VR + Biopsychosocial Model = Alternative Pain Management Treatment

Sarasota, FL (WorkersCompensation.com) – The marriage of virtual reality and behavioral health therapy may be the next best alternative to opioids for treating injured workers with chronic pain. A Las Vegas-based digital health company says combining the two forces, along with telehealth has resulted in significant improvement in:

• Sleep duration and quality
• Physical and mobility-based goals
• Pain reduction

Where VR has gained traction in treating chronic pain in recent years, combining it with the biopsychosocial model has generated interest among researchers as well as workers’ compensation stakeholders.

“The Harvard MedTech Vx Therapy appears to be an effective tool in the treatment of pain and the psycho-social issues associated with pain,” according to a recent study published in PubMed Central. “This translates into a greater degree of pain resiliency and an overall improvement in general wellness and improved workplace functionality.”

Advocates say the treatment is based on relatively new science about the brain, along with personalized behavioral coaching.

The adage that ‘you can’t teach an old dogs new tricks’ is a myth. Actually, the brain can create new pathways and be retrained, regardless of chronical age. Neuroplasticity is the brain’s ability to reprioritize maladaptive signals to achieve homeostasis, which allows living things to maintain fairly stable conditions necessary for survival.

With extended VR, “the brain will permanently lower the priority given to pain, noxious and maladaptive signals resulting in the patient becoming more resilient,” said Mark Pew, ‘the Rx Professor,’ who also serves as an advisory board member and consultant to Harvard MedTech. “You’re not stuck with the brain you were born with.”

Pew explained and shared some of the company’s recent findings about the therapy during the recent Workers’ Compensation Institute’s annual conference in Orlando, FL.

VR and Brain Training

VR therapy capitalizes on the brain’s ability to hyper focus and reprioritize signals. While it’s been around since the 1950s, it’s been used effectively to treat pain patients for the last couple of years. A review of 28 recent research articles suggests VR can distract patients and, thereby, help reduce pain and anxiety. VR provides various immersive environments that allow patients wo interact with a virtual scenario that distracts them from their pain.

Different modules included in VR therapy focus on different parts of the brain, which can help a person calm down or speed up and get ready for the day ahead, for example. The modules include:

• Knowledge: Education to empower patients to think about their symptoms in positive ways
• Distraction: Provide an analgesic and anxiolytic effect up to 50% - within minutes
• Meditation: Reduce stress, anxiety and depression and improve sleep patterns through programs tailored to the patient
• Escape: Remove social isolation by allowing patients to explore a world beyond the confines of their recovery to instill hope for their future

MRIs done on pain patients with and without VR therapy demonstrate the changes in the brain. They show how those experiencing immersive VR can dramatically reduce the effect of pain.

“Pain is both a sensory and an emotional experience and is also known to be affected by various psychological factors,” according to the research article. “Several different theories of pain control have been proposed, however, one of the most widely adopted theories revolves around the Gage Control Theory of pain, which posits that alternative stimuli can reduce the intensity of physical pain by blocking pain messages at nerve gates in the spinal cord. Virtual reality therapy has the ability to affect this pathway by blocking or de-sensitizing the physiologic sensation of pain from the peripheral nervous system through psychological inputs to the brain.”

Personalized Clinical Coaching

Working with a personal clinician may help better identify the most effective virtual scenario for each injured worker and expedite the process of mitigating pain.

“You could do VR with just the device. It would have value – neuroplasticity, immersion is still good, so it can be stand-alone,” Pew said. “Harvard MedTech decided to incorporate the whole program – social support through personal clinicians. That creates the full circle.”

The increased use of telemedicine during the pandemic presented an opportunity for clinicians to assist injured workers with chronic pain to use VR therapy in their own homes. Weekly communication between the injured worker and clinician helps the employee focus on the immersive scenario that works best.

“They talk them through the different modules, figure out what programs work,” Pew said. “They ask them for journaling … so they can see the progress may be very small initially, but each week is better. You look at your pain scale, range of motion, amount of sleep, amount of time walking – you get those positive reinforcements. Journaling, plus a personal clinician pushes progress; helps motivate the person.”

Using VR therapy for an average of 12 weeks enables injured workers to feel relief from pain – up to several hours after the VR device is removed. The better habits instilled during the VR therapy, combined with the help of the personal clinician results in even better outcomes, advocates say.

“What do you do when you take off the device? You still have to manage that pain for the rest of the day,” Pew said. “That’s where the psychosocial support comes in.”

Use in WC

While the program is relatively new, Pew says adoption “has dramatically increased.” His focus now is largely on educating workers’ compensation stakeholders and pointing out that VR is about more than just gaming.

“It’s not invasive, it’s not developing codependency,” Pew said. “VR is about equipping your self-efficacy to manage pain themselves … it’s empowering that patient to manage the pain themselves as opposed to pain managing them or relying on a pill.”

Share This Article: