Journal of Pain Management, Palliative Medicine and Supportive Therapies
âThe Magic Mirrorâ: Community-Based Mirror Treatment of Stump and Phantom Limb Pain In 1,600 War- And Mine-Am-putees In Rural Cambodia
Abstract
Yang Van Heng, Houy Chandy, Ha Sam Ol, Margit Steinholt and Hans Husum
Background: Cambodia has around 40,000 war amputees. The vast majority suffer stump and phantom limb pain affecting the quality of life of both amputees and their families.
Methods: Two pilot studies in the actual catchments area showed that mirror treatment significantly reduced pain in lower limb amputees. Therefore, a campaign of community-based mirror treatment was conducted from 2021 to 2025. By open inclusion a total of 1,600 participants with upper or lower limb amputation participated. At the first encounter pain was registered by VAS scale, pain education and mirror training were provided, and all participants took a mirror back home. VAS ratings were again registered after a four-week treatment period. The campaign was implemented in three rural provinces in Northwest Cambodia. Most participants were poor farmers who had suffered amputation years and decades earlier.
Results: In lower limb amputees the mean VAS score before treatment was 8.0 (95% confidence interval 82.8% to 83.9%), in upper limb amputees 6.9 (95% confidence interval 6.6 to 7.3). After mirror treatment we observed a mean VAS reduction of 83.3% in the lower limb amputees (95% confidence interval 82.8% - 83.9%), and 82.2% in upper limb amputees (95% confidence interval 80.0% - 84.5%).
Conclusion: Severe post-amputation pain is the rule in poor communities. Mirror treatment is an effective, cheap, and safe treatment method. The efficacy of home-based treatment makes it possible to conduct large-scale community- based treatment programs in low-resource settings.