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Virtual Reality Distraction to Help Control Acute Pain during Medical Procedures

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Abstract

Excessive pain during medical procedures is a widespread problem. Severe pain is especially problematic for severe burn patients who often endure dozens of wound cleanings/debridements and dozens of physical therapy sessions over a period of weeks or months after their initial injury. Pain medications help substantially, but are typically inadequate to control such intense pain from mechanical stimulation of pain receptors during severe burn wound cleaning/debridement. Immersive Virtual Reality (VR) distraction, a nonpharmacologic analgesic used in addition to traditional pain medications, may help bring pain down to more tolerable levels during medical procedures. Patients report 35–50% reductions in procedural pain while in a distracting immersive world, and fMRI brain scans show large drops in pain-related brain activity during virtual reality analgesia (www.vrpain.com). Contrary to concerns that distraction would not work with patients in severe to excruciating pain, preliminary results show that VR distraction is most effective for patients who need it the most, those with the highest pain intensity levels. VR is thought to reduce pain by blocking people’s view of the real world, directing patients’ attention into the virtual world, leaving less attention available to process incoming signals from pain receptors. Consistent with an attentional mechanism, results of laboratory studies show that highly immersive VR systems (hypothesized to be more attention demanding) reduce pain more effectively than less immersive VR systems. We review evidence from clinical and laboratory research studies exploring Virtual Reality analgesia, concentrating primarily on the work ongoing within our group. We briefly describe preliminary results of VR applications for settings other than burn patients; dental fears patients, venipuncture, cerebral palsy patients during physical therapy, older male patients undergoing endoscopic trans-urethral microwave thermo-therapy of an enlarged benign prostate, and patients in pain from a blunt force trauma injury. Finally, we briefly discuss recent and future improvements in VR distraction technology.

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Acknowledgments

This manuscript was funded by the following NIH grants2R01GM042725-21A1 (PI Patterson), NIH 1R01AR054115-01A1 (PI Sharar), Shriners Hospitals for Children, Tampa Florida (award ID #71011-GAL2018, PI Walter Meyer III, MD), and from a charitable donation from the MayDay Fund (PI Walter Meyer III, MD).

The current Springer chapter is an updated version of the following Springer journal review manuscript. Significant portions of the following article originally published by Springer are reproduced verbatim in the current chapter, with kind permission from Springer Science+Business Media and with authors’ permission. Hoffman HG, Chambers GT, Meyer WJ 3rd, Arceneaux LL, Russell WJ, Seibel EJ, Richards TL, Sharar SR, Patterson DR. Virtual reality as an adjunctive non-pharmacologic analgesic for acute burn pain during medical procedures. Ann Behav Med. 2011;41:183–91. Copyrighted by The Society of Behavioral Medicine 2011.

Conflict of Interest Statement

The authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Human Photonics Lab, Department of Mechanical Engineering, University of Washington, Seattle, WA, USA

    Hunter G. Hoffman

  2. University of Texas Medical Branch and Shriners Children’s Hospital, Galveston, TX, USA

    Walter J. Meyer III

  3. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA

    Sydney A. Drever, Maryam Soltani, Mark P. Jensen & David R. Patterson

  4. Department of Health Sciences, University of Florence, Florence, Italy

    Barbara Atzori

  5. University Jaume, Castellón, Spain

    Rocio Herrero

  6. University of Washington, Seattle, USA

    Rocio Herrero

  7. Department of Computer Science, King Abdulaziz University, Jeddah, Saudi Arabia

    Wadee Alhalabi

  8. Department of Computer Science, Effat University, Jeddah, Saudi Arabia

    Wadee Alhalabi

  9. Department of Radiology, University of Washington, Seattle, WA, USA

    Todd L. Richards

  10. Department of Anesthesiology, University of Washington Harborview Medical Center, Seattle, WA, USA

    Sam R. Sharar

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  1. Hunter G. Hoffman
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Editor information

Editors and Affiliations

  1. Institute for Creative Technologies, University of Southern California, Marina del Rey, CA, USA

    Albert “Skip” Rizzo

  2. Université du Québec en Outaouais, Gatineau, QC, Canada

    Stéphane Bouchard

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Hoffman, H.G. et al. (2019). Virtual Reality Distraction to Help Control Acute Pain during Medical Procedures. In: Rizzo, A.“., Bouchard, S. (eds) Virtual Reality for Psychological and Neurocognitive Interventions. Virtual Reality Technologies for Health and Clinical Applications. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-9482-3_8

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