We have commented previously on how virtual reality (VR) is beginning to help many people suffering chronic pain. It was with the increasing availability of VR for gaming that the potentially therapeutic effects of this technology were discovered, almost by accident. Indeed, VR is helping people suffering a variety of conditions as diverse as post-traumatic stress disorder, bipolar disorder and early-stage dementia.
In 2016, on the MCV video gaming website, journalist Ben Parfitt published an enlightening and heart warming case study – “Can VR help my wife recover from a life changing accident?”, which I would very much urge everybody to read. His wife, Libby, suffers CRPS and is of course a regular contributor to this Blog.
But that was three years ago and technology marches on apace, particularly when an industry spots a new and potentially lucrative market! Indeed, it is over two years since I first had the opportunity to try for myself a VR application developed specifically for therapeutic purposes. Whilst I am fortunate indeed not to suffer chronic pain, I can attest to the fully immersive effects of VR.
What is virtual reality?
VR is the use of computer technology to create, and place the user inside, a simulated environment. With the use of a headset and sometimes also hand and other sensors, the user can see, hear and even move around in that environment.
As Libby Parfitt commented in Ben’s case study, “I was really surprised at how completely real it felt. I genuinely felt transported to another place. I didn’t expect that level of immersion. Things like the quality of the graphics, the depth of field, the tracking – that was absolutely perfect. It felt organic and natural and not fake at all.”
VR as a therapy for chronic pain: how does it work?
It’s the totally immersive experience which distracts the user from their pain. A 2016 study involving thirty burns patients who used a specially developed VR application, found that almost all of them reported a decrease in their level of pain within a session lasting only five minutes. Ten of them said that they felt no pain at all during the session.
Distraction-related VR therapy is based on the “gate control” theory of pain, which was developed in the 1960s. According to the theory, pain messages travel from the periphery of the body through nerve “gates” in the spinal cord and up to the brain. The theory uses the concept of gates to describe how some pain messages are allowed to get through and reach the brain, while others are blocked.
It’s thought that distraction-related therapies give the brain an opportunity to send a signal down the spinal cord to close the pain gates before the signal arrives at the brain.
Whatever the nature of the neurophysiological mechanism at work, functional MRI scans (fMRI) have revealed a significant reduction in pain related brain activity in people while using VR.
What VR applications are there for chronic pain?
The following are just two of the companies now offering VR therapy applications:
CognifiSense is pairing VR technology with psychological therapies exclusively to treat chronic pain. They say “our core product, VR Neuropsychological Therapy or VRNT is a proprietary technology aimed at creating a lasting reduction in chronic pain. We combine psychological therapies with the immersive power of VR to address the maladaptive neuroplastic changes in the brain that drive chronic pain.”
These changes occur in the brain when the nervous system responds to an injury by building new nerve connections or strengthening existing ones. It’s thought that these changes sometimes drive chronic pain and ‘retraining’ through VRNT can help to change those nerve connections, reducing pain.
They explain that “immersive video games that shift the user’s focus from the pain are known as “distraction therapy”. VRNT differs from distraction therapy in that it specifically targets the brain’s “neuroplasticity”, or ability to change over time.”
AppliedVR has been developing therapeutic VR technology for some years now and provides applications for both hospitals and individual patients. Their modules cover a variety of techniques, including relaxation, breathing, mindfulness and positive thinking. These modules help patients cope with chronic pain, anxiety and stress as well as more specific scenarios such as childbirth or fear of undergoing an MRI scan.
How much is VR for chronic pain?
The cost of VR headsets continues to reduce.
As to the cost of dedicated therapeutic software, that can range from just a few pounds to several thousands of pounds. To a certain extent that is dictated by the quality of the product.
A major issue for VR therapy generally is whether people should be ‘self-medicating’ themselves at home or whether their VR therapy should be monitored in a clinical environment. Of course, the latter will add substantially to the cost, but in the long run could unsupervised VR therapy possibly do more harm than good?
It has been suggested that in the future this problem could be overcome by a virtual therapist ‘running’ the sessions. This could make the best therapy available to a far greater number of people than ever before.