Virtual Reality and Acute and Chronic Pain

At the 2018 American Academy of Pain Medicine Annual Meeting, a panel discussed the use of virtual reality (VR) for acute and chronic pain. The panel included:

• Kim Bullock, MD – Stanford University
• Jeffrey Gold, PhD – Keck School of Medicine, USC
• Ted Jones, PhD – Pain Consultants of East Tennessee

There is a shortage of treatment options for pain medicine. It’s very difficult to find physicians that are board certified for pain medicine, pain psychologists are in extremely short supply and it’s also difficult to find occupational and physical therapists that specialist in chronic pain. It also seems that chemicals (pharmacy, medical marijuana) will not solve our problems with pain.

Virtual reality is showing promise for treatment of patients with chronic pain. The first study discussed had 30 patients recruited from their outpatient pain management program. The patients all participated in a five-minute virtual reality session. The patients reported a 33% reduction from pre session to post session and a 66% reduction in pain during the VR session.

Their second study featured patients with neuropathic pain (CRPS, neuropathy). Each was given three sessions of VR lasting 20 minutes. The findings showed a 69% reduction in pain during the session and a 53% reduction in pain after the session. 90% of the time there was an after effect that lasted from 30 hours to 72 hours. The pain reduction effect did not last longer than a couple days and it didn’t seem to change the psychological variables associated with pain.

The study conclusion of those studies was that VR may have a role in managing pain and that more research into this is needed. The impact seems similar to a tens unit which distracts the patient from focusing on their pain when it is being used.

VR has been used for years in psychiatry for treatment of a number of conditions and there a collection of evidenced-based studies on it’s use in this area.

VR shows great promise in treating children as they really embrace the technology and feel it’s like a video game. Children’s hospitals are using VR to distract patients during procedures like blood draws, IV placement, and cast removal. This is benefiting the patient, parents, and the staff working on the patient as it is easier to work on a relaxed patient.