Chronic pain is a common and complex condition which affects one in five Australians aged 45 and over. Now virtual reality is reaching beyond the worlds of games and e-commerce to offer hope to people whose lives are dominated by pain.
While drugs appear to be reaching their limits where pain management is concerned, and have well-known side effects, the brave new world of VR is a new tool for dealing with an ancient problem. It appears to work by bypassing the body to some extent, and dealing directly with the mind, which ultimately decides which pain is worth worrying about and which isn’t.
Many people suffering with chronic pain have no apparent ongoing physical causes for the pain, but that makes it no less real as far as the mind and nervous system is concerned.
The red warning light can become stuck ‘on’ for whatever reason, while not providing any survival benefit.
MRI research shows that what happens in the brain in these situations is the pain response moves from the sensory and motor regions to areas associated with emotion and decision-making.
Excited neurotransmitters can then get stuck in a pain feedback loop, a living nightmare for the person involved.
VR pain management goes beyond relaxation and distraction (which are also delivered by video games) to re-engineer the brain’s pain management pathways. Graphic, 3D representations of the connections between different parts of the body, and the pain response, can become real experiences with lasting effects in a realistic VR setting, like a high-tech version of the old trick of amputees dealing with phantom limb pain by using mirrors.
For people who are unwilling or unable to use psychedelics, it appears VR can the potential to deliver similar benefits, by breaking down established connections between body and world, and body and mind. As the brain learns to live in chronic pain, it can also unlearn it.
VR treatment also has the possibility to be done anywhere there is an internet connection. The US company AppliedVR has already had remarkable successes with treating chronic back pain with small, mailable headsets.
Another company, Karuna Labs, is combining VR pain management with telehealth in a twelve week program.
With 68% of Australians with chronic pain being of working age, and 40% of early retirements being due to chronic pain, there are strong economic benefits to less people living in misery, as well as the obvious personal advantages.
Around the world, rapid advancements in VR technology by all the major tech companies are creating exciting new treatment possibilities, especially for chronic pain and otherwise untreatable conditions such as fibromyalgia.
Late last year the American FDA gave authorisation for the first VR product to be marketed to treat chronic pain.
Australian company Neurotechnology says virtual reality presents very exciting possibilities for pain management.
‘We can create analgesia with VR,’ said a spokesperson. ‘People in pain – burn victims and women in labor amongst others – if immersed in a virtual environment, feel much less or no pain while in the virtual environment. This is useful because it allows us to achieve the goal (analgesia) in a drug-free way. It is novel and there are clearly disadvantages to using opioids and other pain killers. Some hospitals are doing this already.’
According to Neurotechnology, VR can work as a therapeutic tool, and as an adjunct to therapy.
‘One of the principles of neuroplasticity is that the brain cannot tell the difference between the real and the perceived, or perhaps all reality is only known to us through perception,’ said a spokesperson.
‘Visual perception is considered the strongest channel of perception. We know that if we imagine a scene in detail – somebody cooking our favorite meal or a cold drink on a hot day – we can generate a physiological response to the image. People respond physically to pictures, adverts for food or sexual pictures. We can also relate to our dreams as if they are real and experience terror or bliss.
‘So imagine we were able to create an avatar of a person who looked like them and felt like them and moved like them. Imagine that the person identified this person as them – because they helped design it – and imagine that this avatar body mirrored the person’s real-life body. If we could create the illusory experience of a person’s real body in VR, so that the brain could not tell the difference between the real and the perceived, and imagine we could create any reality we wanted for this avatar.
Beyond the physical
‘What outcomes could we generate – what therapy could we do if we were not limited by the physical constraints?
‘Research shows that people respond physiologically to VR the same way as they would to reality.
‘Researchers all over the globe are doing other research altering experience, perception and psychology using mini VR experiences to generate therapeutic gains. If you had such a machine if you could create those experiences, what therapy would you create?’
Neurotechnology has developed a technology called CognitiVR as a drug-free, surgery-free solution for treating chronic pain conditions, leveraging the power of VR and neuroplasticity theory.