Virtual reality could be the future of pain management

It is difficult to exaggerate how painful a process of treating burn victims is; for burn victims, the air itself is extremely painful. They have to suffer weeks of stripping of wounds, cleaning the tender skin of debris, crushing the area with ointment and repairing it with new bandages, and it is considered one of the most physically painful treatments. To combat this, most patients rely on constant and intense use of opioids.

But in 2008, researchers at the University of Washington published the first such study with virtual reality (VR) to mitigate the use of highly addictive drugs. The researchers replaced the clinical hospital environment with a computer-generated snowtopia where patients could throw snowballs with penguins and snowmen through a VR headset while doctors washed the treatment area. It worked and the study concluded that VR could replace part of a dose of opioids.

A decade later, virtual reality medicine has kicked off, generating a lot of business and a new field of study of what is considered one of the most promising and powerful non-invasive tools for treating pain. It is now a growing part of a $ 885.7 million VR healthcare industry.

In the eyes of Jeffrey I. Gold, a pain treatment physician at Los Angeles Children’s Hospital, it is the future of medicine, as virtual reality can eliminate the need for billions of dollars worth of drugs.

If gold is right, as researchers increasingly find, this could have a common effect across the healthcare industry that will ultimately reduce health care costs, as patients depend less on medications to compensate for pain. .

“This is where virtual reality should go. It’s where you can start reducing the need for certain types of drugs that can have side effects.” Gold said.

How virtual reality works to alleviate pain

Conventional pain control techniques are based on distractions such as blowing bubbles with younger patients or administering painkillers or sedate. Unlike these, RV has the unique ability to manipulate how the brain processes pain by engaging the senses with powerful immersive experiences.

Gold published a study on the impact of virtual reality on pain in children. The researchers gave 12- to 17-year-olds who received blood-drawn VR headsets and instructed them to play a game made specifically to soothe pain. Once the set was put on, the health workers drew blood.

They then compared the experience to children who were given traditional methods of distraction, such as bubbles or reading a book, and calming techniques.

The study found that children who used VR during their procedures felt less pain and anxiety than children who did not.

“People always talk about” just distracts the kid like “hey, look here.” Well, that’s not what we’re doing, “Gold said.” It’s a little more involved in terms of immersion, presence, which we call cognitive load. “

One way to think about pain is as an “alarm” that the brain triggers. Virtual reality directs the brain to initiate more relaxing “sounds” in the form of a visual and audible world that forces the senses to experience something else. This drowns out this “alarm” created by the pain. The brain, in fact, does not record the placement of the needle as painful as it would be without VR.

The study confirmed what researchers have been seeing for years. But what excited gold was its potential for children: by making procedures more attractive and less painful, children with chronic illnesses may be less afraid to treat their illness, he said.

“Having a child have a positive experience in a routine procedure can change the game for that child.”

Other researchers studying the use of virtual reality found that technology not only comes into contact with the patient’s senses, but in some cases can act as a support network, just like a family. Another study by Cedars Sinai in Los Angeles used virtual reality to help women give birth with painful contractions. The researchers put a headset on the working women showing them soothing animated scenes of nature pulsing, almost as if the elements were breathing. A calm voice used words of encouragement to help the mother through the contractions.

Women who used VR reported lower levels of pain and anxiety, as did children.

“What I think was so impactful about this particular intervention, is that what they were hearing was almost the same … maybe you hear a doula,” said Dr. Melissa Wong, a maternal-fetal medicine specialist at Cedars. Sinai Los Angeles who led the study.

“A VR Pharmacy”

Wong’s study in Cedars-Sinai indicated that virtual reality could be an alternative to epidurals or nitrous oxide, two common pain control solutions used during childbirth. But even more, he pointed to a series of stories that show that pain is not only an acute or chronic sensation in the body that causes the alarm of the brain, but also the environment around it.

Wong said one of the strongest indicators of whether or not patients request epidurals during childbirth is whether or not they have a birth support person in the form of a partner, family member, or doula. Patients who do not are more likely to need an epidural.

“So it suggests, again, that [pain] it’s kind of the way everything is being approached, rather than literally the fibers of pain, ”Wong said.

In other words, pain is not simply a feeling. It is also a patient’s support system, environment, and mental form. By taking patients from a clinical hospital of linoleum floors and wheeled carts to a magical virtual world that has its own soundscapes and therapeutic guides, their pain may seem far less than it could be.

Brennan Spiegel, a Cedars-Sinai doctor in Los Angeles who oversees virtual reality programs, coined “a virtual reality pharmacy”: the idea that virtual reality therapies should be created to help specific situations, such as going through, dressing for a burn wound, undergoing chemotherapy, or having an anxiety attack.

But the industry is still young and many of the devices have yet to get full approval from the Food and Drug Administration. Still, there is a growing demand.

Companies get involved

Companies like KindamR, a seven-year-old based in Alameda, use virtual reality programs to calm pediatric patients before an MRI and calm them before an operation. XRHealth, a five-year-old Massachusetts-based company, offers a plethora of apps designed to treat physical immobility and mental health.

And six-year-old, Los Angeles-based AppliedVR developed a set of virtual reality-based “video games” designed to calm the anxiety of veterans and treat the acute pain of people giving birth and burning victims. The company has raised about $ 34 million to date, an amount that has increased the entire startup of the chronic pain market and valued at more than $ 67 million, according to Pitchbook.

Following the idea of ​​a “pharmacy for VR,” AppliedVR has two opioid-saving treatments: one for patients who use it to help with acute pain and one for chronic pain. The effects of chronic pain are usually long-lasting stress and a feat of movement, which is why the company incorporates cognitive-behavioral therapy into treatment.

Its chronic pain product is EaseVR, an aVR device used in an eight-month program that takes patients through different education and training modules to explain how stress can affect pain, how they can prevent it. stress and how to use breathing and acceptance therapy to reduce pain long after removing VR headphones.

Laura Garcia, research director at AppliedVR, said the company found that patients are able to use the benefits of virtual reality for up to six months after taking off their headphones.

“As long as you have the headphones on, you’ll be able to learn your skill sets and change your brain so you can deal with the pain in a different way,” he said. “So imagine having a pill that gives you benefits and relieves you [pain] for the time during which you use the pill, but also six months later. “

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