Using Virtual Reality Therapy to Treat Chronic Pain
Everyone experiences pain—pain is a healthy and important sensation detected by specialized nociceptors that alerts us to potential injury. Nerve fibers relay pain signals to the central nervous system through group Aδ fibers for fast pain and group C fibers for slow pain. According to the Gate Control Theory of Pain developed by scientists in 1965, pain perception is regulated by gated mechanisms in the spinal cord that can increase or decrease the severity of the painful sensation. The “gate” to the brain prioritizes signals from other nerve fibers over those sent from nociceptive nerve fibers. This prioritization is evolutionarily beneficial because it allows our biological needs, such as fleeing from danger, to take precedence over our reaction to a painful injury. While short-term pain is necessary to prevent injury, it can also be detrimental if persisting for long periods of time. Chronic pain, a diagnosis received by 3 million people in the United States annually, describes pain lasting longer than 12 weeks.
Currently, chronic pain is managed using physical therapy or analgesic medications that disrupt the transmission of C fiber nociceptive signals to the central nervous system. However, these management techniques are both ineffective and sometimes dangerous. In fact, over half of US opioid overdoses are due to prescription drugs. Due to these dangers, alternatives such as virtual reality (VR) therapy have emerged as innovative techniques to manage chronic pain. VR refers to a 3D environment experienced through systems like goggles and tracking sensors. Patients in VR therapy are presented with interactive scenarios that immerse them in virtual environments without negatively altering synapses to create addiction. Since the brain prioritizes non-pain signals, the distracting stimuli of the VR environment causes a downregulation of nociceptor signalling.
Currently, chronic pain is managed using physical therapy or analgesic medications that disrupt the transmission of C fiber nociceptive signals to the central nervous system. However, these management techniques are both ineffective and sometimes dangerous. In fact, over half of US opioid overdoses are due to prescription drugs. Due to these dangers, alternatives such as virtual reality (VR) therapy have emerged as innovative techniques to manage chronic pain. VR refers to a 3D environment experienced through systems like goggles and tracking sensors. Patients in VR therapy are presented with interactive scenarios that immerse them in virtual environments without negatively altering synapses to create addiction. Since the brain prioritizes non-pain signals, the distracting stimuli of the VR environment causes a downregulation of nociceptor signalling.
Chronic pain is only somewhat managed by current medication regimes. VR promises to change that.
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As a result of these advantages, VR is now being studied as a non-invasive and non-addictive treatment for chronic pain conditions such as SAIS, fibromyalgia, and phantom-limb pain (PLP). In a 30 patient study on patients with SAIS, a joint damage condition where tendons rub on shoulder blades, participants were asked to do either a home based-exercise program or VR bowling, boxing, and tennis using the Nintendo Wii for six weeks. Although both groups reported a decrease in pain intensity, VR patients scored significantly better in tests evaluating shoulder movement. Another study investigating the use of relaxing meadows and beaches in VR as treatment for fibromyalgia, a musculoskeletal disorder resulting in sleep and memory issues, in females found pain intensity decreased both after the session and during a 6 month follow-up. These results indicate that VR therapy has significant long-term effects. While these studies have focused on injury-related pain, further research on patients with upper limb amputation and PLP found a 51% decrease in their pain-rating index following 12 sessions of a VR racing game. This relief was maintained during the 1, 3, and 6 month follow-ups, and half of the tested patients using pain medication reported switching to a lower dose.
Together, this research suggests that motor execution with VR is an effective treatment strategy for both injury- and amputation-related pain. Despite this, it is worth noting the inconvenience of most VR therapy—unlike traditional painkillers, patients must come to the clinic for treatment. Yet, since the benefits of VR therapy far outweigh its disadvantages, VR therapy may be the future of pain control.
Together, this research suggests that motor execution with VR is an effective treatment strategy for both injury- and amputation-related pain. Despite this, it is worth noting the inconvenience of most VR therapy—unlike traditional painkillers, patients must come to the clinic for treatment. Yet, since the benefits of VR therapy far outweigh its disadvantages, VR therapy may be the future of pain control.
Featured Image Source: bruce mars
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