Virtual reality treatment helps hospital patients overcome chronic pain

Virtual Reality (VR) is an amazing technology, and probably not for the reason you’re thinking – so far it’s helped legally blind people regain their vision, helped doctors zoom through tumors to improve cancer patient survival rates, and accelerated the development of new drugs. It’s also pretty awesome for gaming too …

Now a compelling new study from Wolters Kluwer Health, which was published in the journal Pain, has found integrating an immersive VR system into a chronic pain treatment significantly improved a patient’s pain-relief outcome. The research then went on to conclude that “Digiceutical” therapies, where a digital tool is used in tandem with a traditional medical treatment, may be effective for patients suffering chronic pain.

The study focused on VR as an adjunct to Spinal Cord Stimulation (SCS), a therapy for chronic pain involving a surgical implant designed to deploy electrical pulses that interrupt pain signalling to the brain. Fifteen subjects with SCS implants for chronic leg pain were recruited for the study.

The experimental method uses VR to show patients a virtual image of their own body. The idea is patients will be able to see the effect of SCS in real-time, watching parts of their leg light up when electrical current is switched on.

Prior research has suggested this kind of embodied VR experience can deliver analgesic effects, so the new study hypothesised this method could amplify the efficacy of SCS. Generally, SCS is only helpful in 60 to 70 percent of patients, and even then it only reduces pain sensations by around 50 percent.

The study tested three different interventions: Congruent SCS-VR, where the VR visualiSations were in sync with the tingling areas in a patient’s leg, Incongruent SCS-VR, where distinctly different parts of a patient’s leg lit up in VR compared to the SCS target, and VR alone, just VR visualisations with no SCS current.

Subjective pain scores from the patients decreased by 23 percent when SCS was delivered in combination with incongruous VR visualisation, but that pain reduction nearly doubled to 44 percent when the VR visualizations were in sync with the electrical stimulation. Virtually no change was seen in pain scores when VR visualisations were deployed with no SCS.

“We also show that analgesia persists after congruent SCS-VR had stopped, indicating carry over effects and underlining its therapeutic potential,” the research team writes in the study. "[T]he strength of the effect, its selectivity, its ease of application, and consistent increase across sessions and long-term analgesia will facilitate the application of prolonged and more frequent therapy doses in future SCS-VR studies, likely further boosting the described effects."

Further work is needed to understand exactly how this kind of congruent embodied VR experience amplifies the efficacy of SCS. However, the difference in effect size between the congruent and incongruent VR visualizations suggests the results are more than a case of simple distraction. Instead, the researchers hypothesise the synchronised visual and tactile sensations may enhance the way SCS masks our feeling of pain.

“Linking latest VR technology with recent insights from the neuroscience of body perception and SCS-neuromodulation, our personalized new SCS-VR platform highlights the impact of immersive digiceutical therapies for chronic pain,” the researchers conclude in the newly published study.

The new study was published in the journal Pain.

Source: Wolters Kluwer Health