Virtual Reality as a Means to Reduce Pain
Burns are regarded as one of the
most painful medical experiences to endure. Following the initial incident is
the process of having skin removed and bandages applied, which can last for
months. These treatments are crucial to the recovery of the patient, but are so
intense that opioids alone do not provide enough relieve to combat the pain. In
response, researchers at the University of Washington have developed
alternative methods to assist their patients in the pain relief process. The
program, which started in 1996 uses virtual reality to distract their patients
during burn treatments. Researchers created a virtual world called SnowWorld in
which patients travel down a snow-covered hill using a one-push button to aim
and shoot snowballs at their snowmen opponents. The goal of the program is to distract
the patients enough to reroute their attention from the pain of the treatment.
The idea behind this is to interrupt the physiological pain signal by drawing
attention away from the stimulus via the virtual reality game, which requires
constant attention. Patients are frequently triggered during the treatment process,
and experience the initial physical and psychological pain of their accident.
By creating a world of snow, the designers are attempting to, “put out the
fire.”
Results of these studies indicate
that patients who are exposed to virtual reality find their overall pain,
anxiety, and time spent thinking about their pain has reduced by half (see
below). This method is important as it has been reported that those who experience
less pain overall and have a positive outlook on their experience recover more
quickly. Another benefit is that because the virtual world draws attention away
from a painful process, less medication is needed to help cope, meaning
patients do not encounter as severe of withdrawals from the opioids that they
are given. Opioids can cause nausea, and are highly addictive, so finding an
alternative method to medication is encouraging on multiple fronts. It has been
observed by multiple care providers that their patients even look forward to
their treatments as they offer such a great relief from their everyday pain.
This is an interesting way to provide treatment to a burn victim. I'm curious in how the pathways take your mind off of the pain receptors. It makes sense if you're distracted and something happens then it won't hurt as much. I would love to look at an MRI of the brain and see the differences in activity for someone using the VR and someone that is not. Also, it is cool to see that VR technology is improving to a point where it can convince someone that they are on a snowy mountain. I'm sure there will be many more applications of VR technology in the medical field soon.
ReplyDeleteI found this post very interesting. I am also curious on its effects for mediating pain and taking the patients mind off of pain. I can see how opioids can cause nausea but virtual reality induced nausea is also a big thing. My roommate got the playstation VR set and when I first tried it on I got really dizzy, although I was playing a game involving the control of an aircraft. I'm curious to see how they will use VR and what kinds of activities and games they recommend to avoid so the patient doesn't run into other risks.
ReplyDeletehttps://www.cnet.com/news/the-dangers-of-virtual-reality/
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ReplyDeleteThis method of relieving pain is rather interesting because it involves the redirection of synapses, as opposed to directly blocking receptors. What comes to mind is an application of long-term potentiation, wherein one may withstand greater thresholds of pain by eventually training the brain to ignore the pain in favor of other pathways, or remove chronic pain altogether.
ReplyDeleteThe idea of relieving pain without medication reminds me of a fascinating 2007 TED Talk by V.S. Ramachandrayan, a world-renowned cognitive neuropsychologist. At the time he was tackling the issue of mirror neurons and perceived pain in what are known as 'phantom limbs': the perception of sensation in limbs that were removed. Amputees sometimes report pains in amputated limbs due to peripheral nerve injury, despite being consciously aware that the limbs are not present. These pains are often described as the phantom limb being paralyzed or fixed in position, which Ramachandrayan calls learned paralysis because it is due to a lack of feedback to a command from the brain.
To relieve this pain, Ramachandrayan found a cheaper alternative to VR: mirrors. He realized that the brain was not receiving the visual feedback of actual movement, so when patients observed the movement of the functional limb in the mirror where the brain would perceive the amputated limb to be, the pain was relieved. Closing their eyes would suddenly resurrect the pain, and watching the movement again relieved the pain. This doesn't mean that individuals with phantom limbs would have to walk around with a mirror for the remainder of their lives. With regular practice, patients eventually reported that their phantom limbs were once again mobile and therefore their phantom pain was relieved. This is perhaps one avenue of exploration for using VR (or cheaper alternatives) and long-term potentiation to extend past initial pain treatment.
Here is a short video explaining the premise of mirror neurons: https://www.youtube.com/watch?v=s_SDvafWRiU
Here is the full 2007 TED Talk by V.S. Ramachandrayan: https://www.youtube.com/watch?v=Rl2LwnaUA-k
I highly recommend watching the entire video as it is incredible and Ramachandrayan is a fantastic presenter. The portion of the video relevant to my comment, however, is between 9:37 and 17:51.
This is a fascinating concept and I think very relevant given the opioid crisis going on. What is the physical mechanism this works by? Is it actually effecting neurons in the SAM pathway? Or is it method of distraction where the other neurons being affected are ignored?
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