Abstract
Neuropathic pain (NP) is a chronic, debilitating, and resistant form of pain. The onset rate of NP following spinal cord injuries (SCI) is high and may reduce the quality of life more than the sensorimotor loss itself. The long-term ineffectiveness of current treatments in managing symptoms and counteracting maladaptive plasticity highlights the need to find alternative therapeutic approaches. Virtual reality (VR) is possibly the best way to administer the specific illusory or reality-like experience and promote behavioral responses that may be effective in mitigating the effects of long-established NP. This approach aims to promote a more systematic adoption of VR-related techniques in pain research and management procedures, highlighting the encouraging preliminary results in SCI. We suggest that the multisensory modulation of the sense of agency and ownership by residual body signals may produce positive responses in cases of brain-body disconnection. First, we focus on the transversal role embodiment and how multisensory and environmental or artificial stimuli modulate illusory sensations of bodily presence and ownership. Then, we present a brief overview of the use of VR in healthcare and pain management. Finally, we discus research experiences which used VR in patients with SCI to treating NP, including the most recent combinations of VR with further stimulation techniques.
Highlights
Pain management remains one of the biggest challenges in healthcare, mostly due to the uncertain results of drug therapies and their many undesirable side effects [1]
This study aims to present an overview of the role that Virtual reality (VR) could have in the management of chronic pain and PN
The high level of presence associated with first-person simulations is strongly associated with decreased pain [30,116,117]. This is probably due to the high distractive capacity of VR, which in the case of first-person perspective enhances the “disembodying” effects of the painful body toward the presence in the virtual environment. Another combined treatment that has proven effective in reducing pain caused by burns [118] and physical trauma [119,120,121] is VR hypnosis (VRH)
Summary
Pain management remains one of the biggest challenges in healthcare, mostly due to the uncertain results of drug therapies and their many undesirable side effects [1]. Producing specific changes in the subjective experience of embodiment may produce alterations in bodily sensations, interactions with the environment, and, in certain conditions, reduce pain intensity [20,21,22,23]. This process results from integrating all sensory afferents with memory and ongoing cognitive and affective activities [24]. One of the strengths of immersive or semi-immersive VR lies precisely in the creation of a condition in which the subject is no longer a mere external spectator but an actor in a condition of complete sensory immersion [44]
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