America.  Sadly, he had his second near-fatal accident when he crashed his motorbike during one of these desert races.

More recently, Erez had another vehicle accident in December 2017 that was followed by a serious heart attack just one (1) month later.

Being optimistic by nature, Erez always tries to gain valuable insight even from the worst moments in his life.  For his inspirational views, please visit his website:

Erez’s Mirror Therapy for Phantom Limb Pain  

Following his elective lower right leg amputation, Erez suffered phantom pain.

In his words,

‘… the results and the process [of mirror therapy are] just amazing.’

Erez used a custom-made 3-sided mirror box that included a white-framed mirror.  Hinged on both sides, the mirror box can be unfolded and assembled like a ‘triangular tunnel’.  A plain mirror may also be used.

Erez’s good leg was placed right next to the mirror while his amputated right leg remained well hidden inside this triangular tunnel.

As Erez moved his toes very slowly, he tried to imagine moving the same muscles in his phantom toes at the same time.

Given that he spoke about mirror therapy with such amazing clarity, I will quote Erez from here on (see his YouTube, below),

‘… This is the important part … you move your toes and you try with your mind to move … your missing toes – but when you look at them in the mirror, it’s as if they are there … and you feel your muscles in your residual limb …  Move those toes as if they are there.  

Then I will start to do some rotational work , and I will move both legs in the same direction as if everything is there.  

Because what happens is:  Your brain sees this leg and your foot.  It thinks it is there.

This is the most bizarre thing there is.  It is as if you still have it … You  really have to be open-minded and to accept the fact that what your eyes see is reality … It’s almost like you bypass this reasoning side of your brain …

I will move my muscles.  I will move my residual limb as if I have an intact full foot …

The results were amazing … [inserted: my painful ‘tiger-clawed’ phantom toes were] released, so the pain is gone …

… the protocol is 4 weeks of 10 minutes every day.  You do this for 4 weeks …

… You cover your residual limb.  You use … a … magazine cover, or whatever, … to hide your good foot so you don’t see it, and all you want to see is your reflection of your foot, as if you still have [a] missing limb …’ 

Watch Erez Avramov’s helpful video, here:

‘Mirror Therapy – Personal Success Story’

An 8-minute YouTube dated 8 July 2013


Thank you very, very much, Erez, for sharing your powerful story about your personal experience with mirror therapy!

I am sure that your story will inspire others to try mirror therapy for their phantom pain.

Sabina Walker

Blogger, Pain Matters (in WordPress)




(2) Amputee Pursues Lifelong Dream to Race the Dakar Rally. ADV Pulse (27/10/14).





Mirror, Mirror, Short Or Tall, Which One Has No Pain At All?

Title adapted from:

Mirror, mirror on the wall, who is the fairest of them all?

Feature Image sourced from:

For related blog posts, see:


Dear Pain Matters blog readers,

Up to 90% of all amputees suffer from phantom limb pain (PLP), or more simply, phantom pain.

Mirror therapy is an inexpensive pain treatment option for some patients with phantom pain, complex regional pain syndrome (CRPS), pain after stroke and other painful conditions.

Stephen Sumner (aka Mirror Man), an amputee and humanitarian from Vancouver, Canada, was so impressed with the pain-relieving effects of mirror therapy on his phantom pain that he set up his mission called ‘Me and My Mirror’.


Reality is merely an illusion, albeit a very persistent one.

Albert Einstein

Stephen’s Story, Before Mirror Therapy

Stephen endured a left above-knee amputation after a truck crashed into his scooter in a hit-and-run accident that left him for dead on a quiet country road near Siena, Italy, one balmy evening in 2004.

Using his words, Stephen ‘suffered terribly … suicidally’ from severe PLP for 4 – 5 years thereafter.  He used to endure ongoing electrifying shocks that shot up his missing left leg and throughout his body.

Quoting Stephen, it was like having ‘lightning bolts through my foot’ in a leg that no longer existed.  His entire body would jolt and spasm uncontrollably, as if he was ‘being spiked with a cattle prod day and night’.  Stephen would be reduced to screaming and tears with no sleep at all during these severely painful bouts.

Stephen added, ‘I could have killed myself.’

Stephen’s phantom toes would be ‘stuck’ in an excruciatingly painful and clenched position.  The pain ‘was like a vice over the back of my heel.  It was like it was being crushed.’  Stephen’s phantom pain felt like ‘crippling electric pulses’ … ‘burning and crushing, but the worst is the itching’.

Stephen stated that his phantom pain was ‘… not in the head, it’s in the limb.’

Stephen’s Story, After Mirror Therapy

Then one day, Stephen read about mirror therapy on-line.  The first time he placed a mirror against his left thigh and looked at the reflection of his right leg (where the left leg used to be), he felt immediate relief.  Five (5) minutes later, his pain was gone.  Stephen did mirror therapy twice daily for 10 minutes at a time.  Finally, after 5 weeks, his phantom pain disappeared for good. 

Quoting Stephen, mirror therapist:

‘… within … 3 and 5 weeks, the pain … disappeared … my phantom pain had gone away, almost magically …’ 

Stephen continued,

‘… 10 minutes per session, 2 sessions per day, 5 weeks, and you’re done for life … If I get some kind of a flare-up, I just whip out the mirror, and I’m good again …’

(Go to the following 10-minute video called The Me & My Mirror Back Story; 2:30 minutes).

Stephen offers mirror therapy to amputees with phantom pain in 3rd world countries including Cambodia, Laos, Vietnam, Sri Lanka, Burma, Myanmar, Vietnam, southern part of India, Lebanon, Ethiopia, Syria, Egypt, Tunisia, Algeria and the western Sahara region.

Stephen often treats amputees with PLP due to traumatically torn or mutilated limbs resulting from war, landmine blasts, unexploded ordnances (cluster bombs, cluster munitions) and road accidents.  Stephen also treats patients who lost their limbs due to severe diabetes and other diseases.

Stephen collaborates with medical experts in the local hospitals, trauma centres, physical rehabilitation centres and prosthetic clinics.  Recently, he was at the ‘Jaffna Teaching Hospital’ with Physical Rehabilitation Therapists and Orthopedic Surgeon.  He also teaches locals how to make therapeutic mirrors for pain relief.

Stephen uses this simple mantra for mirror therapy:







In Stephen’s words,

‘… You feel immediate relief, but you have to carry on for 4 or 5 weeks.  So, my mantra is:

  • 2 sessions a day 
  • 10 minutes per session
  • 5 weeks.’

(Global News, 2016)



Stephen uses acrylic mirrors due to their cost-effectiveness, safety, lightweight nature and transportability (i.e. on the back of his beloved bicycle).




According to Stephen, it is often difficult for amputees in Cambodia and other 3rd world countries to open up about their phantom pain.  Many amputees with phantom pain are ashamed.  They would rather suffer in silence than risk being labelled as ‘outright crazy’ or ‘insane’ for ‘complaining’ about pain in a limb that does not even exist.

Also, the fact that many amputees here are Buddhists raises the topic of karma including what the amputees ‘must have done in a previous life to deserve this fate’.

When Stephen is seen riding around on a bicycle with his prosthesis clearly visible to all, the locals are more likely to empathise and connect with him.  When Stephen tells them that he used to suffer from phantom pain, they finally open up about their own phantom pain.





A Cambodian Amputee Named Pov Sopheak 

Pov Sopheak (50), a former soldier and security guard in Cambodia, is also an amputee with phantom pain.  He traumatically lost his left leg in a landmine explosion in 1990.  Pov’s severe phantom pain including sharp pains in his phantom big toe and little toe affected the quality of his life including sleep for 2 decades.

In Pov’s words,

‘[It] feels like my leg is shaking.’   

Pov’s life finally turned a corner after meeting Stephen.

With Stephen’s guidance, Pov used the mirror to ‘trick’ his brain into thinking that his left leg was not missing after all, but rather, still very intact.  While moving his right leg including wiggling his toe and flexing his foot in front of the mirror, Pov was able to ‘fool’ his brain into thinking that the reflection of his good leg was that of his missing left leg.

This simple yet elegant treatment helped to relax Pov immensely.  Furthermore, Pov’s brain was able to imagine and ‘perceive movement’ in his missing left leg again, after decades of ‘immobility’ and ‘non-use’.  Mirror therapy was able to jump-start brain circuitry pertaining to his left leg.  For Pov (and many others just like him), this was a prerequisite for phantom pain relief.

Quoting Pov,

 ‘It’s a new sensation. It’s strange but in a good way … I see my leg in the mirror and I feel happy, like my mind is at ease.’

Pov made a commitment to mirror therapy for 4 – 5 weeks in the hope that his phantom pain would lessen with time.

Additional Thoughts

In the absence of incoming signals from both legs (and/or in the presence of abnormal signals coming in from the stump itself), a brain may become chronically stressed.  This often leads to phantom pain.  

On the other hand, many amputees with phantom pain instantly feel better during mirror therapy.  The reflection of the intact limb in the mirror helps to ‘convince’ their brain that it is finally perceiving two (2) normal limbs.  

Importantly, many amputees are finally able to ‘move’ their phantom limb for the first time in years, and perhaps decades, during mirror therapy.  This can lead to a state of calm and relaxation, together with immediate pain relief.  

In Stephen’s words,

‘Looking in the mirror, the brain suddenly enables you to move your phantom foot and do everything the real foot is doing.’

‘The brain just wants to be tricked. It’s dying for release’ (Fitzpatrick, 2012).




Photo sourced from:

If you would like to support Stephen’s important mission to deliver mirror therapy and a therapeutic mirror to PLP amputees in 3rd world countries, please go here:

More details are available on Stephen’s website and in his book called Phantom Pain: A Memoire: It’s All in Your Head.

You can also follow Stephen on social media including Twitter and Facebook.

Biking Laos – Mirror Man Cycling Laos 

2 Times, 10 Minutes, 4 Weeks (21/1/2013)


Several questions to ponder over include:

  • What % of amputees are finally pain-free after 4 – 5 weeks of mirror therapy?
  • What % of amputees remain pain-free 6 – 12 months after mirror therapy?
  • If the benefits are not lasting in some amputees, can mirror therapy be done repeatedly to relieve phantom pain?
  • Are left-sided amputees more likely to benefit from mirror therapy than right-sided amputees (or vice versa)? If so, why?  If not, why not?
  • Is the corpus callosum in the brain involved?


Stephen’s easy-going, can-do attitude as well as his passion and commitment to treat amputees with PLP via mirror therapy have made him a welcome hero in many 3rd world countries.

In his friend’s words,

‘He’s not your regular officious [non-government organisation] guy.  He rides up on his bicycle with a smile on his face and a bunch of mirrors.’

In my view, Stephen is one amazing guy with one big heart!

… And I am not the only one who thinks this!

A fiction movie called ‘ Phantom Pain’ (in German, ‘Phantomschmerz’), released in 2009, was completely inspired by Stephen’s early experiences as an amputee.

Sabina Walker

Blogger, Pain Matters (in WordPress)



Your perception IS your reality.




(1A) Sumner, Stephen. Me and My Mirror.

(1B) Fitzpatrick, Michelle. Mirrors ease Cambodian amputees’ phantom pain. The China Post and AFP (28/2/2012).

(1C) Perur, Srinath. The mirror man. mosaic (7 July 2014).

(1D) Otis, Daniel. Meet the ‘Mirror Man’ who’s on a mission to help fellow amputees. CTV News (25 December 2018).

(1E) Ross, Amy. Mirror Medicine: A Cure for Phantom Limb Pain? Pacific Rim Magazine.

(1F) Mullen, Dene. The man with the mirror. Southeast Asia Globe (12 July 2013).

(1G) Man in the Mirror. Asia Life (2/2/2012).

(1I) Lazaruk, Susan. Local amputee bikes through Asia helping others who have lost limbs. Vancouver Sun (22 April 2019).

(1M) Boynton, Sean. Vancouver humanitarian promotes therapy for amputees, thanks to gift from Yaletown shooting survivor. Global News (22 April 2019).

(1N) Other articles:


(2A) Me and My Mirror 2018 (6-minute YouTube)

(2B) Mirror-therapy and how it helps amputees. Global News (12 January 2016) (3-minute video)

(2C) Mirror therapy hoping to help amputees with pain. Global News (30 Oct 2014 (a 6-minute video).

(2D) Other videos:

Film (Fiction, in German; Inspired by Stephen Sumner’s Experience)

(3) Emcke, Matthias. Phantom Pain (Original Title: Phantomschmerz) (2009).