The latest tool to help reduce chronic pain sounds as if they belonged to a video game collection: virtual reality or VR. It is a computer-generated three-dimensional environment that you can see through special glasses and is gaining interest as a promising therapy.
In 2021, the FDA approved an at-home prescription VR device to help reduce chronic low back pain, and hospitals are investigating the effects of VR on pain relief.
“In the past, many providers have used opioids as a way to treat chronic pain. As it has become clear in recent years, opioids have many disadvantages and providers are thirsty for alternative treatments. Dr. David Binder, physiotherapist and director of innovation at Spaulding Rehabilitation Hospital in Boston, said. that’s why there’s a growing interest in this technology and that’s why we’re working on it.”
virtual reality experience
VR is immersive technology that makes you feel like you’re in another world. Sitting comfortably, you wear a VR headset with screen glasses that give you a 360-degree view of the virtual environment. You can look anywhere in the virtual space up, down, left, right or back and hear the sounds coming from the speakers in the earpiece or earpiece.
In a video game, you can wear a VR headset to ride a virtual roller coaster. You will see the track in front of you, the amusement park to the sides and the sky above. You’ll experience the thrill of seeing your car drive forward, twist or turn while you hear the rattling of the car on the track and the shouts of other drivers.
VR for chronic pain
Unlike thrilling VR video games, to reduce pain, VR aims to calm you down, often with tranquil nature settings such as a grassy field with bright blue skies and a stream flowing nearby. You can hear sounds like birds chirping and water gently bubbling between rocks. And environments are not always computer generated; some are videos of real places.
VR devices for reducing chronic pain also include other features such as the voice of a narrator that guides the user to enter the virtual environment, do breathing exercises, channel negative thoughts about pain, or learn about pain responses.
In hospital settings, clinicians are there to help you understand and reinforce concepts in VR treatment sessions.
How VR can help chronic pain
Strategies used to reduce chronic pain in VR include mindfulness (focusing on the present moment), meditation, guided imagery, or cognitive behavioral therapy (redirecting negative thoughts to positive thoughts)—all methods used to control stress and mood.
“Stress, anxiety, depression, and fear all contribute to pain,” Binder says. “A lot of evidence shows that if you can treat them, you can help reduce pain.”
Also, VR and its many stimulants may be distracting your brain from receiving pain signals.
“We use this wiring all the time anyway. For example, if you accidentally hit your elbow and it hurts, you rub the elbow and it feels better. “You’re tricking the brain by generating the sensory response of touching the elbow, which cancels out some of the pain signals,” Binder says.
proof of efficacy
Much of the evidence for VR for pain relates to the treatment of sudden, severe pain—for example, using VR to distract people undergoing burn treatment—or pain after surgery or during childbirth or cancer treatment.
While there isn’t much evidence yet that being in a VR environment reduces chronic pain, some studies are encouraging.
For example, the evidence leading the FDA to approve the VR device for chronic low back pain (EaseVRx) was a randomized trial involving 179 people. Half used a 3D VR device and half used a dummy device (with only a 2D environment). After eight weeks of treatment, pain levels were reduced by more than half in 46% of participants using the VR device, compared to 26% in the other group.
Availability of technology
Back pain VR device requires doctor order. It is not covered by insurance, and Binder does not anticipate that any VR device will be covered for chronic pain until VR becomes mainstream.
However, there are a number of VR devices with pain relief programs (not FDA-approved) that can be purchased online or through dedicated physical therapy apps.
Some hospitals and rehabilitation centers are also using VR for chronic pain.
And if you just want to try the tech, you can buy a VR device (starting at around $300) and download a meditation program for it.
Supervised by a physical therapist will not have the same training and guidance found in a program designed to reduce chronic pain. However, it probably won’t hurt unless you have any condition that would make VR use dangerous, such as dizziness or balance issues.
The future of VR pain management
It’s too soon to know if VR will become a standard part of chronic pain management.
The answer depends on what happens with the research and how much value VR adds to the treatment of chronic pain.
“If VR content shows clear improvement, lowers pain scores and improves faster, and there is evidence from reputable academic centers, big tech companies will likely be interested. They’re already investing heavily in VR,” Binder says. “You can see adoption of VR at a level that would never have been imagined.”