Pain . . . What Pain? Just Retrain Your Brain!

Maria was cooking in her kitchen when hot oil splashed from a pan onto her hand. Her reaction was a typical one when it comes to pain. She instantly recoiled and ran to the sink to place her hand under cold water from the faucet, attempting to minimize the damage done by the burn.

As you can imagine, Maria’s burn hurt badly and became the main focus of her attention. This makes complete sense, since pain is how your brain tells you that something is wrong. Your nerves sense damage in your body and send a signal to your brain that tells you to feel hurt.

But, when it comes to ongoing pain, especially if it’s something that’s already been treated and is healing, that feeling of “pain” coming from the brain is no longer providing valuable information. It’s just capturing all of our attention. The same is true for hospital patients undergoing painful treatments or procedures — yes, some of these things do hurt, but in these situations, the “hurt” isn’t helpful. Of course there are numerous ways to temporarily mask pain, including plenty of over-the-counter pain relief medications and lots of prescription pain medications, but all of these, when used for a prolonged period of time, can have harmful effects on your stomach and on liver and kidney function, and obviously many prescription painkillers are addictive. Now, there’s a very unique and promising new non-pharmaceutical pain relief therapy — one that uses virtual reality to re-train your brain!

Virtual Reality to Help You Forget About Pain

Pain may be really good at making sure you pay attention to it, but in some cases, technology, such as virtual reality (VR) can be compelling enough to actually take over the thoughts and feelings that would otherwise be dedicated to pain. This may sound like “just a distraction,” but since pain itself is really just a mental signal from your brain, stopping that signal is actually stopping the pain.

An ongoing clinical trial at Cedars-Sinai Medical Center in Los Angeles is investigating whether brief VR experiences reduce pain and anxiety for patients staying at the hospital. In the study, published online yesterday by JMIR Mental Healthresearchers examined 100 hospitalized patients who reported pain scores of greater than 3 on the Numeric Pain Rating Scale, which runs from 0 to 10. Fifty patients received virtual reality therapy consisting of wearing VR goggles to watch calming video content such as helicopter rides over scenic portions of Iceland, or imagery of swimming in the ocean with whales. Those patients reported a 24% drop in pain scores after using the virtual reality goggles. Another 50 patients viewed a standard, two-dimensional nature video, depicting relaxing scenes with a calming music audio track, on a close-proximity screen. Although those patients also experienced a reduction in pain, the decrease of 13.2% was less dramatic.

The results from this study and from previous work in this area are promising. It seems that the immersive experience of VR is powerful enough to help treat pain — not just to distract people, but to actually affect the brain in ways that reduce the pain. 

How Does VR Work to Reduce Pain?

While it remains unknown exactly how VR works to reduce pain, Spiegel attributes the benefit to what he calls “immersive distraction.” In other words, when the mind is deeply engaged in an immersive experience, it becomes difficult, if not impossible, to perceive other stimuli, including pain. “We believe virtual reality hijacks the senses, but in a good way,” Spiegel said. “It creates an immersive distraction that stops the mind from processing pain, offering a drug-free supplement to traditional pain management.”

Because the VR intervention was only 15 minutes long and included only one visualization, it is possible that pain could rebound after completion of the therapy session, Spiegel said. Longer-term pain reduction might require sustained and repeated exposure to virtual reality content. The research team is now conducting a larger trial as a follow-up to measure the impact of virtual reality on the use of pain medications, length of hospital stay, and post-discharge satisfaction scores.

Some Patients Are Ineligible or Reluctant to Use VR

If you were given the option to use VR instead of feeling pain, would you do so? I certainly would. Unfortunately, some patients at Cedars-Sinai were ineligible to do so, and others were reluctant. 

Of all the people at Cedars-Sinai in Los Angeles who were being considered for a VR study, only 6% were both eligible and willing to experience the technology. Why? Exclusion criteria included presence of motion sickness, stroke, seizure, dementia, nausea, and isolation status for infection control, rendering 83% of subjects ineligible for VR. On top of that, 66% of eligible patients refused to participate in the study. This may seem like a very high number, but consider for a moment what it’s like to be a hospitalized patient asked to wear a pair of unfamiliar, toy-like goggles. 

Researchers indicated that they have to be very careful about not spreading infection in vulnerable patients, not worsening neurological symptoms, and not precipitating new adverse symptoms in patients already trying to recover from illness. So, the hospital must have special considerations for VR, just as it does for any other new biomedical innovation. 

VR Can Trick Your Brain to Forget the Pain

VR for treating pain is being used not just in hospitals. Late last year, Stanford university hosted a VR Pain Conference, the mission of which was to bring together representatives from the research, clinical, regulatory, funding, and business sectors, with a goal of charting a path to move VR forward into the realm of clinical care to treat pain and other disorders.

Just a few nights ago, Lester Holt, the NBC Nightly News anchor, did a report about Dr. Kim Bullock, a neuropsychiatrist at Stanford University who made a remarkable pain-relieving discovery by accident. While studying VR for conditions such as severe anxiety, a welcome side benefit of that treatment was that the patients’ chronic pain disappeared. They showed an example of a man with chronic pain in one arm manipulating objects in virtual reality using his good arm, while the VR environment showed him that he was using his painful arm. Because his brain saw his painful arm doing all of these things without pain, this was apparently enough to trick his brain into believing that he had no more pain in his bad arm, and lo and behold at the end of the experiment his painful arm had no more pain. You can watch the full video here.

Scientists are continuing to explore the specific components of virtual reality that contribute to pain reduction in seniors. For more details, please read our previous blog post on this subject. I will continue to keep you updated on this and other exciting new technologies as I find out about them.

Are you in Chronic Pain?

Unfortunately, many people with chronic pain wind up needing long-term care, sometimes in nursing homes. Nursing homes in the DC Metro area can cost from $120,000/yr to more than $150,000/yr. The Medicaid Asset Protection Law Firm of Evan H. Farr, P.C. handles Life Care Planning and Medicaid Planning, which is the process of protecting you or your loved ones from having to go broke to pay for nursing home care, while also helping ensure that you or your loved ones get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home. If you or a loved one experiences chronic pain, check out virtual reality, but also please contact us to make an appointment for an initial consultation:

Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.

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