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Virtual reality (VR) seems set to become the Next Big Thing.
With specialized software and headsets to generate images, sounds, and other sensations to create a realistic-seeming environment, users can create virtual experiences that can literally be out of this world. Though VR setups were once extremely expensive, advances in computer technology have reduced the price enormously. Using Google Cardboard, for example, users can take advantage of the motion tracking properties of smartphones to create a VR system costing as little as $50. And better systems are already being developed for widespread use in the near future. Having sampled some of the new commercial applications out there, I can safely say that virtual reality (VR for short) may well become one of the most exciting new developments in the world of computer technology over the next twenty years.
Along with its potential for entertainment and education, VR is slowly becoming an important medical tool as well. Mental health professionals are already experimenting with VR in the treatment of emotional problems, including phobias and PTSD. With realistic VR simulations, people suffering from crippling anxiety relating to different situational "triggers" can learn to overcome their fears through simulated exposure to these triggers. VR can also be used in training scenarios allowing medical students to witness surgeries taking place thousands of miles away and diagnose disease in patients they may never meet in person.
But can it help with chronic pain? The total number of patients worldwide suffering from pain relating to injuries, medical conditions, or the aftermath of surgery far exceeds the number of patients suffering from diabetes, heart disease, and cancer combined. According to a 2011 report by the Institute of Medicine, the annual cost of treating pain in the United States is more than $560 to $635 billion, a figure that will almost certainly skyrocket as the Baby Boomer generation grows older. Along with the sheer expense associated with treatment and lost productivity, the risk of addiction from many of the drugs currently prescribed for pain patients clearly demonstrates that the need for better and less addictive pain treatments seems greater than ever.
As an alternative to medication, there are numerous psychological treatments that have been proven to be effective in controlling pain. Along with cognitive-behavioural therapy, biofeedback, acceptance-based therapies, and hypnosis, virtual-reality distraction is generating considerable interest among researchers and patients. The basic principle underlying distraction therapy for pain is the use of external stimuli such as a video, music, deep breathing, or blowing a pinwheel to take the patient's mind off of their pain. With virtual reality distraction, patients are immersed in a multisensory, three-dimensional simulated environment. Using a head-mounted display helmet and headphones, as well as a joystick or wand, VR users can move through the virtual world as if it were real. Along with the head-mounted display to generate visual stimuli, the helmet also contains motion trackers allowing the visual field to change as the head moves. The headphones can also add music or sounds from the virtual world and even permit conversations with simulated characters.
Research looking at VR distraction has already been found to be extremely effective in managing the pain reported by burn patients and needle-related pain. Over the past five years, the amount of research in this area has risen sharply. In a meta-analysis recently published in the journal Psychology of Consciousness, fourteen recent studies looking at VR distraction in managing pain were examined. The authors of the research, Melissa P. Kenney and Leonard S. Milling of the University of Hartford in Connecticut, specifically focused on how effective VR distraction was in managing different forms of pain, whether it was more effective with children or adults, and whether specialized pain management VR applications worked better than commercially available products.
Among the specialized VR applications they looked at was the computer game SnowWorld which was developed by researchers at the University of Washington and Firsthand Technology. A review in The New York Times stated that SnowWorld "puts Pixar-like animation to medical use in a virtual video game that relieves the pain of burn victims. Try it. It is completely absorbing to pelt woolly mammoths and penguins with snowballs while your ears are filled with the irresistible strains of (Paul Simon's) Graceland." Originally developed for burn patients, the VR game is now being used with a wide range of pain disorders.
When comparing the results of the different studies examined, Kenney and Milling found that VR distraction appeared to be just as effective as any other psychological pain treatment (and in some studies, even more so). While adults seemed to benefit more than children, overall they found no real difference in terms of kind of pain studied and the age of the pain patient. One surprising finding was that there didn't appear to be any significant difference between specialized programs developed for pain patients and commercial VR applications. This suggest that the feeling of being immersed in a virtual setting, not to mention the sense of fun associated with VR, is probably the most important aspect of VR distraction for many pain patients.
Unfortunately, few of these studies looked at chronic pain and more research is needed to see if VR distraction can help with hard-to-treat conditions such as fibromyalgia. Also, more research is needed to see how VR distraction can be adapted to be more effective for children dealing with pain. Still, these research results do suggest that VR distraction can help pain patients in much the same way that other psychological treatments are already being used. Not only does VR appear to be as effective as cognitive-behavioural techniques, biofeedback, and hypnosis, but pain patients can use VR technology on their own without the need for treatment professionals to be physically present. This can make it a far more cost-effective treatment for pain than many of the other alternatives currently available. Even though some VR users report developing problems such as motion sickness, they can usually overcome it easily enough and it's a minor issue compared to the risks of pain medication.
While VR distraction is hardly likely to wean pain patients off of the need for medication, the benefits it offers makes it an exciting option that needs to become more widely available for people in pain. As better and less expensive VR technology comes online over the next few years, immersing yourself into a virtual world to deal with pain may well be what the doctor ordered.
