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Thursday, April 20, 2017

Reducing Pain through Virtual Reality - The Medical Futurist Newsletter Special Edition

Pain management is a challenge at times. Despite many advances in pharmacology there are pain syndromes that are difficult to manage.

For one, pain is subjective, although at extremes it can be measured by changes in vital signs, heart rate, respiratory rate and involuntary reflexes.

In some cases VR has relieved pain when other medications have not.

attribution: The Medical Futurist Newsletter

Brennan M. Spiegel, MD and his research team at the Cedars-Sinai Medical Center in Los Angeles have already treated more than 300 patients with virtual reality (VR) therapy in a pilot project. These individuals with chronic pain were able to immerse into a VR experience for 20 minutes, and forget about their pain through travelling to Iceland or swimming in the ocean. 

Spiegel: “Our experience has shown that when VR works, it really works. But we’ve also found that not everyone is willing yet to try it out, particularly older patients. In our first study, published in JMIR Mental Health, we found that the average age of patients willing to try VR was 49.7 years old, whereas those unwilling to try it were 60.2 years old on average. This is consistent with the known “digital divide” between generations with regard to comfort and familiarity using digital technologies”.

Do you think VR has any side effects? Or that people could become addicted to it?

Spiegel: “We don’t have much information on this yet, at least as it pertains to therapeutic VR. Compared to something like opioids, which have caused a worldwide dependency epidemic of catastrophic proportions, a non-pharmacological pain remedy like VR is highly desirable and not meaningfully addictive in the same manner. But we should not brush aside concerns that VR has potential to be addictive. That said, in our experience to date, we have not seen patients getting obsessed with VR”.

I read that VR reduced pain was 24 per cent in hospitalized patients. That's a very promising result! What are your personal experiences in this regard?

Spiegel: “After practicing medicine for 19 years, I cannot think of any other treatment I’ve used (short of life-saving maneuvers) with a greater immediate impact on patients than VR. In one case, I treated a patient with 8 out of 10 abdominal pain of unclear origin. Narcotics didn’t work and she was receiving an intravenous drip with ketamine – a powerful analgesic that forces patients into a trance-like state. That didn’t work well, either. But within 10 minutes of using VR she reported “zero pain.” She literally said: “I’m ready to go home, as long as I can bring this thing with me.” She was discharged the next day after nearly a week in the hospital”.

In your view, could VR be included soon in everyday hospital practice?

Spiegel: “Using VR in clinical practice turns a lot of heads. Wherever we travel in the hospital with VR goggles, we receive questions from doctors, nurses, and other hospital staff intrigued by the concept of using VR for patient care. It’s hard to leave a unit without allowing curious doctors and nurses to try the headsets. Time and evidence will tell if this excitement should be sustained. We think it will”.

I believe VR will be effective at home as well.

Reducing Pain through Virtual Reality - The Medical Futurist Newsletter Special Edition

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