September 5


Mirror Therapy: The Surprising Science Behind How It Works

By Joshua Turner

September 5, 2023

Mirror therapy is a non-invasive technique that has gained popularity in recent years for its effectiveness in treating various conditions, including phantom limb pain, stroke rehabilitation, and complex regional pain syndrome. It involves using a mirror to create the illusion of a functioning limb or body part, which can help reduce pain and improve movement.

The basic principle is that the brain can create new neural pathways and rewire itself in response to visual feedback. Using a reflector to reflect the image of the unaffected body part can trick the brain into perceiving the affected arm or leg as functional. It can help reduce pain and improve mobility, even when traditional treatments fail.

Key Takeaways

Understanding Mirror Therapy

Mirror therapy involves the use of a reflector to create a reflection of the unaffected hand or leg. This reflection is then used to create the illusion that the affected body part is moving. This technique is commonly used to treat conditions such as phantom limb pain, stroke, and complex regional pain syndrome.

It works by activating mirror neurons in the brain, which are responsible for creating the sensation of movement when we observe someone else performing an action. Using it creates the illusion of motion in the affected hand or leg, which can help activate these neurons and improve motor function.

It is typically performed by placing a reflector in front of the unaffected limb and positioning it so the reflection appears to be the affected arm or leg. The patient then performs a series of exercises or movements using the unaffected body part while watching its reflection. It creates the illusion that the affected arm or leg is moving, which can help to improve motor function and reduce pain.

The Brain’s Role in Mirror Therapy

The brain can change and adapt in response to new experiences, a process known as neuroplasticity. Mirror therapy takes advantage of this ability by providing the brain with visual feedback that can help to rewire the neural pathways associated with movement.

It also works by activating the sensorimotor cortex, the part of the brain responsible for controlling movement. When an individual performs an action, the sensorimotor cortex sends signals to the muscles to execute that movement. In this treatment, the reflector provides visual feedback that can stimulate the sensorimotor cortex and help to retrain the brain to perform the desired action.

Phantom Limb Pain

Phantom limb pain is pain or discomfort in the missing body part. It involves using a mirror to create the illusion of a complete limb, which can help to reduce pain.


The patient sits in front of a reflector and places the remaining body part in front of it while it reflects the image of the missing body part. The patient then performs a series of exercises with the remaining body part while looking at the reflection of the missing limb in the reflecting device.

Research has shown that this therapeutic intervention can also improve hand and upper extremity function in amputees. Mirror exercises can help patients retrain their brains to recognize and use their remaining body parts more effectively. It can be used for both upper and lower-limb amputees.

In addition to improving physical function, it can positively impact a patient’s mental health. Reducing phantom limb pain and improving function can help patients experience a boost in their overall quality of life.

Stroke Rehabilitation

Studies have shown mirror therapy can improve upper limb function in stroke survivors, particularly those with hemiparesis.

The visual feedback to the brain through the intervention can help rewire neural pathways and promote neuroplasticity, which is necessary for recovery after a stroke. It can also be used to reduce pain and improve sensory function in stroke patients.


Mirror therapy is not just for amputees. It is also an effective treatment for non-amputees who suffer from various conditions that affect their functional independence, mobility, and self-care.

It can be easily incorporated into a patient’s daily routine and can be done at home with minimal supervision. It is a safe and non-invasive treatment requiring no medication or surgery. Patients can use a mirror box or a simple reflector to perform the therapy.

Complex Regional Pain Syndrome

Mirror therapy can help alleviate the pain and discomfort associated with complex regional pain syndrome (CRPS). This condition is characterized by chronic pain often disproportionate to the initial injury or trauma.

Studies have shown that it can be an effective treatment for CRPS, with some patients experiencing significant pain relief and improved mobility. It is important to note that this should be used in conjunction with other treatments, such as physical therapy and pain medication, for best results.

Functional MRI Studies

Functional magnetic resonance imaging (fMRI) studies have provided insight into the neural mechanisms underlying mirror therapy.

One study found that it increased activation in stroke patients’ primary and premotor cortex, indicating improved motor function. Another study found that it increased activation in the supplementary motor area involved in motor planning and execution.

In addition to motor areas, it has been shown to activate the somatosensory cortex, which processes sensory information from the body. This suggests that it may improve sensory and motor functions.

A study using fMRI to compare mirror therapy to physical therapy found that both treatments resulted in increased activation in motor areas. Still, only this intervention resulted in increased activation in the insula, which is involved in pain perception. This suggests that it may be particularly effective for reducing pain in specific patient populations.

Understanding Action Observation

Action observation is the process of watching someone else perform an action and then replicating that action. In this therapeutic intervention, the patient watches their unaffected limb in the mirror while achieving the same action as their affected body part. This creates the illusion that the affected limb is functioning correctly, which can help retrain the brain to use the affected body part.


Reaching is a common action used by watching themselves reach for an object in the mirror, patients can train their brain to recognize the position of their affected body part and improve their ability to reach for things in real life.

It has been shown to be effective in treating visuospatial neglect and hemineglect. Patients can retrain their brains to recognize and use their affected body part by using the reflector to create an illusion of a complete limb. Action observation is vital in this process, allowing patients to watch themselves perform actions and create new neural pathways in the brain.

Quality of Life Improvements

Mirror therapy has been shown to positively impact the quality of life of individuals who have experienced a loss of body part function. It can help improve self-esteem and reduce feelings of depression and anxiety.

It can also help individuals regain a sense of control over their bodies, leading to increased confidence and greater independence. This can be particularly important for individuals who have experienced a loss of body part function due to a traumatic injury or illness.

In addition to these psychological benefits, it can help improve physical function. This can lead to improvements in activities of daily living, such as dressing, grooming, and eating.

Frequently Asked Questions

What conditions can be treated with mirror therapy?

It has been used to treat various conditions, including phantom limb pain, stroke, complex regional pain syndrome, and Parkinson’s disease. It has also been used to improve motor function in individuals with cerebral palsy and multiple sclerosis.

What are the benefits of mirror therapy?

The benefits include reduced pain, improved motor function, and increased range of motion. It has also been shown to improve body image and reduce the frequency and intensity of phantom limb sensations.

Can mirror therapy improve motor function?

Yes, it has been shown to improve motor function in individuals with various conditions. It works by activating the mirror neuron system in the brain, which helps to improve motor planning and execution.

How does mirror therapy affect the brain?

It affects the brain by activating the mirror neuron system, the neurons responsible for motor planning and execution. This activation can lead to improvements in motor function and changes in brain structure and connectivity.

What is the recommended duration of mirror therapy?

The recommended duration varies depending on the condition being treated and the individual’s specific needs. However, most studies have used it for 30-60 minutes per session, 2-3 times daily, for several weeks.

Are there any risks associated with mirror therapy?

There are generally no risks associated as it is a non-invasive and low-risk intervention. However, individuals with certain conditions, such as epilepsy or photosensitive migraines, may need to avoid using reflectors or flashing lights. It is always critical to consult with a healthcare professional before starting any new therapy.

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