“Electronic painkillers” are here. Wearing VR glasses can cure back pain. How is this done?

"Low back pain and shoulder pain are caused by human walking on both feet."

Popular science book "Stay away from pain! Said in "The Science of Pain Relief".

Young people now have sore backs and legs that are too common. What else can I do besides lying flat and liberating the upper body?

Why don't you try a VR headset? Let VR "hijack" our brains, where we play games, enjoy the scenery, and swim with dolphins, unconsciously distracted from the pain, and no longer so uncomfortable.

This is not a science fiction scene, but an invention that has already landed.

Why can VR treat low back pain?

On November 16, EaseVRx was authorized by the U.S. Food and Drug Administration (FDA) to be sold as a "prescription drug".

This is an immersive virtual reality (VR) system for relieving chronic low back pain. It was launched by AppliedVR, a US VR medical solution provider established in 2005.

▲ EaseVRx.

Chronic low back pain generally refers to moderate to severe waist pain that lasts more than three months. It is one of the most common chronic pain diseases in the United States and may inhibit daily activities. The current treatments for chronic low back pain mainly include analgesics, exercise, steroid injections, surgery and transcutaneous electrical nerve stimulation.

Cognitive Behavioral Therapy (CBT), which is commonly used to treat anxiety, phobia and depression, can also be used to reduce chronic low back pain.

VOX has reported that many chronic pain patients have never received a specific diagnosis, and all standard treatments are ineffective for them. There is such a possibility-the pain is not caused by any physical problems, but psychologically.

▲ Picture from: AppliedVR

EaseVRx is a VR device based on cognitive behavioral therapy. It helps patients with chronic low back pain aged 18 years and above reduce pain through methods such as deep relaxation, attention shift, inner feeling awareness, empathy, distraction, and immersive enjoyment.

This set of VR equipment is for home use. It consists of a VR headset, a controller, and a "breathing amplifier" connected to the headset. It can transmit the patient's breath to the microphone on the headset for deep breathing exercises. The EaseVRx treatment plan consists of 56 VR sessions with a length of 2-16 minutes.

Prior to approval, the FDA evaluated the safety and effectiveness of EaseVRx in a randomized double-blind clinical study. The study divided 179 participants with chronic low back pain into two eight-week VR programs, one in the EaseVRx group, and the other as a control group, a two-dimensional VR program that did not use cognitive behavioral therapy.

At the end of the eight-week treatment period, 46% of EaseVRx participants reported a pain reduction of more than 50%, compared with 26% of the control group; 66% of EaseVRx participants reported a pain reduction of more than 30%, and the control group participated The proportion of respondents is 41%.

In the later follow-up, the 30% pain reduction effect lasted for three months in the EaseVRx group.

▲ Relief of pain interfering with activities.

In addition, EaseVRx participants were asked to rate pain intensity, pain interfering with activities, pain interfering with mood, pain interfering with sleep, and pain causing stress on a 10-point scale. At the end of treatment, participants’ pain intensity decreased by an average of 1.31 points.

There are also some adverse reactions in the treatment. Approximately 20.8% of participants reported discomfort in their headsets, and 9.7% reported dizziness and nausea.

Josh Sackman, co-founder of AppliedVR said:

Enduring and managing chronic pain every day can be an exhausting and costly challenge, and many patients suffering from it may feel hopeless and long for any relief. As we participate and accelerate more in-depth clinical research, we want patients to know that we are committed to making VR a reimbursable standard of pain care.

Not all pain can be treated with VR

According to Dr. Christopher M. Loftus, Acting Director of the Office of Neurological and Physical Medical Devices of the FDA, pain relief is an important part of patients with chronic low back pain. The license to EaseVRx provides a pain-reducing treatment option that can be used in conjunction with other chronic low back pain treatments, but does not include opioid pain relievers.

No therapy can cure all diseases. All pain may have both physical and psychological components. Cognitive behavioral therapy is also controversial.

▲ Alana Saltz.

Writer and social activist Alana Saltz began to see a doctor when she was about six years old because of chronic headaches, stomach pains, and fatigue. She believes that her pain is physical and structural, and cognitive behavioral therapy can calm her down temporarily at best, but All feelings will come back, the pain will never stop, and she is even more angry because of this:

The therapist told me that the problem lies in my way of thinking, not in medical conditions or systemic injustices, financial difficulties, trauma, and discrimination that I cannot control. This is a big problem with cognitive behavioral therapy. When the therapist always focuses on the patient's distorted thinking instead of the larger problems that affect their lives, the patient will be more harmed.

Therefore, the introduction of VR devices based on cognitive behavioral therapy into the standard of care has caused many people's concerns that it will be used as an excuse to stop patients from taking the required drugs, which has happened before.

▲ Picture from: VOX

The National Institute of Health and Clinical Optimization (NICE) in the United Kingdom has proposed that people with unexplained chronic pain should not be prescribed painkillers, and it is recommended that these patients be provided with exercise, talk therapy and acupuncture. Part of the reason is that commonly used opioid painkillers are highly addictive and risky. Large doses can cause stupor, coma and respiratory depression.

On the one hand, this can inhibit the abuse of highly addictive and risky drugs; on the other hand, it makes it more difficult for many people suffering from chronic pain to find a cure.

▲ Picture from: The Guardian

According to statistics, the way in which hundreds of thousands of people in England and Wales treat their illnesses has been affected by this policy. Nick Entwistle is one of the people who will be affected by the changes in the guidelines:

I am open to CBT and acupuncture treatment. But if the pain cannot be relieved by medicine, I am worried that there will be many unnecessary suicides.

Myra Christopher, a member of PAINS (an organization that aims to improve the treatment of chronic pain), has similar opinions. She hopes that people with chronic pain can get comprehensive chronic pain care, which may or may not include opioids, interventional surgery, Acupuncture, physical therapy, biofeedback, and behavioral health.

In addition to chronic pain, what else can VR treat?

Although there are doubts about cognitive behavioral therapy and VR devices based on it, it is certain that healthcare VR is an evolving field, and other digital health companies are using this technology to solve different medical problems, and have received FDA approval for many times. Approved.

In June 2020 , the FDA approved a VR video game called "EndeavorRx" as a prescription therapy for the treatment of ADHD in children aged 8 to 12.

▲ EndeavorRx.

This game has undergone seven years of clinical trials, involving more than 600 children. In a study that lasted 5 days a week, 25 minutes a day, and lasted 4 weeks, one-third of the children who received treatment had “difficulties in at least one objective Then there are obvious attention deficits."

This improvement lasted for a month. EndeavorRx has produced a small range of adverse reactions, including depression, headache, dizziness and leading to aggression.

In October of this year, digital therapy company Luminopia's VR treatment for children with amblyopia was approved by the FDA . Amblyopia is a disease that affects 3% of children. Amblyopia occurs when the brain and eyes stop working properly, causing the brain to rely more on one eye instead of the other, and causing weaker eyes to have worse vision.

▲ Picture from: the verge

Luminopia's specific method is that when a patient watches a program or movie through a VR headset, the headset displays an image to each eye. The image has a superimposed layer, and the image seen by the strong eye has a lower contrast, forcing the brain to use both eyes correctly. To see them. After watching the show 6 days a week, 1 hour a day for 12 weeks, 62% of children's eyesight has greatly improved.

AppliedVR, the company that developed EaseVRx, is not only relieving low back pain, but also testing its VR platform to treat other pain.

AppliedVR hopes to create an immersive 3D virtual world to alleviate all pains-fibromyalgia, labor pains, burn pain, discomfort during cancer treatment and infusion… The company has developed more than 40 different VR modules. Realize "out of the box" in the future.

In general, VR cannot yet be used as an independent treatment and standard treatment for these conditions. It is just an alternative, often in combination with prescription drugs and other recommended therapies.

In fact, looking at so many VR therapies, the most intuitive is the magic of VR in shaping the whole senses.

▲ The world's first head-mounted display.

But virtual reality is often associated with escapism. We can't help but worry that when VR becomes Baishibailing's psychotropic drug, it is more and more intelligent to create happiness and comfort, whether people are willing to face the cruelty of reality and physical pain, or disdain to distinguish between reality and virtuality, and embrace lightness Is the young digital body becoming a "neurowalker"?

At least for the moment, Josh Sackman, co-founder of AppliedVR, believes:

The goal of teaching patients pain management skills through VR is that when they take off their headsets, they will be more prepared to face life that may feel painful.

▲ The title picture comes from: Bloomberg

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