Home-Based Virtual Reality Reduces Chronic Low Back Pain

By Pat Anson, PNN Editor

A new clinical study has found that home-based virtual reality (VR) therapy can significantly reduce pain levels in people suffering from chronic lower back pain. Patients who watched VR programs also reported better mood, reduced stress and that pain interfered less with their sleep.

The study, published in the Journal of Medical Internet Research, is the first controlled trial to compare home-based VR therapy to a “sham” or placebo treatment for chronic pain. The research was funded by AppliedVR, a Los Angeles-based company that is developing therapeutic VR content to help treat pain and other conditions.

Eighty-nine people used the company’s EaseVRx headset daily for eight weeks, immersing themselves in relaxing and meditative VR programs designed to make their pain seem less important, similar to cognitive behavioral therapy. A control group received the sham treatment, watching routine nature scenes with the headset. All participants had chronic low back pain for at least six months.   

By the end of the study, 87 percent of people in the VR group reported less pain intensity, with nearly two-thirds experiencing at least a 30% reduction in pain compared to the control group. There were also significant improvements in sleep, mood and stress in the VR group.

Importantly, the improvements in pain and other symptoms were cumulative over time – meaning the relief was long-lasting and not just when people were watching VR programs.

“If you look at the results graph, you’re able to see the trajectory of pain and pain intensity very reliably declining over the course of the eight weeks. It’s a really strong time trend. It’s not just a random effect,” explained Beth Darnall, PhD, AppliedVR’s chief science advisor.

You can see the graph below. Over the course of 56 days, average pain intensity fell by 43% in patients using the EaseVRx headset, compared to 23% in the control or sham group.

JOURNAL OF MEDICAL INTERNET RESEARCH

Most of the research to date on VR therapy has focused on treating acute pain in hospitalized patients. AppliedVR is trying to demonstrate that virtual reality can also be used to treat chronic pain at home. A small study released last summer showed that home-based VR therapy reduced pain in people with fibromyalgia and chronic low back pain.

Darnall was hesitant to say if there were any pain conditions that VR therapy might not useful for.

“At the end of the day, pain is pain,” said Darnall, who is a pain psychologist at Stanford University. “This basic approach, in which we’re equipping people with self-regulatory skills, is going to be beneficial and broadly applicable for every pain condition.

“We have multiple studies in progress that are testing this device on different populations. It’s really going to be an exciting year, because there’s going to be an explosion of research that’s really going to inform our understanding of how this may help people across different disease conditions.”   

AppliedVR’s headset received breakthrough device designation from the Food and Drug Administration last year. The company hopes to get clearance from the FDA later this year to begin selling the devices. Due to a recent decision by Medicare to start covering breakthrough medical devices, the company is hopeful that private insurers will also start paying for VR therapy. 

Can 3-D Sound Technology Silence Chronic Pain?

By Pat Anson, Editor

Cognitive behavioral therapy. Mindfulness meditation. Acupuncture. Massage. Yoga.

The list goes on and on.

You name it and most chronic pain patients have probably already tried some type of alternative treatment for pain relief. Many give up after a short trial period or simply can't afford to continue treatment.

But there's an innovative and inexpensive new way to treat chronic pain -- a CD that uses binaural sound technology to help listeners relax and "deamplify" pain signals. Think of it as a three-dimensional (3-D) stereo sound that reaches parts of your brain that regular sound can't.

"It's so easy. Anyone can pop in a CD and listen to it. The trick is to use it over time because when you use it regularly, you're training your brain away from pain, says Beth Darnall, PhD, a pain psychologist, clinical associate professor at Stanford University, and author of The Opioid-Free Pain Relief Kit: Ten Simple Steps to Ease Your Pain.

In addition to several practical tips at relieving pain, the book comes with a 20-minute CD that Darnall narrates using binaural technology, which she says is the "gold standard" in psychology for treating post-traumatic stress disorder (PTSD) and anxiety.  Darnall believes her CD is the first to use binaural sounds to treat chronic pain.

"The person just puts on headphones and I walk them through a total body progressive relaxation. Layered behind my voice are tones that go in one ear and in the other ear, in rapidly alternating sessions," Darnall told Pain News Network while attending PainWeek, a week-long conference in Las Vegas for pain management practitioners. 

"Most people will not perceive these tones, but your brain perceives them. This is called binaural technology and what it does is stimulates the different hemispheres of your brain in rapid alternating secession."

Wearing headphones is the key to making binaural technology work. So is listening to the CD at least twice a day. Darnall says it works in a way similar to cognitive behavioral therapy -- by "calming"  the brain and quieting the constant barrage of pain signals it is receiving.

BETH DARNALL, PHD

"Its only when you use headphones that the binoral works because the tones are going in one ear and in the other. And they're talking directly to your nervous system," explains Darnall.. "Even if you don't hear it, they're there.

"When you use it regularly, you're training your brain away from pain. You're literally retraining your neural networks to a calmer -- I don't want to say pain free --  state that helps people de-amplify. You're basically dampening the pain processing over and over again. And so over time your brain is less likely to go straight to the pain and amplification. You keep things at a calmer level where you have less pain and less distress."

You can click here to download an mp3 file and listen to a sample one-minute recording from the CD.

"We have observed is that it is very effective for pain," says Darnall, who recommends that users not be driving, doing chores or be engaged in anything else while listening to the CD.

"Sit. Close your eyes. Be present because we really want to induce a total body state ofdeep relaxation. If you're multi-tasking and doing other things, you're not fully relaxed."

Darnall recommends other relaxation techniques in her book to help people reduce stress and sleep better -- techniques she says can help reduce the need for opioid medication. She says listening to the CD will help enhance that process, but like any alternative treatment it takes time and effort to make it work.

"Most people with chronic pain, have been living with pain so long, if you listen to this once or twice, you're not going to scratch the surface. But over time we can train the whole nervous system away from pain," she said.