The applications of VR seem to offer a valid support in the management of symptoms. It is not yet clear through which mechanisms they are able to act
There is pain and pain. Chronic pain, for example, affects millions of people in the world and represents one of the main causes of disability. Often the available drug and non-drug therapies are not effective enough to adequately address and manage this condition, he explains Alessia Violino, national manager of the Pain and palliative care cultural area of Siaarti (Italian society of anesthesia, analgesia, resuscitation and intensive care). At an international level they are being studied – and in part already being applied – new therapies supported by technology which seem able to provide a more precise and personalized answer to the problem.
Reduce suffering
For situations where the chronic pain becomes difficult and the physiological mechanisms of modulation are so altered and complex as to condition its perception to the point of considering an intractable painful condition up to a few months ago, today applications of virtual reality (Vr) and augmented reality (Ar) are being tested which according to latest international works seem effectively reduce suffering and the dosage of medications, including opioidsthus improving the quality of life of patients. While some of these technologies have already demonstrated their effectiveness in the literature, many are still in the experimental stagesays the expert.
The experience in the USA
Hundreds of hospitals in the United States are evaluating the use of virtual reality, including highly regarded centers such as New York’s Hospital for Special Surgery and Boston’s Children’s Hospital. Hill Cedars-Sinai Medical Center at the forefront of using virtual reality to treat people with chronic pain. The VR program, led by gastroenterologist Brennan Spiegel, professor of medicine and public health at Cedars-Sinai, involved more than 3,000 patients. Virtual reality has been shown to reduce pain, experimentally for now, in a variety of studies conducted within the hospital. Spiegel and his team also developed it a digital pain relief kit, including virtual reality, used at home to help patients improve their quality of life and reduce the need for pain medication.
The FDA has already approved the first digital therapy with VR
In November 2021, the Food and Drug Administration approved the first technology VR for the treatment of adult patients diagnosed with chronic back pain. The device uses the principles of cognitive behavioral therapy techniques to reduce pain. If VR applications in this branch of medicine are increasing, it remains to understand what their mechanism of action is. This is a still unexplored field – underlines Alessia Violini -. Most of the articles found in the literature assume the fact that isn’t just a distraction from the real world to bring an advantage in the reduction in the perception of chronic pain. Last September, however, an experimental study was published in which the variation of the response to a nociceptive stimulus is evaluated, induced on patients who experience virtual reality for therapeutic purposes: virtual reality seems to raise the pain threshold.
In Italy
And in Italy? The so-called digiceuticalsor digital therapies, are currently confined to scientific debates even if for some years there has been a movement of opinion in their favour and there is strong interest from the industrial world. There are many company-level development studios dealing with technology, but we have no news of attempts at clinical trials in particular on chronic pain, confirms the Siaarti expert.
In Trentino, laboratories and apps
In Trentino, the provincial company for health services
where Dr. Violini works, e Bruno Kessler Foundation (Fbk) have launched a project which involves the activation of laboratories with the application of virtual reality in subjects suffering from chronic pain that is difficult to treat. We should enter the operational phase in early 2023. In collaboration with Fbk we have also sent a project for the recruitment of PhD students within the European Union’s “Marie Skłodowska-Curie” programme, he adds.
But not finished. Still in Trentino, TreC Pain is developing (within TreC, the digital healthcare project started in 2014) a prescribable app for the patient suffering from persistent and chronic pain which will support the experimentation with virtual reality. This will allow us to collect a variety of data and have it in real time feedback from patients, available to the doctor who will be able to interact remotely and intervene in those situations in which there is uncontrolled pain or side effects that are difficult to manage, underlines the expert who, together with Siiarti, is also working on a single computerized medical record project of pain therapy at national level.
December 30, 2022 (change December 30, 2022 | 1:30 pm)
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