Treating MS pain with virtual reality

By Leigh Charvet, PhD, clinical neuropsychologist, as told to Alyson Powell Key

Charvet and Martin Malik presented the study “Virtual Reality as an Intervention for Chronic Pain in Multiple Sclerosis” at the 73rd Annual Meeting of the American Academy of Neurology, 17-22. April 2021., where researchers discuss the latest research on multiple sclerosis and other brain and neurological diseases.

VR is rapidly evolving, both technologically and its use in all kinds of healthcare applications. It offers a 3D environment that you are psychologically immersed in, including all sensory experiences. It’s like a perfect 3D movie environment.

VR is also being used quite a bit now for medical education, allowing doctors to go inside the heart, walk through the brain or see diseases. It is also used in rehabilitation to make exercise more enjoyable and provide feedback that can aid in recovery.

Treating MS pain with virtual reality

We are very interested in the rehabilitation space and using VR for its sensory psychological benefits. It was first used in the research world for people who had acute burns, such as veterans.

The basic idea is that the more you are immersed in VR, the less your brain can pay attention to other stimuli such as pain signals. When the pain is overwhelming, you can enter another world. That was the basis of our interest in using it for MS-related pain. Does VR enhance the mind’s ability to distract from pain or discomfort signals?

Most of our patients live with the burden of daily pain. So we took a specific angle to see if repeated VR sessions can enable the mind to reduce pain signal noise and provide escape, both inside and outside the VR environment, over time.

Eight patients were enrolled in the study based on severe chronic pain associated with multiple sclerosis. We designed the intervention as 8 separate days of 35-minute VR sessions. The larger study is designed to compare different VR materials. We categorized it as active, where you sit but move your hands and actively browse the environment, versus passive, where you watch an emotionally neutral or fun video.

All participants were seated. For the “interactive” material, participants used hand controls to move through virtual 3D spaces. They navigated through a virtual environment and performed simple activities such as catching or throwing a ball. For the “passive” content, they explored the 3D space without interactive navigation or activity. Instead, they watched neutral and fun VR videos such as tours of natural settings. In both conditions, all participants completed a guided VR meditation experience, exploring a relaxing VR environment with peaceful breathing instructions.

We measured pain ratings before and after each session. People had a significant reduction in the amount of pain they experienced during that time. Another thing we found is that patients’ chronic pain ratings decreased after repeated back-to-back VR immersion. And everyone who completed the study said they enjoyed the VR sessions.

The future of VR for pain management

VR technology is moving so fast and now VR is at home. It is attractive because it is not a drug and could be on demand. The next step is to test home delivery and develop it to reach larger sample sizes. We want to compare and refine the content to find what would be most useful for that person. There is interest in offering VR as a treatment for patients with different conditions.

There is great power in how we can apply it; it just needs to be studied to maximize the benefits.

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