virtual reality

The excruciating pain of having a burn wound cleaned can make you wish that you could be anywhere else—as far away as possible. An arctic snowscape, perhaps.

With immersive virtual reality (VR), that option is transcending the hypothetical. Immersed in a VR world while undergoing painful treatment, people reported a 20-40 percent reduction in pain.

Luke Moore, a 26-year-old man who sustained deep second and third-degree burns extending over 80% of his lower leg in a campfire accident in Washington State, joined me on the Aches and Gains radio show to describe how immersive VR helped him get through the pain of wound cleaning and physical therapy. He would don VR 3D goggles and lose himself in Snow World, playing a snowball fight game against arctic animals and snowmen. “It takes a lot of the pain away,” Luke said. “While I’m distracted, I don’t feel what they’re doing the majority of the time.”

That’s the idea … to distract your brain from the pain in the real world, drawing you instead into a computer-simulated, 3-dimensional environment. Immersive VR distraction can increase pain tolerance, reduce pain intensity, and lessen the time we spend thinking about pain, studies show.

Why does it work?

The theory is that humans have finite attention resources, so when distraction consumes some of those resource, it leaves less cognitive capacity available for processing pain. Psychologically, it also helps reduce patients’ anxiety when they’re preparing to undergo painful treatment. That alone can reduce their pain significantly.

Dr. Sam Sharar, an expert in immersive VR distraction from the University of Washington, talked to us about which conditions this therapy best treats, the exciting technology behind it, and what the future holds.

When a user puts on the special VR headgear, they are surrounded by synchronized, responsive 3-D images and sounds—if they look up they might see a dark starry sky; if they look down a slow-moving river. Used for everything from education to games to training fighter pilots, the technology has been adapted more recently for medical settings, like distracting patients from pain. Depending on the severity of the injuries, it might be used alone or in combination with pain-relief medication—but distraction alone holds up as a reasonable treatment for mild pain.

Studies on adolescents and kids as young as six and in patients up into their 70s and 80s returned good results. Dr. Sharar authored a study that found VR proved effective in reducing pain among pediatric burn patients who had to undergo intensive stretching and painful range-of-motion exercises. Remarkably, these kids reported substantial relief. “Their pain scores would be reduced somewhere between 20-40 percent when you added virtual reality onto their background pain medication,,” Dr. Sharar said. Interestingly, these patients reported a consistent magnitude of that pain reduction after using VR 3-4 times. That’s reassuring, Dr. Sharar said, “that this isn’t just a novelty effect; there is something biologic going on in this technique to bring relief time after time.”

Burns, which can cause one of the most intense types of pain imaginable due to the thermal injury to the part of the skin layer called the dermis, were the main candidate for this type of therapy in the beginning. Now, researchers are looking at expanding the use beyond acute pain to help people with chronic pain conditions.

Another goal:

Making the technology accessible to more types of patients, such as older adults—who are some of the hardest patients to treat with drugs, because they often experience more side effects, as Dr. Sharar said. He’d also like to see the technology accessible for outpatient use or in low- and middle-income countries.

It would also be interesting to have more virtual environments to choose from—for example, winter scenes for burn patients, or a warm beach for patients with frostbite. Environments might also be tailored according to patient preferences. While Snow World benefited from Paul Simon’s generous offer to include his songs, I know patients who’d like to be able to select classical or jazz music, for example.

Also ahead:

Extending the immersive experience beyond the senses of sight and sound. If patients could feel and smell in the virtual world, that would be even more distracting.

We’ll keep an eye on this technology as it evolves. But if you missed our conversation with Luke Moore and Dr. Sam Sharar, check it out for a fascinating technological glimpse into what virtual reality can do for real-world pain (you can find Part I here and Part II here). And remember:

“Nobody is immune to pain, but together we can overcome it.”