Virtual Reality for Chronic Pain

Virtual Reality for Chronic Pain
Lauren Ostlund, PharmD, Broadway Family Medicine

Chronic low back pain is one of the most common chronic pain conditions in the United States and has been associated with smoking, depression, sleep disturbances, and other medical comorbidities according to the National Health and Nutrition Examination Survey from 2009–2010. Additionally, patients with chronic low back pain reportedly have less formal education, lower income levels, and more frequent healthcare visits.

A new creative treatment device, granted Breakthrough Device designation by the United States Food and Drug Administration, has been introduced for patients who are at least 18 years old with chronic low back pain. EaseVRx™ is a virtual reality experience delivered by a device worn over the face. It integrates cognitive behavioral therapy into virtual reality, while also utilizing deep breathing exercises with a breathing amplifier, to help patients manage aspects of chronic pain that are not treated with medication therapy. 

EaseVRx™ includes 2-16 minute treatments completed daily for 8 weeks. Skills practiced include deep relaxation, attention-shifting, interoceptive awareness, perspective taking, distraction, immersive enjoyment, self-compassion, healthy movement, acceptance, visualization, knowledge of pain, and rehabilitation. The device cost and addition of traditional pharmacologic or physical therapies that the patients used in the study are unknown. Chronic pain diagnoses in the study were self-reported and not verified with medical records. Results showed greater reductions in the EaseVRx™ group compared to the control group for average pain intensity and pain-related interference with activity, along with improved mood, stress, and sleep. Although some supportive evidence is present, more research is needed to determine the potential clinical impact of virtual reality treatment for chronic pain. Specifically, understanding full treatment plans of patients prior to EaseVRx™ use, and significance of EaseVRx™ on outcomes, will be essential going forward. 

References:

  1. Shmagel A, Foley R, Ibrahim H. Epidemiology of chronic low back pain in US adults: national health and nutrition examination survey 2009–2010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027174/pdf/nihms770787.pdf 
  2. U.S. Food and Drug Administration. FDA authorizes marketing of virtual reality system for chronic pain reduction. FDA News Release. Published online Nov 16, 2021. Accessed January 27, 2022. https://www.fda.gov/news-events/press-announcements/fda-authorizes-marke...
  3. Garcia LM, Birckhead BJ, Krishnamurthy P, et al. An 8-week self-administered at-home behavioral skills-based virtual reality program for chronic low back pain: double-blind, randomized, placebo-controlled trial conducted during COVID-19. J Med Internet Res. 2021;23(2):e26292. Published 2021 Feb 22. doi:10.2196/26292.