The first time Nancy Baker saw people use virtual reality to deal with chronic pain, it was a revelation.
One had suffered from complex regional pain syndrome for years, experiencing unrelenting pain in one arm. “She tended to guard her arm-she didn’t like people to touch it, she didn’t like to move it,” says Baker, an associate professor of occupational therapy.
Baker and a colleague put a virtual reality (VR) headset on the woman and gave her hand controls that allowed her avatar in the VR headset to move its arms. The VR is immersive-with the headset on, all you see is a vivid setting, encompassing 360 degrees as you move your head and move around. In this case, the setting was a space station in zero gravity, and the task was to pull herself through the station by grabbing handholds on the walls, floor, and ceiling.
“She was moving both arms so naturally in real life-you could not tell which arm had the problem,” Baker says. “Afterwards, she came out and said she would never have dared move her arm that way if it was real. She didn’t have pain while in the virtual reality setting. And she was smiling. People with complex regional pain syndrome don’t smile-because they’re always in pain and miserable.”
Another person had complex regional pain syndrome of the leg, and they also put him in the VR anti-gravity setting, where he roamed around. “He came out and said, ‘Wow, I had no pain. That was amazing. I haven’t had no pain in years,'” Baker reports. He said later that he’d had no pain for another hour to two on his drive home, which had never happened before.
“Here was this simple device that you could put on somebody and you could take them away someplace else,” she says. It was the beginning of Baker’s quest to understand how VR might be used to treat chronic pain. She’s now published three papers on the topic, and is continuing with research in this area.
Distraction and Embodiment
Some 20% of Americans live with chronic pain, according to the Centers for Disease Control and Prevention. It is “a disease in and of itself,” says Baker. Those who suffer from it may have had an injury in the past that started the pain, and though that injury healed sufficiently, the pain persists.
“The pain is more intense and lasts longer than in typical healing, and now it is more of a bio-psychosocial disease,” says Baker. “The pain can be extremely bad.”
“Often people with chronic pain see their bodies as different-they have body dysmorphia,” Nancy Baker says. “In the VR, they can let go of these perceptions of their bodies.”
Photo: Alonso Nichols
Some might say that such pain is “all in the person’s head”-of course all pain is registered in the brain, Baker notes-“but people with chronic pain have legitimate, awful pain. It’s not going to heal and go away in the same way that acute pain will,” she says.
How does the VR experience help alleviate pain? For starters, it’s very distracting, taking the person’s mind completely away from focusing on their pain. That is especially apparent in dealing with sudden, acute pain, and VR has been used successfully to help alleviate suffering during things like dental surgery, childbirth, and treating burn wounds.
As physician Brennan Spiegel, A94, writes in his book VRx: How Virtual Therapeutics Will Revolutionize Medicine, “It turns out our brains are designed to live in one reality at a time,” and taking people away from the ability to focus on their pain diminishes the experience of the pain.
Another reason why VR is effective is it “feels hyper-real,” says Baker. “It feels more real than real when you’re in the headset. It might be the fact that every aspect has been designed intentionally; there’s nothing superfluous.”
But it’s not just distraction, Baker thinks. “When you’re in virtual reality, you no longer have a body-your vision is completely occluded. That means you can no longer see, monitor, or be aware of what your body is doing in space.”
People with chronic pain tend to always be monitoring what they’re doing, she says, so in a VR system, “you can’t be hypervigilant because your body’s not there anymore.”
Embodying the Feeling
Some research suggests that by manipulating a person’s perception of their body using VR, it is possible to change their perceptions of pain, not just distract them, Baker says, a process called embodiment. That’s when people see a virtual object-something representing their arm, a leg, or even whole body-as actually being their body, and they respond to what’s happening to that virtual body as though it was their own body.
