Therapeutic virtual reality used to treat severe pain
Therapeutic virtual reality can be used to reduce severe pain in hospitalized patients, according to a new study by researchers at the Cedars-Sinai Medical Center in Los Angeles, California, and published in the journal PLOS One.
Therapeutic virtual reality is emerging as an effective, non-pharmacological treatment modality for pain. Virtual reality sessions have been used to help treat anxiety disorders, support physical rehabilitation, and distract patients during wound care. Previous studies testing the intervention in hospitalized patients have been limited by short intervention times and lack of randomization.
Led by Brennan Spiegel, MD, director of health services research in academic affairs and clinical transformation, researchers randomized 120 people who were inpatients at Cedars-Sinai Medical Center between November 2016 and July 2017. Patients were eligible if they had a pain score of more than three out of 10 during the 24 hours preceding inclusion.
About 60 people randomized to the intervention group received a library of 21 immersive virtual reality experiences, including a guided relaxation in natural environments, a simulated flight, and animated games, on a Samsung Gear Oculus headset. They were advised to use the headset for three ten-minute sessions over the subsequent 48 hours. 59 people in the control group were instead instructed to tune their television set to a health and wellness channel that included guided relaxations and poetry readings. The authors note that virtual reality exposure times of over ten minutes had a higher risk of cybersickness.
On average, self-reported pain scores went down by 0.46 points in the control group and dropped by 1.72 points among people who used virtual reality. Among patients with baseline pain above seven out of 10, this difference was more pronounced, with a reduction of 0.93 points in the control group and of 3.04 in the virtual reality. Effects of the virtual reality intervention on pain were significant both initially and after 48 to 72 hours of use, and patients reported higher satisfaction with the virtual reality experience than with watching television. There was no difference in opioid prescribing between the study groups.
While it's still not clear whether different forms of virtual reality have varying efficacy, the current study does support the effectiveness of virtual for managing inpatient pain. This effectiveness also prompts many questions deserving future study, especially around the possibility of therapeutic virtual reality's ability to potentially reduce opioid requirements.
"Evidence reveals that virtual reality therapy can tamp down pain signals through a variety of mechanisms,” said Spiegel. “In this study, the largest of its kind to date, hospitalized patients with pain were randomized between [virtual reality] or a relaxation program on TV. The [virtual reality] outperformed the control condition and demonstrated benefits over several days of use."