VR Increases Tolerance to Pain

We have published several previous articles on the positive effects of XR/VR in healthcare, but these have focused on the training and rehabilitation aspects of the technology. Now, a major study has established a firm link between VR systems and pain management, paving the way for more patient-centric solutions to this age-old problem.

Chemical Interventions

Pain management has always been about removing the feeling of pain for a patient, and typically this has involved some form of chemical intervention. As far back as 3000 BC, the Sumerians isolated opium for pain relief, inadvertently introducing the concept of substance abuse in the process.

From those beginnings, humans have had a long relationship with pain management, particularly when associated with pharmaceuticals of different forms. The evolution of pain management transitioned from ancient magico-religious beliefs to scientific methodologies, highlighted by significant milestones such as the discovery of opium in the 17th century; the advent of anaesthesia using ether or chloroform in the 19th century; and the emergence of contemporary analgesics like morphine and its more normal derivative, heroin, in the 20th century. 

The 19th century also marked the inception of interventional pain management with initial brain blockades as an alternative to addictive chemicals. Currently, the discipline is an established speciality that integrates pharmacological, procedural, and other treatments with an enhanced comprehension of pain causes.

Diversion Tactics

We are all very much aware of the phrase ‘bite the bullet’ but probably less aware that it was coined during 18th- and 19th-century warfare, where a soldier who was going to undergo painful surgery, such as amputation, was encouraged to bite on a lead bullet. The absence of morphine for the common soldiery meant that they were usually offered this alternative to stop them biting their tongue off during the painful procedure. 

Diversion as a means of alleviating pain has been understood for centuries and has come in many forms. Humans have historically recognised the fundamental notion of distraction and have exploited different means to achieve it. In antiquity, non-pharmacological techniques such as cold treatments, massage, hot baths, and other rituals were employed for pain alleviation, incorporating an intrinsic aspect of sensory redirection. 

An early significant instance originates from the Roman physician Scribonius Largus (c. 1–50 AD), who advocated the use of an electric torpedo fish for headache treatment, a method that was presumably functioning through nerve stimulation and resulted in a type of sensory “diversion”, however vague it may have been. Historically, pain was frequently regarded as an existential or “magico-demonic” phenomenon, with therapies typically encompassing religious rites or herbal cures, which may have exerted psychological or diversionary effects beyond their physiological attributes.

The advent of the gate control hypothesis by Melzack and Wall marked a crucial juncture in the history of pain treatment. This hypothesis suggests that pain perception is not solely a direct consequence of physical injury but is also shaped by cognitive and emotional variables. The idea established the theoretical basis for non-pharmacological approaches, such as distraction.

By the end of the 1970s, the gate control theory facilitated the evolution of the biopsychosocial model of pain, which perceives chronic pain as a multifaceted condition shaped by biological, psychological, and social elements. This concept highlighted the utilisation of several therapeutic modalities, including psychological techniques.

VR Lends a Hand

In conjunction with diversion tactics established in medical circles, many researchers are keen to find new methods of taking people’s minds off pain, and VR is firmly in their sights.

For some time now, VR has been employed in the field of pain management for hospitalised adults and children as a means of alleviating pain. This technology is meant to distract patients from their pain, and usually only the patient has experienced it. However, this is about to change, as research conducted by the prestigious Cornell University has included trials with not only relatives of the person experiencing pain but also strangers. The idea is akin to the old adage of a problem shared is a problem halved, the notion of using VR and a shared space to help support pain sufferers now has a lot of credibility.

The impacts of social virtual reality (SVR) were studied by researchers in Cornell’s Virtual Embodiment Lab, which is run by Andrea Stevenson Won, an associate professor of communication in the College of Agriculture and Life Sciences. Researchers conducted the studies by inducing a known level of physical discomfort in the participants. From the team, Isabelle McLeod Daphnis said “People study social interaction for pain management, and people study virtual reality for pain management—we’ve kind of combining those two things, which I think is really unique.”  Professor Won went on to say “virtual reality is a particularly effective distractor that allows you to do a lot of interesting things with embodiment, but until we did it, nobody had ever looked at the effects of social interaction with another person in virtual reality on pain. We expected it to be additionally helpful because not only is it distracting, but it’s also engaging with another person.”

This work builds upon research first reported a few years ago, in which people engaged with a stranger in SVR while experiencing moderate, albeit escalating, physical pain. The recent study utilised the identical pain-induction method: the participant positioned a hand on a thermal apparatus that progressively heated until the subject could no longer tolerate it and withdrew their hand. The heat level, consistently kept within a safe range for humans, and the individual’s pain profile, rated on a scale of 1 to 10, were documented.

For this study, each of the 70 participants—mostly Cornell students—experienced induced pain under four randomly ordered conditions: connecting with a companion (a friend or family member) in virtual reality (VR); connecting with a companion via Zoom; connecting with a stranger (in this case, lab assistants) in VR; and being alone in VR.  The results were tabulated and patterns observed.

Most participants said they would rather communicate with either friends or strangers in VR than in the other two study contexts. However, a minority said they could handle greater discomfort without the distraction of another person. Some people also reported that the more real and immersed they felt in the VR, the less pain they could handle. The results are encouraging, as they clearly point to the shared experience as being easier to cope with and paving the way for further work in this important area.

Non-Pharmaceutical-based Intervention

Medics are very keen to explore any pain-management system that removes the possibility of addiction coming from pharmaceutical intervention. The team at Cornell is keen to capitalise on their findings, and they plan to expand the experiment to get an even greater spread of data, thereby cementing the notion of VR as a credible means of fighting pain.

Once the link is fully established and proven, the way will be clear for developers to exploit the power of VR to create credible environments for pain suppression. Part of the current investigation is focusing on trying to establish whether any virtual environment suffices or if specific elements are needed to capture the attention of the users.

The creation and development of VR worlds is complex and needs a professional touch. If you are considering a VR development, why not chat to our team of dedicated designers and see how we can help you?