A Virtual Reality Tool Helps Ease Extreme Pain When Drugs Can’t

 

By Everyday Health Guest Columnist

Published Feb 16, 2016

By Jo Marchant, PhD, Special to Everyday Health
I’m feeling anxious as research assistant Christine Hoffer, at the University of Washington in Seattle, straps a small, black box to my foot. It will heat up for 30 seconds, she explains, simulating a burn to my skin. I give the resulting pain on my foot a score of 6 out of 10: intense and impossible to ignore.
Hoffer then fits me with noise-canceling headphones and virtual reality goggles, and I’m surrounded by shimmering walls of ice.
As I float through this virtual canyon, I can look up at the stars and down toward a sparkling river — and even spin around. Perched on icy ledges on either side are penguins, igloos, and snowmen throwing snowballs at me. I fire snowballs back. While I’m immersed in the game, Hoffer switches on the black heat box for several more 30-second bursts, but I’m having far too much fun to focus on my foot.
A few moments ago this was intensely uncomfortable; now I’m barely aware of the pain.

How Illusions Relieve Extreme Pain

SnowWorld, the virtual reality system I describe above, was developed by psychologist Hunter Hoffman, PhD, and colleagues at the University of Washington Medical Center in Seattle as a pioneering approach to reduce pain. It’s basically a souped-up distraction technique, he explains. The brain has a limited capacity for attention, so if you’re immersed in something else, you have less capacity left to experience pain. This is why music, video games, or going for a walk can all ease pain to a certain extent. But this virtual reality treatment is helping to tackle some of the most extreme pain in medicine: severe burns.
Patients with severe burns have to undergo regular sessions of agonizing wound treatment, during which dead tissue is scrubbed away, as well as physiotherapy to stretch and tear scar tissue as it forms. Even at the highest doses, drugs often can’t make these sessions bearable. But SnowWorld helps: Trials with patients from scalded children to soldiers gravely injured after being hit by an improvised explosive device in Iraq show that SnowWorld eases pain by 15 to 40 percent on top of any relief that drugs can provide. That’s significantly more effective than video games or music, and Hoffman believes immersion — the feeling of being present in this virtual world — is key. Creating the illusion that we’re in a safe place far from the agonizing therapy room reduces our awareness of the pain.

Mind Over Matter in Medicine

Virtual reality is one of several psychological approaches to pain that I investigated while writing my book Cure: A Journey Into the Science of Mind Over Body. Mindfulness meditation — being aware of your thoughts and feelings moment by moment — is another proven method. Rather than trying to distract themselves from pain, practitioners aim to acknowledge and embrace the pain. Trials show that removing the anxiety and fear associated with pain can dramatically reduce the distress it causes.
Placebos (fake pills) can also be very effective in treating pain, and in fact a significant proportion of the relief you feel after taking real painkillers is due not to their biochemical action, but to your psychological belief in the drugs. Meanwhile, simply receiving medical care from an empathetic practitioner can ease pain regardless of which pill you take. These changes aren’t all in the mind, but are underpinned by physical pathways, such as the release of endorphins.
What all these lines of research show is that our experience of pain, far from being a direct or inevitable consequence of damage to the body, is ultimately controlled by the brain. If you feel afraid or under threat, the warning signal is amplified. But if you feel safe and cared for — whether that’s achieved by meditating, taking a pill, or entering a virtual world — your brain perceives that the crisis is over and eases off the pain.
In Cure, I also explain how similar principles apply to other aspects of our conscious awareness, such as fatigue, nausea, and depression. And because the brain controls so many aspects of our physiology, these changes can also influence physiological functions, such as digestion and immune system activity.

Mind Over Matter in Medicine

In medical conditions from irritable bowel syndrome to multiple sclerosis, feeling stressed and alone amplifies your symptoms, while psychological techniques, from hypnotherapy to cognitive behavioral therapy, help reduce them.
The mind is not a miracle cure: It can’t get rid of cancer, banish an infection, or mend a broken leg. But in the right circumstances, it can dramatically ease symptoms and improve your quality of life — over and above the relief you get from drugs. The research shows that by harnessing your psychological resources, you can maximize the effectiveness of the drugs you take, and sometimes even replace them.
By the end of my SnowWorld experience, I’m no longer anxious. Instead, I feel empowered by such a clear demonstration of the role of the brain. I’ve learned that although you should always listen to pain, you don’t have to be ruled by it.
PHOTO CREDIT: Christopher Ames/iStock; Stephen Dagadakis © Hunter Hoffman, U.W.
Jo Marchant, PhD, is the author of Decoding the Heavens, which was shortlisted for the Royal Society Prize for Science. She lives in London and has a PhD in genetics and medical microbiology, and has written on everything from the future of genetic engineering to underwater archaeology for New Scientist, Nature, The Guardian, and Smithsonian magazine. She has appeared on BBC Radio, CNN, and the National Geographic Channel. Her book Cure: A Journey Into the Science of Mind Over Body was published by Crown on January 19, 2016.