Stage 3 - Mirror Box Therapy.

Although there is much research into the effectiveness of Mirror Box Therapy there is no best protocol. All the management of exercises and protocol is best tailored to suit the individual; this page is intended as a guide only.


Mirror Box Therapy is used for many conditions including, phantom limb pain; Complex Regional Pain Syndrome (CRPS) and for rehabilitation after a stroke; an injury; or surgery.

Visualization therapy has been described in medical literature to be of benefit to 80% of users, but does not always show immediate results. The rate and amount of recovery much depends on the extent of the damage, and the intensity and duration of the therapy you receive. Recovery also is likely to be influenced by personality, life experiences and coping styles. Motivation to recover is a key factor in obtaining an optimal level of rehabilitation.

Why it works

A little understanding of how the brain works will help you understand Mirror Box Therapy.

The brain consists of billions of neurons and trillions of connections. These neurons are able to store a map of our body, this is why we can close our eyes and still touch our nose, ear, knee or indeed any part of our body without looking. So if you were to lose a limb, the limb may have gone but the brain’s map still has the image of the limb. The brain continues to send electrical signals through neurons to the limb and the mismatch between the brain’s map and what actually exists, causes pain.

While putting the affected limb inside the mirror box and the unaffected limb in front of the mirror, and looking at the image in the mirror the brain receives visual feedback thus fooling it into thinking that the affected limb is still working, encouraging the brain to adjust to its new environment. This same principle of fooling the brain also works for CRPS/RSD and limb rehabilitation after surgery or an injury.

Mirror Box Therapy for stroke rehabilitation works differently as it is the brain that is damaged and not the limb. Along with the neurons we have mirror neurons; these mirror neurons fire just by seeing someone doing something, simulating the action in our minds (we empathize).Therefore by seeing the affected limb in the mirror essentially working, the brain is encouraged to rebuild the network within the brain and restart its communication with the limb. The brain will actively open new pathways that have lain dormant until now.

How to use a Mirror Therapy Box.

To use a mirror box is easy; the patient places the affected limb in the box and the unaffected limb in front of the mirror. Then whilst looking at the reflected image and doing gentle symmetrical exercises it appears that the affected limb is moving normally. Patients with no limb movement are to visualize and attempt to move the affected limb into a comfortable position whilst simultaneously moving the unaffected limb in the same way.

In Complex Regional Pain Syndrome CRPS, phantom limb and other Neuropathic pain conditions, this visual feedback helps the patient to  “move” the affected limb in the mind and to unclench it from potentially painful positions; satisfying the brain by making oneself believe that the limb is actually normal.

Patients’ recovering from a stroke or injury benefit tremendously, as the use of this technique shows improvement in the motor functions of the affected limb and aids a speedy recovery. In some cases results have been achieved by putting the good hand inside the box it is not understood how this works, showing that there is still much to learn about mirror therapy.

General suggestions:

  • Be guided by your therapist.
  • Do the same exercises shown by your therapist, but inside the mirror box.
  • Keep the exercises simple, Remove any jewellery.
  • Always look at the mirror image.
  • Practice symmetrical movements. In some cases, it can feel very unpleasant to leave the limb in the box still and exercise the limb in front of the mirror only.
  • Use the mirror box as often and for as long as it is comfortable, but do not turn it into a chore.
  • Move the affected limb as much as possible and then move the good limb a little bit further.
  • Always look at the reflection in the mirror.
  • Consider introducing aids such as physio balls.
  • Experiment with a softball in one hand and firm ball in the other.
  • Introduce a helping hand.
  • Move the hand in the box as well.
  • Increase the severity of exercise gradually.
  • Make sure the intention to move is always symmetrical even if the ability as been lost.

Opening and Closing.

These unique patented Folding Mirror Therapy Boxes are lightweight and fold in seconds, making them truly portable.

To open the small and medium box, pull yellow loop between the top and bottom leaves. Reverse procedure to fold.

Always fold mirror internal for transportation and storage.

Caring for your mirror.

The mirror is a high-quality Acrylic mirror with a vinyl cover for protection during transportation, and when removed you should reveal a clean, scratch-free surface.

Cleaning. (Always use cotton wool pads or clean soft lint-free microfiber cloth).
Your mirror will require no more than a gentle dust and polish and maybe the occasional clean with a proprietary cleaning product.
Occasionally there may be some residue left from the protective cover. There are many household products that will remove this, from simple Olive Oil to dedicated adhesive removers and even WD40. Then a clean with warm soapy water or a proprietary cleaning product. Full instructions and a list of tested products can be found online at the address below. The use of solvents such as Acetone, methylated spirits and paint thinners are not recommended and may cause surface damage.
For more information and cleaning tips go to: –

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