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Using virtual reality to combat pain

 


Click for Larry’s podcast with Drs. Bullock and Won

This post first appeared in the San Jose Mercury News

When I think of virtual reality, I think of playing games or being immersed in a 360 degree video experience where the action takes place all around me. But when Kim Bullock and Andrea Stevenson Won talk about VR, they have something else in mind — helping patients cope with pain. Bullock, a psychiatrist, is the founder and director of Stanford’s Neurobehavioral and Virtual Reality clinics and laboratories. Won directs Cornell’s Virtual Embodiment Lab.

I had a chance to speak with both researchers during a recent visit to Stanford’s Virtual Reality-Immersive Technology Clinic, where I learned about some proven techniques and promising research when it comes to using VR for pain management. You can listen to the entire interview at larrysworld.com/vrpain.

Bullock and Won are working on ways to use VR to help people with psychosomatic pain remap the way they visualize those parts of their body where they experience the pain so that’s it’s less prevalent and less debilitating.

The technology builds on what is known as “mirror therapy” where doctors traditionally used a mirror to create what Psysiopedia refers to as a “reflective illusion of an affected limb in order to trick the brain into thinking movement has occurred without pain.” But VR is much more powerful than a mirror because it allows the patient to visualize more than just the swapping out of, say, a left foot for a right foot.

“If I move my right hand in real life and I can’t move my left hand in real life, I can transform the movement of my right hand so that I see both my left hand and right hand moving freely and naturally,” said Bullock. But with virtual reality “you can push it even further so you can move your hand in real life and see your foot move in virtual reality,” she added.

The researchers are focusing on psychosomatic pain, but virtual reality has already been shown to distract patients from physical pain, such as when cleaning burn wounds to prevent infection.

“Our interdisciplinary team is putting burn patients (especially children and teenagers) into VR during wound care and physical therapy,” wrote University of Washington cognitive psychology research scientist Hunter Hoffman. In preliminary research Hoffman and colleagues found “huge drops in how much pain the patients experience during their short visit to virtual reality,” that exceeded the pain relief from morphine according to research summarized on the website of the Human Photonics Laboratory’s website, vrpain.com.

During our interview at Stanford, Bullock described the VR effect as going well beyond distraction.

“Instead of just having your head and eye movements tracked, your whole body is tracked and now you can create the illusion that your inside another body, you’re inhabiting an avatar,” Bullock said.

It’s about tricking what Bullock describes as our “reptilian brain,” which reacts to injuries through pain as a mechanism to discourage movement of an arm or a limb.

“The brain says we better turn up the pain, so we’ll have time to recover and not have any movement, so we’re programmed that movement and pain are intimately connected and they feed on each other,” Bullock said. With VR ,”we can stop the vicious cycle of immobility and pain,” and give the body the “illusion of movement.”

I’m not a medical doctor and I don’t play one on TV or even on the web, but I have experienced the power of persuasion when it comes to managing physical symptoms. A couple of years ago I suffered an intestinal blockage and, after I posted about it on Facebook, a friend of mine, Dr. Danielle Rosenman, advised me to imagine a river flowing freely through my intestines. Although my results are anecdotal, the technique has been effective. On her professional website, Rosenman writes that she “uses neuroplasticity, imagery, meditation, psychotherapy, and other techniques in her medical counseling practice.”

I’ve used distraction as a way of dealing with occasional discomfort, pain and anxiety by watching TV, playing games or even working at my computer, literally taking my mind off what was bothering me, and that turns out to be a well documented remedy. But when you add in the element of virtual reality, you’re going way beyond distraction because of the transformative impact it can have on the way you’re experiencing the world.

You don’t need to feel pain to understand VR’s emotional impact. Try donning a VR headset and running an application that has you standing on the ledge of a building. When I experienced this at the Facebook headquarters when they were about to launch their Oculus Rift VR headset, I found myself stepping back to avoid falling over. The intellectual part of my brain knew that I was safe on the ground floor but the emotional part of my brain was convinced that I would fall to my death if I took a step forward. That was actually anxiety inducing, so it’s pretty easy for me to imagine turning the tables and using VR as a way of reducing anxiety or even pain.

Dr. Bullock is a psychiatrist, not a pain specialist, and only sees patients dealing with psychosomatic disease.

She is bullish on augmented reality, which which allows you to superimpose computer generated images over your real world visual experience. She said they have a program for spider phobia that allows you to experience virtual spiders in your actual environment. She said that she looks forward to enabling patients to “experience the real world plus the virtual world,” without stumbling into things.

I too am excited about doctors using virtual reality to help us cope and perhaps recover from medical and psychological illnesses. If only we could figure out a way to virtualize the way we pay for medical care.