2015 Issues   /   Pain Management

Direct Visual Observation Therapy Relieves Phantom-Limb Pain

By US Medicine

BETHESDA, MD – With as many as one-third of unilateral=limb amputees suffering regularly from phantom limb pain, military medicine has been in search of an inexpensive and effective treatment.

A study published recently in the Annals of Clinical and Translational Neurology suggests they might be on the way to a solution.1

Background in the study, led by researchers from Walter Reed National Military Medical Center, noted that mirror therapy has been demonstrated to reduce phantom limb pain (PLP) experienced by unilateral limb amputees. Research suggests that the visual feedback of observing a limb moving in the mirror is critical for therapeutic efficacy, they point out.

With mirror therapy not an option for bilateral lower limb amputees, however, the purpose of the study was to determine if direct observation of another person’s limbs could be used to relieve PLP.

To test the theory, researchers randomly assigned 20 bilateral lower limb amputees with PLP to either visual observation or mental visualization treatment. Treatment consisted of seven discrete movements which were either mimicked by the amputee’s phantom limbs moving while visually observing the experimenter’s limbs moving or by closing the eyes while visualizing and attempting the movements with their phantom limbs.

Participants performed movements for 20 minutes daily for one month. Response to therapy was measured using a 100-mm visual analog scale (VAS) and the McGill Short-Form Pain Questionnaire (SF-MPQ).

Results indicated that direct visual observation significantly reduced PLP in both legs, while amputees assigned to the mental visualization condition did not show a significant reduction in PLP.

“Direct visual observation therapy is an inexpensive and effective treatment for PLP that is accessible to bilateral lower limb amputees,” the authors concluded.

  1. Tung ML, Murphy IC, Griffin SC, Alphonso AL, Hussey-Anderson L, Hughes KE,

Weeks SR, Merritt V, Yetto JM, Pasquina PF, Tsao JW. Observation of limb

movements reduces phantom limb pain in bilateral amputees. Ann Clin Transl

Neurol. 2014 Sep;1(9):633-8. doi: 10.1002/acn3.89. Epub 2014 Sep 30. PubMed PMID:

25493277; PubMed Central PMCID: PMC4241790.


Related Articles

Acupuncture Generally Effective for Chronic Pain in Military

FORT BRAGG, NC — While acupuncture is characterized as an alternative or complementary medicine with a low complication rate and minimal side effects, questions remain on whether acupuncture is an effective treatment for chronic pain.... View Article

Veterans’ Chronic Pain: Opioids No More Effective Than Other Medications

MINNEAPOLIS — The VA has struggled to reduce the use of opioids in chronic pain patients over the long term, primarily because of concerns about risk of addiction and other adverse effects. A new veterans... View Article


U.S. Medicine Recommends


More From pain management

Pain Management

Acupuncture Generally Effective for Chronic Pain in Military

Vascular Events Lead to Stroke About a Fourth of the Time. INDIANAPOLIS — While many healthcare systems measure the quality of their stroke care, looking at performance early in the vascular disease process can help... View Article

Pain Management

Veterans' Chronic Pain: Opioids No More Effective Than Other Medications

Vascular Events Lead to Stroke About a Fourth of the Time. INDIANAPOLIS — While many healthcare systems measure the quality of their stroke care, looking at performance early in the vascular disease process can help... View Article

Pain Management

VA Hospitals First to Publicly Report Opioid Prescribing Rates

In January, the VA became the first hospital system in the United States to publicly post opioid prescribing rates.

Pain Management

Long-term Opioid Prescribing Declines in VHA, Bucking National Trend

Extended Prescribing Dropped from 9.5% in 2012 to 6.2% in 2016 By Brenda L. Mooney IOWA CITY, IA—Long-term prescribing of opioid painkillers is on the decline at the VA, in contrast to what appears to be happening outside of federal medicine.

Pain Management

MHS Leads the Way With Alternative Remedies for Pain, Mental Health

The military health system has taken a leading position with the availability and usage of complementary and alternative medicine (CAM)W.

Facebook Comment

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up