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Can Virtual Reality Replace Painkillers?

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Imagine this: You are lying in a hospital bed after surgery when you begin to feel a stabbing pain. Desperate for relief, you look for your daily dose of pain medication. Not so fast. Soon, you may reach instead for a set of virtual–reality goggles.

Using virtual reality (VR) for pain is not some sci-fi snake oil. This high-tech therapy, which immerses you in a three-dimensional, multisensory world of cinematic grandeur, is on the cutting-edge of pain relief approaches.

Scientific evidence: New research shows that VR significantly reduces many types of pain and may lessen (or, in some cases, replace) the need for pain medication—a well-timed breakthrough given the addiction epidemic that’s being fueled by pain medicine such as opioids.

What you need to know about this exciting new advance…

VIRTUAL REALITY IN ACTION

So what’s it like to experience VR? Once you slip on the somewhat clunky-looking headset or even a simpler pair of special goggles, you’ll be ready to watch three–dimensional, 360-degree streaming video complete with sound that depicts a wide variety of vibrantly colored realistic scenes—either photographed or animated. You’ll hear the sounds associated with that scene and even experience vibrations or other sensations for a completely immersive experience.

Depending on the purpose of the VR therapy—whether you need to focus your mind to distract yourself from pain, for example, or you need relief from anxiety—you may view scenes that give you the feeling of swimming with dolphins in the ocean…lobbing snowballs while hurtling through an animated snowscape…or relishing the splendor of a gushing waterfall.

VR therapy has been used successfully by scientists for years to help treat the symptoms of conditions such as stroke, post-traumatic stress disorder, social phobia and burns. In hospitals, VR therapy is used as needed with children to distract them from painful or scary procedures, such as getting blood drawn.

Until recently, however, VR therapy was too expensive and not widely available. That’s now changing.

NEW SCIENTIFIC EVIDENCE

To learn more about the effects of VR, researchers at Cedars-Sinai Medical Center in Los Angeles recently studied 100 patients experiencing pain from many different causes, including cancer, bone breaks and other ailments. In this study, published in JMIR Mental Health, half of the study participants received 10 minutes of VR therapy once a day, and half watched a two-dimensional nature video with calming music on a high-definition computer screen.

Result: While both groups reported less pain, those undergoing VR experienced a significant 24% drop in pain compared with a 13% decrease in the relaxing video group. The period of pain relief varied but generally lasted at least an hour.

While this study did not identify the exact mechanism behind VR’s effectiveness against pain, it is an example of the spotlight attention theory. According to this theory, the human mind is able to track only a certain amount of information at one time—the eyes focus on what is in a “spotlight” and not the areas in the background. With VR, the brain is overwhelmed with positive imagery that engages the mind so that other signals, such as pain, are not perceptible (or not as perceptible) at the same time.

REDUCING PAIN MEDICATION

Many people who use VR continue to have pain reduction even after discontinuing the therapy. Scientists theorize that VR may somehow reset the brain, making some people less susceptible to peripheral pain signals for a period of time.

Scientists are also investigating whether VR can reduce the use of painkillers after an acute injury, such as a broken leg, or postoperatively—for example, after hip- or knee-replacement surgery.

Sobering statistics: A one-day prescription of an opioid painkiller results in a 6% risk for use of the drug one year later. And when treated for at least 31 days with opioids, nearly 30% of patients were still taking the painkillers a year later.

VR EQUIPMENT

Cedars-Sinai and other medical centers use a VR kit provided by the company AppliedVR (go to AppliedVR.io). This kit consists of a Samsung headset and Galaxy phone at a cost of $800. A subscription to access the library of visualizations is extra.

But do not let that cost overwhelm you. You can use your own smartphone to access VR therapy by buying a headset (available on Amazon.com for about $20 to $100) and then streaming VR content by buying an app or going to YouTube.com. Look online for lists of highly rated VR apps.

Important: The VR therapy used in hospitals is prescribed for specific conditions. When using VR therapy on your own, try it on a trial-and-error basis. For example, if you are looking to relax or alleviate anxiety, you can search “VR and beach” or “VR and relax,” and try out different scenes. There may be minor side effects, such as dizziness. People with dementia, epilepsy, nausea and certain other conditions should not use VR therapy without checking with their doctors.

HOW TO ACCESS VR…

Several hospitals across the country are conducting clinical trials on the use of VR therapy for pain management (including neuropathic pain and phantom limb pain) and other conditions such as attention deficit hyperactivity disorder (ADHD), traumatic brain injury, fear of heights and more.

To find a VR trial near you: Go to ClinicalTrials.gov, type in “virtual reality” and choose your state or a nearby state.

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Source: Brennan Spiegel, MD, professor of medicine, director of Health Services Research and director of the master’s degree program in health delivery science, all at Cedars-Sinai Health System in Los Angeles. He is also assistant dean at University of California, Los Angeles, David Geffen School of Medicine. Dr. Spiegel has published numerous medical textbooks, editorials and more than 160 articles in peer-reviewed journals. Date: December 1, 2017 Publication: Bottom Line Health
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