Relief from intractable phantom pain by combining psilocybin and mirror visual-feedback (MVF)
Summary & key facts
This paper reports one person who had long-lasting phantom-limb pain after a leg amputation. Simple tricks like using a mirror to show a fake leg and gentle “phantom massage” reduced the pain. When the doctors gave psilocybin (the active drug in “magic mushrooms”) and used the mirror trick together, the person’s phantom pain went away completely and sudden pain attacks became less common. Other sensory tricks also worked: touching a volunteer’s real leg created organized sensations in the phantom, a “telescoping nail” illusion reduced a specific painful memory, and fake flames felt warm in the missing leg. These results come from a single case, so we cannot assume the same would happen for other people.
- One person with an amputated leg had long-term phantom-limb pain after the amputation.
- Putting a volunteer’s real foot near the person’s phantom and touching it caused clear, matching sensations in the phantom limb.
- Using mirror visual feedback — showing a reflected intact limb so the brain sees a leg where the missing one was — reduced the person’s phantom pain.
- A technique called “phantom massage” also reduced the phantom pain.
- Giving psilocybin together with mirror visual feedback had a stronger effect than either alone for this person. In this case it eliminated the ongoing phantom pain and made sudden pain attacks less frequent.
- Touching the volunteer’s leg where the patient had earlier had external metal fixators produced the feeling of nails in the phantom. Creating the illusion of removing a nail reduced that pain.
- Showing artificial flames near the volunteer produced a feeling of warmth in the person’s phantom leg.
- This report is based on a single case, so the findings are not proof that the same methods will work for other people.
Abstract
AL's leg was amputated resulting in phantom-limb pain (PLP). (1) When a volunteer placed her foot on or near the phantom - touching it evoked organized sensations in corresponding locations on AL's phantom. (2) Mirror-visual-feedback (MVF) relieved PLP, as did, "phantom massage". (3) Psilocybin-MVF pairing produced synergistic effects, complete elimination of PLP, and reduction in paroxysmal episodes. (4) Touching the volunteer's leg where AL previously had external fixators, evoked sensation of nails boring through the leg. Using a "telescoping" nail, we created the illusion of a nail being removed with corresponding pain relief. (5) Artificial flames produced warmth in the phantom.
