By Pragati Verma, Contributor
When Erin Martucci declined an epidural during labor, her doctors offered her a virtual reality (VR) headset. Slipping it on, she was mentally transported to a relaxing beach vista, where she could hear crashing waves and chirping birds, all while lying in her hospital bed in New York. A soothing voice coached her to focus on crashing waterfalls and seagulls flying circles overhead, as well as her breathing. The virtual experience helped her block a lot of pain during the two hours before she was ready to push.
Martucci is not the only patient who has used VR to escape pain. These immersive, multisensory environments that nudge our brains into thinking we are somewhere else are emerging as powerful alternatives to opioids for everything from burn injuries to stroke.
“VR is becoming the new go-to tool to reduce pain and anxiety in several hospitals and doctors’ offices,” said Matthew Stoudt, co-founder and CEO of AppliedVR, the startup that designed the virtual-reality environment for Martucci ‘s hospital. “Our platform is already being used in about 100 hospital systems.”
The idea, according to Stoudt, is that we can alleviate pain by manipulating how the human mind works. “We are not good at multitasking. If we swamp the brain with an overload of inputs in a virtual world, its capacity to process pain goes down,” he explained. “The less you focus on pain, the better you feel.”
Brennan Spiegel, the health services research director of Cedars-Sinai in Los Angeles, agrees. “[VR] will give doctors and patients more options than medicines alone.”
Having treated more than 500 patients using VR technology and having recently published a study on the impact of VR on patients suffering from back, shoulder, foot pain, post-surgical wounds, and severe abdominal pain, Spiegel would know.
The experiments went something like this. Spiegel and his team at Cedars-Sinai asked patients suffering from pain to put on a VR headset and explore an immersive environment for 10 minutes. A control group watched a 2-D relaxation video for the same amount of time. The two groups were then asked to report if they felt better. At the end of the study, 65 percent of the VR group reported a reduction in pain, compared to 40 percent in the TV group. When asked to rate their pain on a scale of 1 to 10 (10 being the highest), the VR group’s reported pain went down from 5.4 to 4.1, and the TV group’s pain dropped to only 4.8.
This reduction of patients’ pain by an average of 24 percent is a big deal as it relates to opioid prescriptions—and their associated addictions. According to the CDC, even a one-day opioid prescription carries a 6 percent risk of use up to one year later. And if patients get a 30-day initial prescription, their chance of being on opioids for a year rises to 45 percent.
Stoudt believes that a nonaddictive pain-management method like virtual reality holds a lot of promise for reducing the widespread opioid epidemic. “Doctors desperately need nonaddictive and noninvasive ways to manage pain to break the opioid addiction. And VR offers exactly that,” he explains.
But despite its positive benefits, Spiegel warns that virtual reality is not a miracle and comes with its own limitations. For instance, VR might not work for people with motion sickness, seizure, or nausea. Many other pain sufferers are not comfortable with the idea of wearing headsets. “We need more data to know when it is and when it isn’t the right approach,” he says.
Today, Spiegel is working on a large randomized controlled trial that compares immersive content with a health-and-wellness TV channel to test VR’s impact on pain management, narcotic usage, length of stay and satisfaction with care among hospitalized patients.
And whereas hospitals are apt places to test virtual reality as a pain-management mechanism, it can be challenging to extend research and feedback into clinical walls. VR is still considered a relatively new and experimental approach in the clinical setting, and doctors and nurses are not trained to work with the equipment.
“It is critical to optimize VR devices to fit seamlessly into clinical workflow design. If they are not built to fit into the day-to-day business of doctors and hospital staff, devices will sit in a corner and gather dust, even if they show a high clinical efficacy,” Stoudt says.
Spiegel believes a “Virtualist Consult Service,” comprising clinicians who specialize in therapeutic VR, could help ease virtual environments into healthcare. “VR can work just like any other clinical procedure,” he said. “If a doctor thinks that his patient will benefit from VR, they can ask for it in the chart, and the team will show up.”
And just as VR will need to adapt to everyday clinical practices, it will also need buy-in from health insurance companies. It’s early days yet, but few insurance firms are evaluating models to include VR medical procedures.
Spiegel, for one, is working with a large insurance provider on a workers’ compensation program, trying to find ways to manage pain among injured workers by using VR and avoiding opioids. The idea is to help them return to work as early as possible. And if VR procedures can mitigate pain without causing addiction and related health problems, thus reducing hospital stays, they’ll make great business sense.
Beyond the prospect of opioid-free pain management and shortened hospital stays, recent price cuts to high-quality and portable VR devices have made it much easier and more exciting to experiment with virtual reality.
VR as a pain-management tool may still need more planning to be ready for prime-time, but an immersive experience could soon play at a hospital near you.