Virtual reality is not new. But, as people search for alternative ways to manage pain — and reduce reliance on pills — VR is attracting renewed attention.
Imagine, for a moment you've been transported to a sunlit lagoon. And, suddenly, it's as if you're immersed in the warm water and swimming. That's what Tom Norris experiences when he straps on his VR headset.
"It's fantastic, I really feel like I'm there," says Norris, who is 70 years old, retired from the military, and lives in Los Angeles with his wife. As dolphins frolic and swim by in the virtual scene, "I get a strong feeling of pleasure, relaxation and peace," he says.
It doesn't take long to produce that effect — about 10 minutes or so, via the headset.
Norris is no stranger to pain. He's got chronic pain through his spine, back and hips, from injuries that go back years.
Ever since he was introduced to virtual reality, he's been hooked. In addition to swimming with dolphins, he's tried other VR experiences, such as wilderness walks.
"I relax. My attention is diverted and it makes the pain more manageable," he says. Norris was on his deck when we spoke, drinking a morning cup of coffee and watching the hummingbirds. "Pain is part of my life," he told me.
He uses lots of tools to help him cope, he says, including peer support groups, which he helps lead. But he says he finds VR particularly helpful. For him, the feeling of relaxation and ease that comes from a virtual swim with dolphins tends to linger for several days.
Norris isn't alone in his positive experience. A study published this month in the journal PLOS ONE is just the latest to document that an immersive, virtual reality experience can be an effective strategy for reducing pain.
VR "changes the way we perceive the pain," explains study author Brennan Spiegel, a physician and the director of Cedars-Sinai Health Services Research in Los Angeles.
The research was done in a hospital where participants were undergoing treatment for various conditions; some were experiencing pain linked to cancer and others had orthopedic pain. "We divided the patients into two groups," Spiegel explains.
One group tried VR. They used Samsung Oculus headsets that were each fitted with a phone that had a VR app. Patients could select from a library of 21 VR experiences available on the app.
They were free to use the VR devices as much as they liked, but were advised to aim for three daily sessions, 10 minutes per session. The other group of patients got to watch a health and wellness channel on TV, as much as they wanted.
"We found that virtual reality reduced pain by about three times as much as watching TV did," Spiegel says. Using a zero to 10 pain scale, the virtual reality experience led to a 2 point drop in pain, compared to a half-point drop for watching TV.
Spiegel's study was partly funded by a grant from Applied VR, a company that sells VR software, but the company played no role in the conduct, data collection, data interpretation, or write-up of the study, he says.
It's not exactly clear how VR works to help reduce pain perception, but pain specialists say there are likely multiple explanations. Distraction in just one element.
"When the mind is deeply engaged in an immersive experience, it becomes difficult to perceive stimuli outside of the field of attention," Spiegel and his collaborators write in their journal paper. In other words, when something captures our attention and uses all our senses, we focus on it. It's like a spotlight — and everything else falls into darkness — at last temporarily.
So, a virtual swim with the dolphins can overwhelm our visual, auditory and other senses. "VR is thought to create an immersive distraction that restricts the brain from processing pain," the authors conclude.
The study adds to other evidence pointing toward potential benefits of VR to manage pain. Going back more than 15 years, studies have shown the technique to be useful in a range of settings — from helping people cope with anxiety to helping reduce acute pain during medical procedures, during physical therapy or during dental procedures. And, there's some evidence VR can help with chronic pain, too.
Still, there are some unanswered questions, says Zachary Rosenthal, a clinical psychologist at Duke University who has been involved in research on VR's effect on pain. "Distraction is helpful for pain," he says. "That's an understood phenomenon. ... But why should VR be better than any other kind of distraction?" he wonders.
Spiegel's research "starts to answer this question," says Rosenthal. "I do think this study moves the needle forward."
If you're new to virtual reality, Spiegel has some advice: "It's always a good idea to check with your doctor first, whenever self-treating symptoms. But in general, it is safe to use VR at home," he says. About 5% to 10% of people who try it get cybersickness, which is basically a feeling of dizziness or vertigo, similar to motion sickness. So, it's good to be aware of this risk.
"For people who own an Oculus Go or Oculus Quest [headset], I suggest Nature Trek, which is an outstanding set of content that is peaceful and meditative" for the treatment of pain, says Spiegel, who has no financial ties to the company. And there are other companies that make a variety of software specifically aimed at easing pain.
"For cheap and easy access to VR experiences, you can simply visit YouTube and search its massive library of free VR content," Spiegel says. "If you want a virtual trip to the beach, type 'VR beach' into the YouTube search engine. Or 'VR forest.' It's all there for the taking."
VR is certainly not a panacea, but it can be another tool in the pain management toolkit. Spiegel and his collaborators say there's still a lot to learn as to which types of VR may be most effective.