Virtual Reality and the Mediation of Acute and Chronic Pain in Adult and Pediatric Populations: Research Developments

Yacine Hadjiat, Serge Marchand, Yacine Hadjiat, Serge Marchand

Abstract

The use of virtual reality (VR) in the mediation of acute pain in adults has shown real benefit to patients for the past 20 years. This review of the literature provides a descriptive synthesis of the types of VR technology, the mechanisms by which VR mediates pain, and a history of early research in the area. A review of the use of VR to mediate chronic pain in adults, and both acute and chronic pain in pediatric populations follows. The studies reviewed provide mixed results and it is noted that many studies have small sample sizes, are case studies, and do not control for extraneous variables such as the dosage and type of VR technology used. Although VR is an exciting area of inquiry that promises to yield multiple applications, there is a necessity to conduct larger random controlled trials to better understand the use cases for which VR is most effective.

Keywords: acute pain; analgesia; chronic pain; complementary pain management; digital therapeutics; distraction; pain; virtual reality.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Hadjiat and Marchand.

References

    1. Michaelides A, Zis P. Depression, anxiety and acute pain: links and management challenges. Postgrad Med. (2019) 131:438MedA 10.1080/00325481.2019.1663705
    1. Patterson DR, Hoffman HG, Palacious AG, Jensen MP. Analgesic effects of posthypnotic suggestions and virtual reality distraction on thermal pain. J Abnorm Psychol. (2006) 115:834–41. 10.1037/0021-843X.115.4.834
    1. Hoffman HG, Chambers GT, Meyer WJ, Arceneaux LL, Russell WJ, Seibel EJ, et al. . Virtual reality as an adjunctive non-pharmacological analgesic for acute burn pain during medical procedures. Ann Behav Med. (2011) 41:183v Me 10.1007/s12160-010-9248-7
    1. Garza-Villarreal EA, Pando V, Vuust P, Parsons C. Music-induced analgesia in chronic pain conditions: a systematic review and meta-analysis. Pain Physician. (2017) 20:597sicia 10.36076/ppj/2017.7.597
    1. Mahrer N, Gold J. The use of virtual reality for pain control: a review. Psychiatr Manag Pain. (2009) 13:100r M 10.1007/s11916-009-0019-8
    1. Ioannou A, Papastavrou E, Avraamides M, Charalambous A. Virtual reality and symptoms management of anxiety, depression, fatigue and pain: a systematic review. SAGE Open Nurs. (2020) 6:10pen 10.1177/2377960820936163
    1. Chan E, Foster S, Sambell R, Leong P. Clinical efficacy of virtual reality for acute procedural pain management: a systematic review and meta-analysis. PLoS ONE. (2018) 13:7. 10.1371/journal.pone.0200987
    1. Ding L, Hua H, Zhu H, Zhu S, Lu J, Zhao K. Xu Q. Effects of virtual reality on relieving postoperative pain in surgical patients: a systematic review and meta-analysis. Int J Surg. (2020) 82:87 Surg10.1016/j.ijsu.2020.08.033
    1. Cipresso P, Giglioli IAC, Raya MA, Riva G. The past, present, and future of virtual and augmented reality research: a network and cluster analysis of the literature. Front Psychol. (2018) 9:2086. 10.3389/fpsyg.2018.02086
    1. Mazurek J, Kiper P, Cieślik B, Rutkowski S, Mehlich K, Turolla A, et al. . Virtual reality in medicine: a brief overview and future research directions. Hum Mov. (2019) 20:16al r 10.5114/hm.2019.83529
    1. Chirico A, Lucidi F, De Laurentiis M, Milanese C, Napoli A, Giordano A. Virtual reality in health system: beyond entertainment. A mini-review on the efficacy of VR during cancer treatment. J Cell Physiol. (2016) 231:275Phys 10.1002/jcp.25117
    1. Sanchez-Vives MV, Slater M. From presence to consciousness through virtual reality. Nat Rev Neurosci. (2005) 6:332 Neurosci, S1038/nrn1651
    1. Malloy KM, Milling LS. The effectiveness of virtual reality distraction for pain reduction: a systematic review. Clin Psychol Rev. (2010) 30:1011–01110.1016/j.cpr.2010.07.001
    1. Hoffman HG, Seibel EJ, Richards TL, Furness TA, Patterson DR, Sharar SR. Virtual reality helmet display quality influences the magnitude of virtual reality analgesia. J Pain. (2006) 7:843 HG, 10.1016/j.jpain.2006.04.006
    1. Garrett B, Taverner T, Masinde W, Gromala D, Shaw C, Negraeff M, et al. . rapid evidence assessment of immersive virtual reality as an adjunct therapy in acute pain management in clinical practice. Clin J Pain. (2014) 30:1089–089:10.1097/AJP.0000000000000064
    1. Maani CV, Hoffman HG, Morrow M, Maiers A, Gaylord K, McGhee LL, DeSocio PA. Virtual reality pain control during burn wound debridement of combat-related burn injuries using robot-like arm mounted VR goggles. J Trauma. (2011). 71:S125. 10.1097/TA.0b013e31822192e2
    1. Wender R, Hoffman HG, Hunner HH, Seibel EJ, Patterson DR, Sharar SR. Interactivity influences the magnitude of virtual reality analgesia. J Cyber Ther Rehabil. (2009) 2:27r Th
    1. Austin PD, Craig A, Middleton JW, Tran Y, Costa DS, Wrigley PJ, et al. . The short-term effects of head-mounted virtual-reality on neuropathic pain intensity in people with spinal cord injury pain: a randomised cross-over pilot study. Spinal Cord. (2021) 59:738ord- 10.1038/s41393-020-00569-2
    1. Mott J, Bucolo S, Cuttle L, Mill J, Hilder M, Miller K, Kimble RM. The efficacy of an augmented virtual reality system to alleviate pain in children undergoing burns dressing changes: a randomised controlled trial. Burns. (2008) 34:803–8. 10.1016/j.burns.2007.10.010
    1. Li A, Montano Z, Chen VJ, Gold J. Virtual reality and pain management: current trends and future directions. Pain Manag. (2012) 1:1–18. 10.2217/pmt.10.15
    1. Wittkopf PG, Lloyd DM, Coe O, Yacoobali S, Billington J. The effect of interactive virtual reality on pain perception: a systematic review of clinical studies. Disabil Rehabil. (2020) 42:3722–33. 10.1080/09638288.2019.1610803
    1. Jansen-Kosterink SM, Huis in't Veld RM, Schönauer C, Kaufmann H, Hermens HJ, Vollenbroek-Hutten MM. A serious exergame for patients suffering from chronic musculoskeletal back and neck pain: a pilot study. Games Health J. (2013) 2:299–307. 10.1089/g4h.2013.0043
    1. Al-Ghamdi NA, Meyer WJ, Atzori B, Alhalabi W, Seibel CC, Ullman D, et al. . Virtual reality analgesia with interactive eye tracking during brief thermal pain stimuli: a randomized controlled trial (cossover design). Front Human Neurosci. (2020) 13:1 Neu 10.3389/fnhum.2019.00467
    1. Davis KD, Moayedi M. Central mechanisms of pain revealed through functional and structural MRI. J Neuroimmune Pharmacol. (2013) 8:518immu 10.1007/s11481-012-9386-8
    1. Descalzi G, Ikegami D, Ushijima T, Nestler EJ, Zachariou V, Narita M. Epigenetic mechanisms of chronic pain. Trends Neurosci. (2015) 38:237euro 10.1016/j.tins.2015.02.001
    1. Bushnell MC, Case LK, Ceko M, Cotton VA, Gracely JL, Low LA, et al. . Effect of environment on the long-term consequences of chronic pain. Pain. (2015) 156(Suppl 1):S4249. 10.1097/
    1. Macdonald G, Leary MR. Why does social exclusion hurt? The relationship between social and physical pain. Psychol Bull. (2005) 131:202 Bul 10.1037/0033-2909.131.2.202
    1. Wiech K, Lin CS, Brodersen KH, Bingel U, Ploner M, Tracey I. Anterior insula integrates information about salience into perceptual decisions about pain. J Neurosci. (2010) 30:16324–632 10.1523/JNEUROSCI.2087-10.2010
    1. Gold JI, Belmont KA, Thomas DA. The neurobiology of virtual reality pain attenuation. Cyberpsychol Behav. (2007) 10:536–44. 10.1089/cpb.2007.9993
    1. Sutherland S. Meeting Report: Virtual Reality Pain 2016 | Pain Research Forum. (2016). Available online at: (accessed January 28, 2022).
    1. Gupta A, Scott K, Dukewich M. Innovation technology using virtual reality in the treatment of pain: does it reduce pain va distraction, or is there more to it? Pain Med. (2018) 19:151hno 10.1093/pm/pnx109
    1. Ahmadpour N, Randall H, Choksi H, Gao A, Vaughan C, Poronnik P. Virtual Reality interventions for acute and chronic pain management. Int J Biochem Cell Biol. (2019) 114:105568. 10.1016/j.biocel.2019.105568
    1. Pourmand A, Davis S, Marchak A, Whiteside T, Sikka N. Virtual reality as a clinical tool for pain management. Curr Pain Headache Rep. (2018) 22:53. 10.1007/s11916-018-0708-2
    1. Iannetti GD, Mouraux A. From the neuromatrix to the pain matrix (and back). Exp Brain Res. (2010) 205:1in R 10.1007/s00221-010-2340-1
    1. Le Bars D, Dickenson AH. Besson, JM. Diffuse noxious inhibitory controls (DNIC) I Effects on dorsal horn convergent neurones in the rat. Pain. (1979) 6:283e rat 10.1016/0304-3959(79)90049-6
    1. Le Bars D, Dickenson AH. Besson, JM. Diffuse noxious inhibitory controls (DNIC) II Effects on dorsal horn convergent neurones in the rat. Pain. (1979) 6:305e ra 10.1016/0304-3959(79)90050-2
    1. deCharms RC, Maeda F, Glover GH, Ludlow D, Pauly JM, Soneji D, Gabrieli JD, Mackey SC. Control over brain activation and pain learned by using real-time functional MRI. Proc Natl Acad Sci USA. (2005) 102:18626–31. 10.1073/pnas.0505210102
    1. Davies JE, Marsden CA, Roberts MH. Hyperalgesia and the reduction of monoamines resulting from lesions of the dorsolateral funiculus. Brain Res. (1983) 261:59s, M 10.1016/0006-8993(83)91283-0
    1. Abbott FV, Hong Y, Franklin KB. The effect of lesions of the dorsolateral funiculus on formalin pain and morphine analgesia: a dose-response analysis. Pain. (1996) 65:17FV, 10.1016/0304-3959(95)00162-X
    1. Potvin S. Marchand, S. Pain facilitation and pain inhibition during conditioned pain modulation in fibromyalgia and in healthy controls. Pain. (2016) 157:1704–704 10.1097/j.pain.0000000000000573
    1. Yarnitsky D. Role of endogenous pain modulation in chronic pain mechanisms and treatment. Pain. (2015) 156(Suppl 1:S242):l 10.1097/01.j.pain.0000460343.46847.58
    1. Julien N, Goffaux P, Arsenault P, Marchand S. Widespread pain in fibromyalgia is related to a deficit of endogenous pain inhibition. Pain. (2005) 114:295d pai 10.1016/j.pain.2004.12.032
    1. Mayer DJ., Wolfle TL, Akil H, Carder B, Liebeskind JC. Analgesia from electrical stimulation in the brainstem of the rat. Science. (1971) 174:1351–35 10.1126/science.174.4016.1351
    1. Do AT, Enax-Krumova EK, Ozgul O, Eitner LB, Heba S, Tegenthoff M, et al. . Distraction by a cognitive task has a higher impact on electrophysiological measures compared with conditioned pain modulation. BMC Neurosci. (2020) 21:53. 10.1186/s12868-020-00604-1
    1. Goffaux P, Redmond WJ, Rainville P, Marchand S. Descending analgesia–when the spine echoes what the brain expects. Pain. (2007) 130:137g an 10.1016/j.pain.2006.11.011
    1. Gougeon V, Gaumond I, Goffaux P, Potvin S, Marchand S. Triggering descending pain inhibition by observing ourselves or a loved-one in pain. Clin J Pain. (2016) 32:238 Pai 10.1097/AJP.0000000000000244
    1. Bantick SJ, Wise RG, Ploghaus A, Clare S, Smith SM, Tracey I. Imaging how attention modulates pain in humans using functional MRI. Brain. (2002) 125:310J, 10.1093/brain/awf022
    1. Colloca L, Raghuraman N, Wang Y, Akintola T, Brawn-Cinani B, Colloca G, et al. . Virtual reality: physiological and behavioral mechanisms to increase individual pain tolerance limits. Pain. (2020) 161:2010–010 10.1097/j.pain.0000000000001900
    1. Chalaye P, Lafrenaye S, Goffaux P, Marchand S. The role of cardiovascular activity in fibromyalgia and conditioned pain modulation. Pain. (2014) 155:1064–06 10.1016/j.pain.2013.12.023
    1. Chalaye P, Devoize L, Lafrenaye S, Dallel R, Marchand S. Cardiovascular influences on conditioned pain modulation. Pain. (2013) 154:1377–377 10.1016/j.pain.2013.04.027
    1. Garcia LM, Birckhead BJ, Krishnamurthy P, Sackman J, Mackey IG, Louis RG, et al. . An 8-week self-administered at-home behavioral skills-based virtual reality program for chronic low back pain: double-blind, randomized, placebo. J Med Internet Res. (2021) 23:e26292. 10.2196/26292
    1. Kenney T. SnowWorld Melts Away Pain for Burn Patients, Using Virtual Reality Snowballs. GeekWire: (2018). Available online at: (accessed September 30, 2021).
    1. Hoffman HG, Richards TL, Coda B, Bills AR, Blough D, Richards AL, Sharar SR. Modulation of thermal pain-related brain activity with virtual reality: evidence from fMRI. Neuroreport. (2004) 15:1245–8. 10.1097/01.wnr.0000127826.73576.91
    1. Hoffman HG, Doctor JN, Patterson DR, Carrougher GJ, Furness TA. Virtual reality as an adjunctive pain control during burn wound care in adolescent patients. Pain. (2000) 41:305–9. 10.1016/S0304-3959(99)00275-4
    1. Hoffman HG, Patterson DJ, Carrougher CJ, Sharar SR. Factors influencing the efficacy of virtual reliaty distraction analgesia during postburn physical therapy. Arch Phys Med Rehabil. (2007) 88:43–9. 10.1016/j.apmr.2007.09.004
    1. Sander S, Boggan B, Eshelman D, Guzzetta C. Effects of distraction with use of virtual reality glasses during lumbar punctures in adolescents with cancer. J Pediatr Oncol Nurs. (2001) 18:83–7. 10.1177/104345420101800244
    1. Vazquez JL, Wiederhold BK, Miller I, Wiederhold MD. Virtual reality assisted anaesthesia during upper gastrointestinal endoscopy: report of 115 cases. Eur Med J. (2017) 1:75d JL 10.12970/2311-9888.2017.05.01
    1. Baeza-Barragain MR, Manzanares MT, Vergara CR, Casuso-Holgado MJ, Martin-Valero R. The use of virtual reality technologies in the treatment of Duchenne muscular dystrophy: systematic review. JMR Mhealth Uhealth. (2020) 8:e21576. 10.2196/21576
    1. van Twillert B, Bremer M, Faber AW. Computer-generated virtual reality to control pain and anxiety in pediatric and adult burn patients during wound dressing changes. J Burn Care Res. (2007) 2:694–702. 10.1097/BCR.0B013E318148C96F
    1. Chan EA, Chung JW, Wong TK. Application of a virtual reality prototype for pain relief of pediatric burn in Taiwan. J Clin Nurs. (2007) 16:786–93. 10.1111/j.1365-2702.2006.01719.x
    1. Sarig-Bahat H, Weiss PL, Laufer Y. Neck pain assessment in a virtual environment. Spine. (2010). E105–12. 10.1097/BRS.0b013e3181b79358
    1. Jones T, Moore T, Choo J. The impact of virtual reality on chronic pain. PLoS ONE. (2016) 11:e0167523. 10.1371/journal.pone.0167523
    1. Mallari B, Spaeth EK, Goh H, Boyd BS. Virtual reality as an analgesic for acute and chronic pain in adults: a systematic review and meta-analysis. J Pain Res. (2019) 12:2053–85. 10.2147/JPR.S200498
    1. Rutter CE, Dahlquist LM, Weiss KE. Sustained efficacy of virtual reality distraction. J Pain. (2009) 10:391–7. 10.1016/j.jpain.2008.09.016
    1. Tse MM, Ng JK, Chung JW, Wong TK. The application of eyeglass displays in changing the perception of pain. Stud Health Technol Inform. (2002) 85:532–5. 10.1037/e705452011-032
    1. Loreto-Quijada D, Gutierrez-Maldonado J, Nieto R, Gutierrez-Marti'nez O, Ferrer-Garcia M, Saldana C, et al. . Differential effects of two virtual reality interventions: distraction versus pain control. Cyberpsychol Behav Soc Netw. (2014) 17:353cho 10.1089/cyber.2014.0057
    1. Hoffman HG, Garcia-Palacios A, Kapa V. Beecher, J, Sharar, SR. Immersive virtual reality for reducing experimental ischemic pain. Int J Hum Comput Interact. (2003) 15:469m Co 10.1207/S15327590IJHC1503_10
    1. Aminabadi NA, Erfanparast L, Sohrabi A, Oskouei SG, Naghili A. The impact of virtual reality distraction on pain and anxiety during dental treatment in 4-6 year old children: a randomized controlled clinical trial. J Dent Res Dent Clin Dent Prospect. (2012) 6:117–24. 10.5681/joddd.2012.025
    1. Gold JI, Reger G, Rizzo AA, Buckwalter G, Kim S, Joseph M. Virtual Reality In Outpatient Phlebotomy: Evaluating Pediatric Pain Distraction During Blood Draw. Los Angeles (2005). 10.1016/j.jpain.2005.01.224
    1. Gold JI, Mahrer NE. Is virtual reality ready for prime time in the medical space? A randomized control trial of pediatric virtual reality for acute procedural pain management. J Pediatr Psychol. (2018) 43:266atr 10.1093/jpepsy/jsx129
    1. Dahlquist LM, Weiss KE, Dillinger Clendaniel L, Law EF, Ackerman CS, McKenna KD. Effects of videogame distraction using a virtual reality type head-mounted display helmet on cold pressor pain in children. J Pediatr Psychol. (2009) 34:574–84. 10.1093/jpepsy/jsn023
    1. Sander Wint S, Eshelman D, Steele J, Guzzetta CE. Effects of distraction using virtual reality glasses during lumbar punctures in adolescents with cancer. Oncol Nurs Forum. (2002) 29:E8–15. 10.1188/02.ONF.E8-E15
    1. Gershon J, Zimand E, Pickering M, Rothbaum BO, Hodges L. A pilot and feasibility study of virtual reality as a distraction for children with cancer. J Am Acad Child Adolesc Psychiatry. (2004) 43:1243–9. 10.1097/01.chi.0000135621.23145.05
    1. Schneider SM, Workman ML. Virtual reality as a distraction intervention for older children receiving chemotherapy. Pediatr Nurs. (2000) 26:593N7. 10.1188/04.ONF.81-88
    1. Patel A, Tran MCJ, Schieble T, Davidson M, Schoenberg C, Bennet H, et al. . Preanesthetic distraction with a Game BoySchoenberg C, Bennet Hention for older children receiving chemotherapy. raction for children with caIn: New York: Proceedings of the 58th Postgraduate Assembly in Anesthesiology. New York, NY (2004).
    1. Reger GM, Rizzo AA, Buckwalter JG, Gold J, Allen R, Augustine R, et al. . Effectiveness of virtual reality for attentional control to reduce children's pain during venipuncture. In: Proceedings of the 2nd International Workshop in Virtual Rehabilitation. New Jersey, NJ (2003).
    1. Gold JI, Kim SH, Kant AJ, Joseph MH, Rizzo AS. Effectiveness of virtual reality for pediatric pain distraction during IV placement. Cyberpsychol Behav. (2006) 9:207ycho 10.1089/cpb.2006.9.207
    1. Lange B. Pain and Anxiety Associated With Minor Medical Procedures in Pediatric Clients and Their Parents: Is Virtual Reality a Useful Distraction Technique? PhD thesis. Adelaide, SA: University of South Australia; (2006).
    1. Iannicelli AM, Vito D, Dodaro CA, De Matteo P, Nocerino R, Sepe A, et al. . Does virtual reality reduce pain in pediatric patients? A systematic review Italian. J Pediatr. (2019) 45:1atr 10.1186/s13052-019-0757-0
    1. Lambert V, Boylan P, Boran L, Hicks P, Kirubakaran R, Devane D, Matthews A. Virtual reality distraction for acute pain in children. Cochrane Database Syst Rev. (2020) 10:CD010686. 10.1002/14651858.CD010686.pub2
    1. Maples-Keller JL, Bunnell B, Kim S, Rothbaum BO. The use of virtual relaity technology in the treatment of anxiety and other psychiatric disorders. Harv Rev Psychiatry. (2017) 25:103 Psy 10.1097/HRP.0000000000000138
    1. Wiederhold MD, Gao K, Wiederhold BK. Clinical use of virtual reality distraction system to reduce anxiety and pain in dental procedures. Cyberpsychol Behav Soc Netw. (2014) 17:359–65. 10.1089/cyber.2014.0203

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