In October, President Trump finally declared what much of the country has known for a long time: the opioid crisis is a public health emergency. Yet while nearly 100 Americans die from opioid-related deaths each day, chronic pain continues to vex more than 25 million Americans. But the fast-developing world of virtual reality (VR) technology is providing relief to patients in clinical trials, hospitals, and soon in our own homes. This growing industry of pain-relieving VR may be at least part of the solution to the opioid epidemic—without the addictive, potentially fatal side effects.
How VR Reduces Pain
The first successful experiments using VR to control pain, conducted in 1996, focused on the acute pain of burn victims. Particularly during bandage changes, where the patients were not at rest, opioids such as morphine failed to control the intense pain. By the early 2000s, cognitive psychologists Hunter Hoffman and Dave Patterson, of the University of Washington in Seattle, had developed a VR computer game called SnowWorld to help patients ignore pain signals while enjoying the intriguing game scenarios. They placed patients inside a $90,000 unit with an eight-pound helmet linked to a refrigerator-sized computer to play the game.
Hoffman and Patterson relied on previous research that indicated the brain interprets pain signals differently based on someone’s current feelings or thoughts and decided to take that research one step further: by intentionally diverting someone’s thoughts with other stimuli, perhaps the pain could be substantially reduced. The theory worked, and VR distraction therapy was born.
Neuroscientist David Linden recently explored this topic on NPR, explaining that the brain has more control over pain than we might think. It can send the cue: “hey that’s interesting, turn up the volume on this pain information that’s coming in,” or it can indicate: “turn down the volume on that and pay less attention to it.” Linden says our perception of pain relies on how the brain processes the information traveling in from the nervous system.
According to William Clark Becker, an internist at the Yale School of Medicine who researches pain management and addiction: “We know that positive thinking can actually work on a molecular level, by stopping ions from jumping the gate and causing pain signals to reach the brain.” With regard to pain he explained, “You can’t transplant people’s nerves. You can’t undo the process, but you can dampen the heightened pain signals that are getting up to the brain. And positive-thinking people are also better equipped to withstand the vagaries of everyday life.”
The VR games used in the medical setting seek to simulate an environment starkly different than the reality currently experienced by the patient. Hoffman’s original SnowWorld experiments were conducted on burn victims from the military, so the game’s environment contrasted the fiery intensity suffered during the cleaning of the burns by transporting patients to a world painted in cool blues and white. While medical personnel changed their bandages, patients flew through a winter wonderland filled with noisy animals, snowmen throwing snowballs and other hurdles, toward which subjects can hurl their own snowballs—all the while distracting their brains from the tremendous pain their bodies were experiencing. In fact, the pain was reduced by half. Sometimes, patients engaged with SnowWorld failed to even notice their painful procedure had been completed.
According to Hoffman, “Acute pain is a perfect match for VR.” He explained, “You only need it for 20 minutes and it has drastic effects.”
Howard Rose, CEO of Firsthand Technology—one of many companies that specialize in VR pain products—said the technology succeeds in other ways than the simplest levels of distraction.
“We know that if people feel anxious and helpless then their suffering from the pain is much greater.” Rose further explained that by transporting them to a place far from the pain, it lessens their anxiety, and the interactive nature of the game also gives them a greater sense of control.
He wondered if these other qualities to the VR therapy might also help patients with chronic pain.
VR Therapy for Chronic Pain
But Rose, Hoffman and others in the field realize that chronic pain presents a more challenging problem. That’s why it may be more of a tool in a toolbox, rather than the be-all end-all solution for chronic pain. Still, it may be a stronger device than those we’ve known so far.
For instance, Hoffman explained, “If you say, ‘go home and meditate,’ not many patients will follow through,” Hoffman said. “But if you give them a VR system and say ‘go into this ancient world and meditate with monks,’ they’re more likely to actually do it.” From this perspective, VR is simply an attractive vehicle for a state of mind we want people to experience.
Indeed, studies show VR has been effective at reducing chronic pain. Dr. Ted Jones, a pain psychologist at the Behavioral Medicine Institute in Knoxville, Tennessee, conducted two small studies with a total of 40 patients. The first fitted 30 patients with the Oculus Rift headset for a five-minute VR session, traveling through a world called Cool!, where they could feed or fire weapons at otters. Results showed participants experienced 66 percent less pain during the session, and one third less pain immediately afterwards. In the second study, 10 patients with neuropathic pain engaged in 20-minute VR sessions, once per week for three weeks. Results revealed participants experienced 69 percent less pain during the experience and 53 percent less pain immediately afterward.
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