A new (virtual) reality in injured workers' pain management & recovery
Studies show that VR therapy can help rewire the brain to reduce reliance on prescription painkillers and ease injury-related fears.
Virtual reality has long been touted as the next big thing in video gaming and social networking, but the history of VR is littered with ideas that failed to gain traction from Nintendo’s crimson-everything Virtual Boy console to the reportedly abrupt end to Meta’s namesake Metaverse project.
While VR has failed to gain widespread adoption in the consumer electronics market, the technology shows great potential for helping injured workers reduce or eliminate the need for prescription painkillers, ease anxiety and depression, improve sleep and speed up recovery, according to Gerry Stanley, M.D., senior vice president and chief medical officer for Harvard Medtech.
Stanley was using VR in the early 2000s to help distract patients in burn units and emergency rooms from their excruciating pain, but says the technology was never really applied across a patient’s continuum of care.
“We asked, ‘If we could leverage this for acute distraction, what can we do with it to create permanent change?”
These permanent changes happen through neuroplasticity, which is the brain’s natural ability to form new pathways in order to achieve homeostasis. It is seen in people recovering from a stroke, which causes spasticity (disruptions in the brain’s normal pathways), as they work to regain the use of their hands.
“What we’re doing is leveraging virtual reality to deal with maladaptive signals, such as pain, depression, anxiety and PTSD, that get in the way of recovery,” Stanley says. “So instead of having to go through the pain, we know that we can form a neural pathway around it.”
While the brain will still recognize signals, whether it be pain, anxiety or a combination, they will no longer be a priority, he says.
The VR therapy accomplishes de-prioritization of pain by overloading the senses, according to Stanley, who explains: “It starts with acute distraction, but over time the brain starts to say, at a subconscious level, ‘I don’t really need to focus on this because it is not really the nuisance that I thought it was.’”
Reducing, eliminating opioid utilization
During VR therapy and after the completion of a 90-day program, patients had “substantial immediate and legacy pain relief,” according to a study by Harvard Medtech of injured workers that used the VR therapy. In addition to reducing pain by approximately 40% while using the headset, patients experienced relief hours after each session. They also thought about their pain less often, according to Stanley.
“They are able to say, ‘My pain was at a nine, but now it is at a three and I can live with it at three,’” he says.
VR therapy also helped 69% of study participants either decrease or end their reliance on painkillers.
The therapy is also showing promise in improving focus and physical activity levels, while reducing pain-related anxiety, according to Harvard Medtech. After finishing the program, patients also experienced:
- A seven-fold increase in the number of activities performed.
- 57% decrease in fatigue.
- 70% reduction in pain-related anxiety.
- 85% decrease in overall forgetfulness.
- 300% increase in the duration of physical activity.
- 470% increase in the ability to focus and complete tasks.
Knowledge, mediation & escape
In addition to distractions, the therapy’s four-prong approach also leverages education, meditation and “escape,” which can range from VR experiences such as flying in a wingsuit to walking the beaches of Mallorca, Stanley explains.
The education piece, or “knowledge” as it’s called in the program, aims to break down big concepts to make them easier for an injured worker to understand.
“It is really predicated on the idea that a lot of people don’t have time with their providers to be educated on why it is important to sleep well, or what is going on with anxiety and depression,” he says. This down-to-basics approach keeps injured workers engaged in their recovery.
The mediation portion starts off as a guided experience to teach the patient about eye control, breath control and body awareness. The aim is to have the patient eventually move away from the guided experience and build up muscle memory to take the techniques outside of the virtual realm.
“If you are in a grocery store and start to feel a panic attack or pain coming on, you can close your eyes and have that muscle memory of sitting in the Zen garden or by a lake,” Stanley says.
To help injured workers overcome mental barriers such as anxiety or depression, the program’s escape pillar allows them to move in a virtual world without pain or the fear or worsening an injury. From scuba diving to flying in wingsuits, these virtual experiences allow injured workers to realize it is safe to enter the world.
Once an injured worker knows it is safe to explore a virtual world, they are then urged to increase their activity in the real world.
“We are using the virtual world to make them feel safe with engaging in the real world,” Stanley says. “The goal isn’t virtual feelings. The goal is to use the virtual tool in a crescendo-decrescendo manner, where they are using it more and more and then less and less as they’re engaging in the real world. “It is really breaking that cycle of fear, anxiety or depression.”
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