A reader Barbara asks why new treatments such as graded motor imagery and mirror therapy aren’t more widely used. She writes:

Are you, I mean all these docs, saying that chronic pain can be cured by these treatments? By cured , I mean stopping the constant pain and returning function. If this is true and you’re talking about treatments that can’t harm, why aren’t many, many pain doctors, orthopedists and neurologists prescribing these? I understand that drug companies would be against it, but why haven’t we seen these treatments adopted by many, many doctors?

“Slipping Through the Cracks”

I’ve always believed that when a cure or very effective treatment for RSD and/or chronic pain is found, it would spread throughout the medical and pain community very quickly. Theses studies have been going on for 4 or 5 years, and yet I don’t know anyone who’s tried them. Are people being cured and does the improvement continue? Are you seeing placebo-type reactions? Are people looking better, but then having increased levels of pain?

The theory makes sense and neatly ties everything into a packet, but it also leaves the cure in the hands of patients. I do worry about what insurance companies will do with this theory – deny other medicine and treatment besides these to people who’re suffering. This is very confusing for those who either give or seek treatment, but want to stay away from anything invasive. Maybe we should all try these treatments and see what they could do for us. That is what I intend to do, and hopefully, I’ll be reporting a cure or at least help in my battles with pain.

Barbara’s points are very important!

First to answer, Do these treatments work? The short answer is a qualified yes, they work. They work to decrease pain or eliminate pain – in some people, in some conditions. Some people are helped more than others, although we don’t yet understand why. Some people get permanent improvement, some need booster sessions.

I believe that the biggest reason why the treatments aren’t more well-known and used more often is that these types of treatments fall outside of many doctors’ areas of expertise. They’ve “slipped between the cracks.” It’s not what doctors like neurologists, anesthesiologists, rheumatologists, orthopedists, or psychiatrists are accustomed to doing. It isn’t medication, it isn’t an injection, etc.

I believe that, while there has been some research, it hasn’t been a lot compared to, let’s say, medication. I’ve seen only approx 6-10 articles in major pain research journals in the last 5 years or so. And that was really because I thought these treatments were innovative and showed a lot of promise, so I searched them out. Barbara is right that it’s really not well known at all.

I wouldn’t be worried about denial of care.  (Unfortunately) nothing in pain medicine works for all, so this is one tool of many in your toolbox for relief and recovery.

It’s also not something that you do by yourself initially. I believe it’s best to have someone experienced in these treatments guide you in using them.

Finally, I do believe that many more people could benefit from them. I hope that by reading about them here, people will ask their doctors, and seek out PTs or others practitioners who use them. And organizations such as RSDSA are writing about them in newsletters and sponsoring conferences for practitioners to learn about them.

Thanks to Urban Eyes for the photo at Flickr.