In the virtual world, there is no pain.
- Commercially available virtual reality technology has been enlisted to fight chronic pain
- Patients put on helmets and receive pain training, then complete a series of tasks
- An Adelaide physiotherapist testing the technology said it showed great promise so far
But virtual reality could help doctors and physiotherapists treat chronic pain, one of society’s most debilitating health problems.
Using off-the-shelf headsets and handsets, Australian company Reality Health has developed a virtual reality program it hopes will make a dramatic difference in treating chronic pain, the leading cause of disability. worldwide according to the Global Burden of Disease study.
A key part of the program is doing what clinicians find most difficult: convincing patients that chronic pain comes from the brain and not from an unhealed wound.
Lorimer Moseley, a clinical neuroscientist and chair of physical therapy at the University of South Australia, said it was something often referred to as “pain system hypersensitivity”.
“Pain protects us and promotes healing… persistent pain overprotects us and prevents recovery,” said Professor Moseley, who provided paid advice to the program’s developers.
“The pain system becomes overprotective and it actually prevents you from doing exactly what you need to recover.”
The virtual reality program attempts to overcome this by essentially tricking the patient’s brain into thinking they are moving less than they actually are.
“The positive attributes of virtual reality are that we are able to alter the sensory input to the brain, and in doing so, we can actually alter the stimulus that the brain receives,” Nigel Cowan, CEO of Reality Health, told the ABC.
“We can reduce sensory input, which means the brain is less likely to want to produce pain and when we combine that with normal rehabilitation therapy, it allows patients to move forward much faster than they expect. normally would.”
Reality Health asked selected physical therapists to try out its virtual reality program on volunteer patients suffering from the four most common areas of chronic pain: lower back, neck, shoulder and knee.
Patients put on the headset and are educated about the pain – where it comes from, how it happens and why it persists in some cases.
They then complete a series of tasks that require them to move in a way that would normally cause their pain, but shows them moving less in the virtual world than their actual movement in real life.
“In the virtual environment we can basically trick their perception a bit and that means they can go a lot further than they normally would,” Adelaide physiotherapist Leander Pronk, who test the VR program without payment.
The clinician then films the patient as they complete the virtual reality exercises, so they can see the difference between their perceived and actual movements at the end of the session.
“The results have been mind-blowing for most of my clients,” Mr. Pronk said.
“Because they know that pain is not related to tissue damage per se, but rather to the fact that the brain is protective, and once they realize that pain is just a protective signal , they feel more confident to go to that limit and sometimes even beyond it.”
Virtual reality also applies to “a range of areas of mental health”
Former mechanic John Harris said the virtual reality program helped him deal with chronic back pain that had restricted his movement for years.
“I was just blown away. It was something I had never experienced before,” he said.
“When Leander showed me the photos of me doing it afterwards, how far I stretched without realizing it was pretty amazing.”
The use of virtual reality in healthcare dates back more than two decades, but its previously high cost and limited availability meant there wasn’t much clinical evidence on its effectiveness.
That’s changing, as cheaper headsets and software make VR more accessible.
Professor Paul Glare, director of the University of Sydney’s Pain Management Institute, which is not involved in the development of the VR module, told the ABC the technology looked promising.
“It makes a lot of sense in neuroscience why it would work, and it would be surprising if it didn’t work in clinical trials,” he said.
“It’s definitely an area that has a lot of potential and I suspect that if it hasn’t already been shown to be effective over another treatment, I’m sure it will be.”
This VR program deals with chronic pain, but its developers hope it can be used for other conditions as well.
“It is also currently being tested in a range of mental health areas, with virtual reality being used in anxiety and depression,” Mr Cowan said.
“It is also used in surgical procedures and in a whole range of activities.”