Patients often experience severe to excruciating pain during medical procedures
such as wound care and physical therapy. Although opioids (morphine related
narcotic pain medications) are currently essential for pain control during burn
wound care, dosage amounts are limited by side effects of the medication (nausea,
constipation, interfering with appetite, sleep cycles, etc). Patients with severe
burns typically undergo daily wound care to clean, re-bandage, monitor the healing
progress, and prevent infection. Unfortunately most burn patients report severe
to excruciating pain during these medical procedures.
Psychological factors (e.g., anxiety) can strongly influence how much pain is perceived. Thus pain may also be reduced by psychological treatments. Previous research has shown that traditional attention distraction is one promising psychological treatment for pain. Toward the goal of taking distraction to a new level, my colleagues and I are exploring whether allowing patients to escape into SnowWorld can help reduce pain perception. Patients don a VR helmet (blocking their view of the burn wound care), and float through an icy 3-d Canyon during severe burn wound care or physical therapy. Aiming with head-tracked gaze, they shoot snowballs at Snowmen, Igloos, and Robots, which explode with 3-D animations and sound effects.
In clinical studies at Harborview Burn Center in Seattle, we have found that
immersive virtual reality can reduce patient’s pain ratings during severe
burn wound care by 30-50%. Patients typically report large reductions in the
amount of time spent thinking about pain, and how unpleasant they found their
pain. Patients also reported large reductions in pain intensity while in VR
adjunctively, compared to traditional wound care with “morphine only”.
In one study we found VR led to large reductions in pain ratings compared to
a Nintendo video game distraction. More recently, using a custom-built water-friendly
fiberoptic VR helmet, we found that VR reduces severe pain during wound care
in a hydrotank. VR can be used in addition to traditional pain medications,
so the patient has nothing to lose by trying VR.
In laboratory pain studies with healthy volunteers, using fMRI brain scans and
a custom build fiberoptic magnet-friendly VR helmet, we have recently begun
exploring what happens to pain-related brain activity when VR reduces pain (Hoffman,
Richards, et al., 2004). In other studies we have tested our notion that high-tech
VR will reduce pain more effectively than low-tech VR by creating a stronger
illusion of presence in the virtual world, drawing more attention into the virtual
world, leaving less attention available to process incoming pain signals. I
will discuss how advanced human-computer interface technologies may increase
the effectiveness of VR analgesia.
This project is one example of how existing commercially available VR technology is currently being used to help people in a growing number of important medical centers around the world. Considering the severity of the problem of excessive pain during medical procedures, and the encouraging preliminary results to be described