“Put On These Goggles and Call Me in the Morning” – Could Virtual Reality be the New Frontier in Pain Management?
Virtual reality is all the rage these days. Thanks to rapid improvements in digital technology, the clunky VR toys of yesterday have now become sophisticated tools that companies are putting to use in a variety of ways. Most of us may still think of virtual reality as a popular element in video game design, but these days VR technology is being used in corporate training, medical schools, and the treatment of conditions like anxiety, depression and post-traumatic stress disorder. A digital marketing agency called Twibi recently stated that, “although this innovative technology has been traditionally associated with the gaming industry, it is amazingly being applied in various fields to manipulate physical surroundings.”
But this recent article from US News explains a use for virtual reality we had heard little about. According to the story by reporter Paul Wynn, this rapidly changing digital technology may very well represent the newest frontier in the management of chronic pain. Naturally we were intrigued. Let’s see if your doctor might be prescribing a set of VR goggles any time soon.
Virtual Reality Plus Cognitive Behavioral Therapy
Virtual reality isn’t a sci-fi plot point device anymore; it’s real life, and researchers have discovered that it has the power to be very beneficial for those who are suffering from ailments of many kinds, especially when mixed with other therapies.
The applications in pain treatment are extremely far-reaching. Wynn writes that “VR research has focused on both acute and chronic pain, and tested in people with post-traumatic stress disorder, idiopathic facial pain, cancer pain, complex regional pain syndrome and other conditions like irritable bowel syndrome.”
From wound care to anxiety disorders, VR is being used to alleviate the discomfort so many people face on a daily basis, simply by providing safe, artificial environments for real healing.
What Is Virtual Reality?
The history of VR goes back a bit further than you might think: the concept was originally developed by the U.S. Air Force in the 1960s. “Once thought of as a sci-fi gimmick with static and monotonous visuals,” Wynn explains, “today’s VR features high-definition images using dynamic light to give each scene a sense of beginning and end. Many VR technologies use dramatic and immersive sound, and many systems monitor breathing so they can guide users through deep-breathing exercises.”
For patients using VR as therapy, headsets are worn for 10 to 20 minutes once a day. During this time, they enter a soothing or stimulating virtual environment, depending on their needs. Wynn describes environments that “vary from swimming with dolphins and ocean exploration to watching Cirque du Soleil or touring exotic destinations.”
Lately, the accessibility of VR has increased exponentially, making the systems more affordable and more popular than ever.
VR is Experiencing a Rapid Expansion of Innovation
VR is hardly an obscure form of therapy, available only on the fringes of mainstream medicine. Hundreds of hospitals across the country are adopting the systems, notably a Cedars-Sinai Medical Center program led by Dr. Brennan Spiegel, in order to provide innovative management of chronic pain.
Spiegel’s program has treated more than 3,000 patients as of this writing, and his work has spearheaded several VR studies. “One study [reported in JMIR Publications] followed 100 patients suffering from pain due to a variety of causes,” Wynn explains. “The team at Cedars-Sinai found that the group that experienced VR technology reported a 24 percent drop in pain scores. The other 50 patients who watched a standard, 2D nature video with relaxing scenes on a nearby screen experienced only a 13.2 percent reduction in pain.”
Understanding VR for Pain Management
Researchers are keen to find pain management tools that can reduce and even replace the use of addictive opioids, which is why the emphasis on VR has been met with so much fanfare. But for all its positives, the fact remains that no one knows why VR works the way it does for pain.
Wynn writes, “Some experts speculate that VR creates a non-medicated form of analgesia by changing the activity of the body’s pain modulation system, while others postulate that VR serves as a ‘pain distraction’ by reducing the perception of pain by absorbing and diverting attention away from the pain.”
As VR Costs Drop, More Research is Possible
This is why we’ve seen a surge in clinical studies about VR, not just by doctors like Spiegel but also academics like assistant professor Andrea Stevenson Won of Cornell University. She has conducted several studies on VR as a treatment option for chronic pain in both adults and children. “In the past,” Won says, “there were very few labs that were working in VR because it was so expensive and technically challenging, but once consumer equipment became available, many more researchers started envisioning new potential applications for virtual reality.”
But she adds a warning, “There’s huge potential for VR as a therapeutic option, but we don’t want this to be oversold and people to get excited about VR treatments before they are proven effective.”
There are other questions, too. Does VR have side effects? Does it have the potential to be addictive? According to current research, addiction is unlikely. Spiegel says, “We have not seen abuse among our patients who are using it for therapeutic purposes, and in fact, what we have observed is that people don’t love using VR after 20 to 30 minutes.”
As far as side effects, Spiegel says that the most common is something he calls “cybersickness”, a feeling of dizziness and nausea because of the initial disorientation of wearing the headset. Blurred vision, eye strain, and headache are also possible, as with any screen-based activity, but are only seen in about 5 percent of patients and usually dissipate once the headset comes off.
Future of VR and Medicine
Would it surprise you to learn that the Food and Drug Administration has gotten involved? Wynn writes, “In November 2021, the Food and Drug Administration approved the first VR technology – [originally called] EaseVRx – for the treatment of adult patients with diagnosed chronic lower back pain. EaseVRx uses the principles of cognitive behavioral therapy techniques for the purpose of reduction of pain and pain interference.” EaseVRx is now known by its new name, RelieVRx.
This marks the start of a whole new category of medical device: “digiceuticals”, or digital therapeutics. This RelieVRx “device is intended for at-home self-use and consists of a VR headset, controller and a ‘breathing amplifier’ attached to the headset that directs a patient’s breath toward the headset’s microphone for use in deep breathing exercises,” Wynn writes.
For doctors and researchers like Spiegel, this is only good news. “The approval sets a positive pathway for future advancements because the FDA provided a special breakthrough designation for the device,” he says. What’s more, the field is wide open for innovation. “One company, CognifiSense, is working on a completely new type of VR therapy, which they have dubbed ‘VR neuropsychological therapy,’” Wynn writes. “This new approach is different from traditional VR therapy because it aims to change how the brain perceives pain and create a lasting reduction in pain.”
While any technology has its positives and negatives, the possibilities with VR seem endless, and doctors are keen to craft a future where pain is managed digitally, not with potentially-dangerous pharmaceuticals.
The article ends with Spiegel’s encouraging words: “There are so many researchers dedicated to keeping this an evidence-based branch of medicine to further study where VR is appropriate and where it’s not appropriate, and how we can best help patients living with chronic pain.”
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(originally reported at https://health.usnews.com)