Virtual Reality Treatment for Chronic Pain
Virtual reality is everywhere it seems, and new virtual reality products are popping up to help with some psychological and physical health conditions.
Recently, virtual reality made an appearance on America’s Got Talent. I’m not sure it was appropriate for the show, but it did showcase how you can use VR to help people overcome phobias like Howie Mandel’s fear of heights (and maybe even is fear of touching people). It’s somewhat easy to see how virtual reality can be used for exposure therapy for these types of issues. But, how can virtual reality be used to treat chronic pain?
This post has been sponsored by PainCareVR. All opinions are my own.
What is virtual reality?
Virtual reality is computer-assisted technology that involves wearing a headset that include a display. The headset may also provide sound, or you may wear headphones to provide sound. You use a joystick to make selections and control the virtual reality world.
Your entire field of vision is occupied by what is on the screen in front of you. If you turn your head, the world does not end, but rather continues, allowing you a full 360 degree experience.
There are all sorts of virtual reality apps, allowing you to do everything from watch 360 degree videos that allow you to feel as if you are in the center of a live concert, to games and learning experiences. There are even apps that allow you to control your computer desktop as if it were a hologram. This last one would be ideal for someone stuck in bed with limited mobility.
When done correctly virtual reality can become a completely immersive experience, allowing you to feel as if you really are somewhere else, actively engaging in different life experiences.
Through a virtual reality headset like the Oculus, you can engage with both virtual and existing worlds. Whether it’s watching a video that actually allows you to feel as if you are in the middle of a live concert (with people all around you and a band on stage), or to move through an actual place as if you are there.
You can use virtual reality to experience life outside, when chronic pain and illness limit you to your bedroom. And, you can also use virtual reality to experience virtual worlds of fantasy and fiction.
Can virtual reality improve ratings of chronic pain?
A 2016 meta-analysis reviewed 14 different studies examining the efficacy of virtual reality (in various forms) for the treatment of pain – both experimental (created for the study) and clinical (pain that the participant was experiencing prior to the study). Generally, virtual reality was found to be helpful. Generally, those who used some sort of virtual reality therapy in these studies saw improvement more often than 82% of the controls (those who didn’t use virtual reality).
Virtual reality was found to significantly improve ratings of pain for both clinical and experimental pain. However, virtual reality was more helpful in improving experimental pain than it was for improving clinical pain. Perhaps the knowledge that the pain is only temporary affects one’s ability to be completely distracted from it?
The review also found that the benefits of virtual reality were there regardless of whether the participant was using a VR game, engaging in a virtual world, or using virtual reality in another way. It seems that virtual reality really can help reduce pain.
A 2018 review reported on studies for both fibromyalgia and chronic migraine that found virtual reality to be helpful in relieving immediate pain. Additionally, in the fibromyalgia study, patients continued to report improvement at six weeks after the study.
So, yes it seems that virtual reality really can help reduce chronic pain, not only while using it but even when not immersed in the virtual world.Virtual reality can help reduce chronic pain, even after you've stopped using it.
How does virtual reality reduce chronic pain?
The key to virtual reality’s ability to reduce pain is in distraction, but that’s not the only way that virtual reality can be used to reduce pain. There are four basic ways that virtual reality can be used to reduce pain.
1 . Distraction
The theory behind distraction for pain relief is that our brain can only pay attention to so much at one time, so by completely distracting it from the pain, you can relieve that pain – even if only temporarily.
The virtual world you are experiencing absorbs and diverts attention away from the pain. The relief provided by distraction is only temporary and while it may last for a little while after the distraction has ended, eventually the pain will return.
Virtual reality is the ultimate distraction. Spending time in a virtual world is all-encompassing. Unlike watching television or playing a video game, there are no other diversions competing for your attention. The virtual world completely absorbs your attention, making it difficult to pull your attention away.
2 . Meditation/ Mindfulness
The effects of distraction can be extended through the use of mindfulness and meditation. Mindfulness and meditation through programs like mindfulness-based stress reduction work to teach you how to shift your focus away from pain.
I’ve attempted to practice meditation and mindfulness for a few years. Several years ago I took the 9-week Mindfulness Based Stress Reduction course. I can honestly say that for many months after that course I felt much calmer, less stressed, and more in control. I also slept better, and generally found that I was more focused throughout my day.
However, since taking the MBSR course, I’ve struggled to maintain a regular meditation practice. I find it easy to get distracted by the noises around me, or even to keep my eyes closed during meditation.
Meditation in the virtual world provided by PainCareVR solved these issues because I was completely immersed in the meditative focus. The sights and sounds all around me matched my meditation. Instead of trying to imagine a bubbling brook, I could literally see and hear it. I could not get distracted by my thoughts because the virtual world matched my meditative world.
3 . Hypnosis
In many ways hypnosis is not much different than meditation. It’s a guided restricting of thoughts, feelings, and behaviors. It’s been used to help people lose weight, stop smoking, and change any number of habits.
The struggle with hypnosis is often that it’s not widely available, because training is not widely available in medical schools or psychological departments. Hypnosis also requires a great deal of skill and time to administer, therefore it is often ignored for other therapies that perhaps do not require the same skill or time. Hypnosis also requires complete attention and concentration on the part of the receiver.
Hypnosis is often provided via audio recordings when a live hypnotherapist is not available. While this has been found to be beneficial it’s not nearly as beneficial as actually having a hypnotherapist present to provide the treatment. Virtual reality can help bridge this gap. Unlike audio or video recordings of a hypnotherapist, the full immersion of the technology allows one to feel as if the hypnotherapist is there with them.
4 . Education
Virtual reality can be not only fun but educational, allowing one to feel as if they are in the same space as the educator. For those who struggle to learn without both visual and auditory stimuli this can be extremely beneficial. And, unlike typical video training, there is no risk of distraction.
I have often struggled with trying to learn through watching videos online. I find myself easily distracted, wanting to do multiple things at once, relegating the video to the background. However, in a virtual reality world, that’s just not possible – so long as the world itself doesn’t provide distractions.
Education can allow us to learn how to the pain centers of the body work, and from there how we can better control them. Education allows us to increase self awareness, and empowering us to cope with pain when it presents.
What is PainCareVR and how can it help?
PainCareVR provided me with an Oculus GO and the PainCareVR software to try. In addition to the software they provide an “amplifier” which is an attachment to the Oculus that allows you to see your breath. This allows the software to measure and help you improve your breathing.
The software itself immerses you in a fantasy world that reminded me a bit of Stargate. The elements of the app are broken down into three parts – Soothe, Train & Learn.
Soothe focuses on meditation, providing a variety of different types of meditations and body scans that you can do, ranging from three to fifteen minutes in length. No matter how much time you have available you have time to take part.
Learn teaches you about your psychological state affects your pain, attempting to teach you acceptance and empower you by giving you the skills and knowledge to cope with your pain. Each of the learning segments is about 2 minutes long, allowing you to learn at your own pace.
Train makes breathing and meditation into a game. These simple games help you improve your focus, concentration, and breathing. The games vary but are all under 10 minutes.
It took me a little bit to get used to this fantasy world, but once I allowed myself, I found I was easily absorbed, especially for the Soothe and Train portions. I enjoyed how the amplifier showed my breathing and allowed me to adjust it to have the desired effect. Most of all, I enjoyed the meditations in the Soothe portion of the app, as they allowed me to be completely immersed in my meditation without the distractions I usually struggle with.
I do wish the Learn portion of the app was a bit stronger and went more in depth with longer exchanges, but from talking to the people behind this app I believe this is just the start and that what they are providing will expand and grow based on user experience and feedback.
Are there any negatives to using a virtual reality headset for chronic pain?
I did struggle a little with using the VR headset, simply from the weight of it. In order to fully enjoy the 360 degree immersion you do need to be able to sit up (or stand) while wearing the headset. I initially used it while sitting in my office chair, and enjoyed being able to spin the chair and see the whole world around me. Unfortunately, my office chair gives me issues just sitting in it for long.
Unfortunately, I struggle with holding my head up while wearing the added weight on my head. I did experience pain from wearing it for about 25-30 minutes while sitting up like that. In subsequent uses, I opted to recline on the couch. While this removed my ability to enjoy the full 360 degree experience, it allowed me to use the headset without any added pain or discomfort.
Part of the problem with chronic pain is that the more we deal with it, the more we focus on it, and the more we focus on the pain, the more we feel it. We have to find ways to remove ourselves from the pain experience. This is where virtual reality comes in.
Any tools we can find to help reduce our pain, even for a time, are worth having in our toolbox. Virtual reality is just another great tool to keep on hand. I feel that when used with meditation and mindfulness as PainCareVR promotes that it can be extremely beneficial.
- Mindfulness Therapy for Fibromyalgia, Chronic Fatigue Syndrome and IBS
- Distraction as Pain Reliever: 10 ways to distract yourself from pain
- Brain Scans Show that Meditation Can Reduce Sensation of Pain
- Ten Tips For Combating Chronic Pain in Winter
Askay, S. W., Patterson, D. R., & Sharar, S. R. (2009). VIRTUAL REALITY HYPNOSIS. Contemporary hypnosis : the journal of the British Society of Experimental and Clinical Hypnosis, 26(1), 40–47. doi:10.1002/ch.371
Jones, T., Moore, T., & Choo, J. (2016). The Impact of Virtual Reality on Chronic Pain. PloS one, 11(12), e0167523. doi:10.1371/journal.pone.0167523
Kenney, M., & Milling, L. (2016). The Effectiveness of Virtual Reality Distraction for Reducing Pain: A Meta-Analysis. Psychology of Consciousness: Theory, Research, and Practice, 3(3), 199-210.
Pourmand, A., Davis, S., Marchak, A., Whiteside, T., & Sikka, N. (2018). Virtual Reality as a Clinical Tool for Pain Management. Current Pain and Headache Reports, 22(8), 1-6.