Pharmacological pain relief is a miracle of modern medicine – but it comes at a price. Could extended reality (XR) offer a drug-free alternative?

In other cases, such as neuropathic pain, a health condition may alter the nervous system, causing sensations of prolonged pain without a source. The nervous system can also be affected by pain in such a way as to prolong or intensify existing sensations of pain. 

Although acute pain can be serious and sometimes life-threatening, chronic pain can substantially lower someone's quality of life, reducing mobility and social interaction and leading to depression and mental illness. These side effects can further exacerbate symptoms. 

Pain management and self-care: a historical snapshot

Believe it or not, humans existed on this earth for many thousands of years with very little recourse to pain relief.

Until the early 19th century – with the introduction of chloroform and ether – medical procedures were carried out without any anaesthesia. Patients were made to sit through excruciating pain and distress unabated.

Chloroform and ether were considered miracles of their day but dwindled in popularity due to their negative side effects. By the 1900s, opiates like morphine became the most widely administered form of pain relief – but not without societal repercussions.

In the late 19th century, physicians were already warning of the addictive nature of opioids – dubbed "narcomania". They observed that "repeated indulgence [induced] bodily and mental prostration and mental perversion". By 1898, a German pharmaceutical business called Bayer Company began producing the first over-the-counter bottles of diacetylated morphine, named "Heroin".

Today opioids are still in use, but the crisis is far from over. During the 1980s, opiate prescriptions increased as aspirin, codeine and morphine became mainstays of pain management, ratified through the World Health Organisation's (WHO) Cancer Pain and Palliative Care Program. 

Alternative treatments

Though not without barriers, the liberalisation of opioids for pain management has created lasting dependence issues for populations around the world. According to the WHO, there were 600,000 drug-related deaths worldwide in 2019, of which 80% were caused by opioids. 

Alternative treatments for pain management are in high demand as clinicians continue the fight to treat chronic conditions and improve their patients' quality of life. Research into cognitive behaviour therapy (CBT), mindfulness and extended reality (XR) have uncovered effective, drug-free alternatives to abate this "invisible illness".

Virtual reality and pain management: how does it work?

Simply put, virtual reality (VR) pain management applications intercept pain signals to the brain by distracting the user.

But it's more than that. By creating engaging experiences for the patient, VR can reinforce positive emotional responses that help attenuate their experience of pain and help them understand their body and its inner workings.

These techniques are more common than you might think. When we knock our head or arm on a hard surface, we immediately rub the affected area. By overlaying pleasurable signals on top of painful ones, we reduce the overall sense of pain. VR exploits this same idea but to greater effect.

In many cases, VR is used as a digital interface to enhance other, proven forms of non-pharmacological pain treatment like mindfulness and CBT. VR presents clinicians with a greater scope of control and techniques to address a wide variety of painful medical procedures. This includes burn dressings and colonoscopies, as well as chronic pain conditions.

Projects of note

In Diane Gromala's Virtual Meditative Walk (VMW), patients are immersed in a deciduous forest.

The surroundings are peaceful and ambient, but subtly changing. Modulations in the user's arousal levels are reflected in their surroundings. Built-in sensors create a bio-feedback loop that helps patients understand the responses needed to achieve a mindful state.

The VMW is intended to increase patients' sense of control and agency over their bodies by providing direct feedback from their embodied responses to stimuli. 

Meanwhile, researchers from Sheffield Hallam University, Sheffield Teaching Hospital and Sheffield Children's NHS Foundation Trust implemented VR pain relief for burn victims. Their tests, which utilised immersive virtual environments during medical interventions, found that VR helped draw patients' attention away from painful procedures. 

These results were corroborated by patients and nurses alike, who testified to the reduction in pain and the resulting ease with which the procedures were carried out. 

The future of XR and pain management

Studies for XR and pain reduction are still ongoing, but early trials suggest it has huge potential to empower patients and clinicians in a variety of palliative settings. These may include dental procedures, other chronic pain conditions and even vaccination anxiety. 

Non-pharmacological alternatives to pain reduction are needed to reduce opioid dependence and XR is demonstrating tangible, real-world results. 

If you're interested in the potential of XR in healthcare, we'd love to help. Visit our online store to browse proven technologies from the likes of RealWear, Magic Leap and Vuzix. Or get in touch with our XR experts to discuss deployment and use cases.