The State of Science in the Use of Virtual Reality in the Treatment of Acute and Chronic Pain

Abstract

Previous reviews have reported virtual reality (VR) to be an effective method to treat pain. This scoping review examines the state of the science for VR and pain both generally and by pain type (acute and chronic) related to types of mechanisms, dosage, effectiveness, and adverse events (AEs). We searched online databases PubMed, Web of Science, PsychInfo, and CINAHL from 2010 to 2020 and included studies from peer reviewed journals that examined people with pain, (excluding pain-free participants) with a primary outcome measuring pain. We assessed studies for risk of bias using PEDro criteria. We described data through counts and percentages. Significant results were determined through P-values. We found 70 studies representing 4105 people; 46 acute pain studies (65.7%), 22 chronic pain studies (31.4%), and 2 (2.9%) “both.” The most common VR mechanism was distraction (78.6%) then embodiment (17.1%). However, distraction was the mechanism for 97.8% acute pain studies while embodiment was more common for chronic pain (54.5%). Dosage of VR was inconsistently reported and varied considerably. VR treatment groups showed significant improvements in pain, particularly for intensity of pain (72.1%) and quality of pain (75.0%). Few studies examined AEs. Limitations of this review include only examining last 10 years of articles and that many studies were missing data. VR appears to be an effective intervention to address both acute and chronic pain. Research evaluating VR mechanisms, dosage, and AEs is warranted, as is further work in under-served populations (children for chronic pain and older adults) as the current evidence is largely limited to adult populations with pain.

The feasibility and effectiveness of virtual reality meditation on reducing chronic pain for older adults with knee osteoarthritis

“…While there is strong evidence demonstrating that VR is effective for reducing acute pain, there is limited evidence on the effects of virtual reality on chronic pain, and an even greater gap in knowledge on VR use with older adult populations specifically 19 . Preliminary studies demonstrate the safe and feasible qualities of immersive VR as a treatment tool for older adults, as this population reports minimal or acceptable adverse side effects, high enjoyment levels, and willingness to try the VR again 20–22 .…”

Immersive medical virtual reality: still a novelty or already a necessity?

“…They provide critical stepping stones towards the wider adoption of medical VR. Further evidence demonstrated in high-quality trials, [10][11][12][13] linking applications to theoretical frameworks, 13 shedding light on mediating outcome factors (eg, content, dosage, frequency, patient characteristics), improving ease of use, and evidence for VR's cost-effectiveness are required for broader acceptance and medical VR uptake.…”

“…VR is effective as an intervention to control acute pain during medical procedures 10 11. For example, a randomised, crossover study reported a 39% reduction in opioid medication when using VR during painful medical procedures compared with the non-VR condition 12.…”

Examining the difference between 10- and 20-min of immersive virtual reality on symptoms, affect, and central sensitization in people with chronic back pain

“…Immersive virtual reality (IVR) has emerged over the last 20-years as an effective and viable method to treat acute pain, and more recently as a treatment for chronic pain (Baker et al, 2022). Chronic back pain (CBP) is one of the most common forms of chronic pain, with a prevalence estimated between 3.9 and 20.3 percent of the population (Meucci et al, 2015).…”

“…One area which has received little attention in the IVR literature is optimal IVR duration. Protocols for acute and chronic IVR session duration ranged from less than 5 min to 45 min or more (Baker et al, 2022). As we develop therapeutic interventions that incorporate IVR, we must determine specific parameters that will lead to best therapeutic results.…”