Immersive virtual reality is transforming medical and psychological research and treatment, including the treatment of clinical pain. In this short perspective paper, we present some of the methodological difficulties that are rarely discussed in the literature of pain research when using virtual reality. These often-unmentioned problems can confound research investigations or interfere with the therapeutic efficacy in clinical trials. We propose practical solutions based on our research experience. We first outline the mechanisms of, and challenges to, the sensations of embodiment and presence, which are critical to creating effective virtual reality illusions, before discussing the particular considerations that need to be contemplated when working with patients with clinical pain. Finally, we discuss some upcoming technological advances that may influence significantly this rapidly expanding field in the near future.

Chronic neuropathic pain is highly disabling and difficult to treat and manage. Patients with such conditions often report altered bodily perceptions that are thought to be associated with maladaptive structural and functional alterations in the somatosensory cortex. Manipulating these altered perceptions using body illusions in virtual reality is being investigated and may have positive clinical implications for the treatment of these conditions. Here, we have conducted a narrative review of the evidence for the types of bodily distortions associated with a variety of peripheral and central neuropathic pain conditions. In addition, we summarize the experimental and clinical studies that have explored embodiment and body transformation illusions in immersive virtual reality for neuropathic pain relief, which are thought to target these maladaptive changes, as well as suggesting directions for future research.

No abstract