22nd Annual Pain Medicine Meeting 2023

The Rise of Precision Virtual Reality Interventions for Chronic Pain: Mechanisms of Action, Indications, Dosing, and Efficacy

Richard W. Kim DO MBA, Ahish Chitneni DO, Mustafa Broachwala DO, Rohan Jotwani MD MBA

Columbia, Cornell, Johns Hopkins

INTRO

•Virtual reality (VR) has received significant attention as a non-pharmacologic modality for chronic pain, particularly with the advance of 3D headsets (3D HMDs).

•Rapidly growing literature base but poor generalizations.

•Questions:

•For whom is this indicated?

•How does VR for chronic pain work?

•How much VR should be prescribed?

•Does it work?

•Study Purpose: Analyze VR interventions for chronic pain in order to determine underlying mechanisms of action (MOA) and efficacy, based on indications.

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METHODS

•Systematic Review [novel approach – treatment groups only]

•Inclusion: 3D HMD VR, chronic MSK/neuropathic pain, 18+

•Exclusion: Low dosage VR, VR for PT, PLP

•Data:

•VR treatment within-group outcomes (i.e. baseline vs. post-intervention vs. follow-up)

•Pain, kinesiophobia, and psychological outcome measures

RESULTS

•n= 327 VR treatment group participants (14 studies)

•Studies with interventions targeting non-specific chronic pain populations did not show significant results.

DISCUSSION

•2 broad MOAs underlying efficacy of VR interventions identified.

•3D HMD + Sufficient Dose + Appropriate Indication/MOA = analgesia

•As with any medical intervention, precision is key to efficacy!

High-quality VR interventions significantly improve chronic low back via psychobehavioral modification, and chronic neck pain by addressing kinesiophobia

22nd Annual Pain Medicine Meeting 2023

THE RISE OF PRECISION VIRTUAL REALITY INTERVENTIONS FOR CHRONIC PAIN: MECHANISMS OF ACTION, INDICATIONS, DOSING, AND EFFICACY

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