Management of chronic pain is a global healthcare challenge and a cause of ever-growing concern for patients as well as healthcare services. Although pharmacological interventions are expected to continue as the primary basis of treatment, the related side effects and high costs are some of the major hindrances to long-term use. Pain, as perceived by medical practitioners, occurs in a multi-modal distribution. It is informed by a combination of visual, auditory, olfactory, and tactile sensations. Along with that, pain is a perceptual experience moderated by attention, cognition, emotion, expectation, motivation, and memory. Because pain has a multi-modal nature, clinicians have examined non-analgesic techniques such as Virtual Reality (VR) to reorient the components of painful instances and modulate the instinctive experiences of pain.
VR is at the cutting edge of technological innovation in medicine. It is a system in which patients are entirely immersed in the virtual world, using a mix of devices such as a head-mounted display or HMD, headphones combined with sound control, a joystick for navigation, a built-in microphone, etc. Latest VR technologies also include head-tracking systems that are integrated into the HMD. This technology allows the investigators to track the head movements of the patients to collect data on how they are responding to various VR environments. These devices allow clinicians to capture variables in patient’s medical data that identify markers of causal relationships between instances of pain and the use of VR technology.
Clinical investigators have hypothesized that VR is a potential non-pharmacological type of pain-relieving technique with applications in managing the overall fear, distress, and unpleasantness associated with a range of medical conditions and procedures. Researchers have made significant headway in testing this hypothesis. For example, VR has been used as a tool for distracting patients during various medical procedures. A recent study conducted by the University of Leeds attempted to reduce the perceived conception of threat related to surgical procedures on specific body parts by presenting healthy limbs to patients in VR environments during pre- and post-surgery phases. Investigations are currently underway to further explore and understand the advantages of VR in pain management. Two main areas in which clinical studies have shown promising efficacy are burn care and cancer care.
Burn wound care has historically been a cause of intense pain and strain for the patients. In burn care treatment and rehabilitation, VR experimentation has been used for pain and anxiety attenuation and fear mitigation. According to a report published by the Clinical Journal of Pain in 2008, a water-based VR system was analyzed during a burn wound debridement procedure for participants between the age range of nine to forty years. Using self-reported scores, this study demonstrated that VR lowered pain ratings for patients engrossed in a VR environment. Furthermore, VR technology has been explored for burn patients undergoing physical therapy in the rehabilitation phase. A study conducted by the American Burn Association examined the neuropathological signaling when VR is combined with analgesia during physical therapy. The study reported improved ratings of pain reduction and increased range of motion during and after individual sessions. In general, VR has shown viability in decreasing pain during burn care, which warrants continued research and discovery.
VR technology is also being investigated as a tool to deliver management of pain associated with cancer treatment procedures, especially chemotherapy, port access, and lumbar puncture. A study published by the Pediatric Nursing Journal observed pediatric cancer patients undergoing chemotherapy treatment consolidated with VR. The study collected self-reported assessments and subjective ratings of discomfort as data points to show that patients undergoing treatment with VR experience lower anxiety and stress levels as compared to the control group. Another study, published by the Oncology Nursing Forum, included a small sample of pediatric patients requiring port access. This study also compared VR distraction with standard care. Results indicated that VR distraction significantly reduced physiological arousal, such as pulse rate and pain ratings. Conclusions from these studies show that VR is currently a major tool of interest in oncology pain management, and ongoing research is expected to expand the applications of VR in administering pain relief.
While a limited number of studies have researched the clinical uses of VR, these studies have sufficiently established preliminary evidence to demonstrate VR as a complementary interventional method in the management of chronic pain. According to the current research, VR maintains efficacy over repeated sessions, improves pain rehabilitation, and expands the range of motions in patients. As the possibility of VR in chronic pain management advances, it has the potential to reduce the prolonged need for analgesics, opioids, and narcotics, thereby lowering healthcare costs and improving patient experiences.
