A rule of thumb here at Kindly MD is to not shrug off a new pain management therapy without doing some investigation. In light of that, the Veterans Administration (VA) is embarking on an entirely new pain management journey with the use of high-tech devices that bring virtual reality (VR) to the table.
We have known about the potential of virtual medicine for the better part of a decade. But potential and proof of efficacy are two different things. Still, it would appear as though the VA believes enough in VR treatment that they are willing to begin using it as a pain management tool.
According to news reports, doctors at eighteen VA health clinics now have the authority to refer chronic pain patients to an 8-week VR program approved by the FDA. Not only that, but the VA was also one of the earliest adopters of the technology. They have been using it to treat PTSD at more than 120 clinics for some two years.
We appreciate the idea of addressing pain management through alternative therapies. Far too often, chronic pain is addressed with medications and surgeries. Strangely enough, both approaches are more appropriate for acute pain. They don't work as well for treating chronic pain.
The Virtual Reality approach to pain management doesn't address the physical aspects as much as you might think. Rather, it approaches pain management from an emotional and mental standpoint. Why? Because pain perception involves all three aspects. Pain isn't just a physical symptom; it also has mental and emotional aspects.
One of the strategies of the VR approach involves distracting patients from their pain. Before you decide that this sort of thing doesn't work, think about your own experiences with pain. Maybe you've injured yourself playing a game of pickup basketball or softball. Yet it wasn't until after the game was over that the pain got really severe. Why was that?
The injury was the injury. But during the game, you were distracted enough that the pain seemed minimal to you. It only became more severe when you got home and sat down to relax. Your physical injury didn't change. All that changed the perception of pain was your mindset.
One of the things the VR treatment does is encourage patients to engage in physical activities that distract them from pain. One such activity involves throwing virtual snowballs at bears. This simple activity engages neural pathways that would otherwise carry pain signals to the brain. Because those pathways are busy dealing with other stimuli, the pain signals never reach their intended target.
How we feel about pain seems to matter in terms of its perception. People who are easily upset or discomfited by pain tend to have lower pain thresholds. On the other hand, people who are not bothered by pain seem to have higher thresholds. VR therapy plays into this concept to some degree. And guess what? It seems to work.
A 2021 study that examined an at-home, self-administered VR program for back pain showed that many patients reported improvement in how they experienced and coped with pain. A second study conducted a year later showed similar results.
There is not just one way to manage chronic pain. That's one of the most exciting aspects of pain medicine. The clinicians that staff pain clinics have access to all sorts of therapies above and beyond surgery and pain medication. Now, clinicians at eighteen VA clinics have access to VR therapy. We think that's pretty exciting.