Mirror Box therapy

People with face pain which is solely on one side of their face, might benefit from a Pain Management technique called Mirror Box therapy.

This treatment does not require expensive equipment (just two mirrors, joined together at a right angle into a "mirror box"), but does require some investment of time.

For ten minutes, twice a day, for eight weeks, a patient touches, strokes, and massages the pain free side of their face, while looking at the reflection diagonally opposite them.

By touching the painfree side, but seeing the painful side being touched (thanks to the mirror box), the brain begins to interpret the pleasurable feeling as coming from the painful side.

After a few months, the brain begins to ignore the painful sensations of the TN, as it comes to expect the pleasurable sensations instead. Our nervous system is that flexible

This is used for a number of asymmetric pain conditions, but there's not said about its application to TN. It is more commonly used for amputees who can still feel pain in missing limbs, but I can't see why this hasn't been adapted to unilateral TN.

It may be well worth discussing this with your Pain Management specialist, and asking if they are familiar with this technique.

It may not work for everyone, but I feel it should be offered to patients long before they are at the end of their tether, and possibly even as an initial therapy before medicines are introduced.

It all sounds a bit freaky-deaky at first, but there's plenty of (reputable) research on the interweb to support it. The best thing is, there's no money to be made out of it, so there's no real incentive to 'sell' the idea.

The mind is a powerful tool!

Yes, it certainly is. But from what I understand, this is a way of training the nervous system, rather than a 'mind trick', or a psychology trick. Also, it appears to work better for people with phantom limb pain than other conditions, but even there, the evidence is not that compelling. This may simply be because of the strict criteria set down for evaluating clinical research, or it may be that it's simply not as effective as people thought it would be.

But, it would be good to see a treatment protocol developed for unilateral trigeminal neuralgia, have it tested by TN sufferers (who may be getting tired of anticonvulsants and antidepressants), and see the program evaluated by a capable research team.