Virtual Reality and Pain Management: Current Trends and Future Directions

Abstract

SUMMARY Virtual reality (VR) has been used to manage pain and distress associated with a wide variety of known painful medical procedures. In clinical settings and experimental studies, participants immersed in VR experience reduced levels of pain, general distress/unpleasantness and report a desire to use VR again during painful medical procedures. Investigators hypothesize that VR acts as a nonpharmacologic form of analgesia by exerting an array of emotional affective, emotion-based cognitive and attentional processes on the body’s intricate pain modulation system. While the exact neurobiological mechanisms behind VR’s action remain unclear, investigations are currently underway to examine the complex interplay of cortical activity associated with immersive VR. Recently, new applications, including VR, have been developed to augment evidenced-based interventions, such as hypnosis and biofeedback, for the treatment of chronic pain. This article provides a comprehensive review of the literature, exploring clinical and experimental applications of VR for acute and chronic pain management, focusing specifically on current trends and recent developments. In addition, we propose mechanistic theories highlighting VR distraction and neurobiological explanations, and conclude with new directions in VR research, implications and clinical significance.

PainDroid: an android-based virtual reality application for pain assessment

“…Our literature findings, however, on the use of VR technology in pain research seem to be consistent with the studies reported in a recent comprehensive review of the literature performed by Li et al [31]. In all, these findings seem to raise three important points that need to be further addressed:…”

Differential Effects of Two Virtual Reality Interventions: Distraction Versus Pain Control

“…The VRD condition significantly increased the pain threshold in comparison with the control condition. Overall, therefore, both interventions have some effects on pain-related variables, a finding that is consistent with previous studies 1,4 and with our own results in earlier experiments involving the same interventions. [20][21][22] Notably, however, neither of the two interventions had any effect on pain intensity.…”

“…Moreover, people enjoy using VR and are keen to use it again during other painful medical procedures. [1][2][3] The effects of VR have been mainly explained in terms of pain distraction. Since attentional resources are limited, diverting attention away from pain by means of VR leaves fewer resources available for pain processing.…”

“…Since attentional resources are limited, diverting attention away from pain by means of VR leaves fewer resources available for pain processing. 1 This mechanism is not new, as distraction is a traditional psychological intervention for pain that has been shown to possess considerable efficacy. 4 However, VR distraction is thought to be more effective because it is immersive and engaging, integrating many sensory experiences and, therefore, demanding a greater amount of attention.…”

Virtual Reality for Pain Control—Virtual or Real?

“…Feedback-based strategies are mainly used for phantom limb pain or complex regional pain syndrome. [2][3][4][5] Based on a recent meta-analysis of 14 controlled studies, VR-induced distraction has been indicated highly effective in alleviating pain. 6 This analysis found a mean weighted effect size of 0.90 for VR distraction but it was not possible to draw any conclusion of VR effectiveness for acute versus chronic pain conditions.…”