Abstract
ObjectiveEmerging evidence suggests that multisensory illusions can modulate pain and can lead to changes in body perception. The aim of this study was to investigate whether contextual factors could explain the analgesic effects of multisensory body illusions on pain and body perception in people with hand OA (HOA).MethodsIn a crossover study, 28 individuals with painful HOA viewed their most affected hand in and outside of a real-time mediated reality system, with illusory stretching of the hand and changes in sensory input. The outcome measures were pain ratings, pressure pain thresholds, hand function and the subjective experience of the illusion.ResultsStretching the hand both inside and outside the virtual environment led to a reduction in subjective pain ratings (all P < 0.05). Virtual stretching led to changes in body perception (P < 0.05) with no changes in pressure pain threshold (all P > 0.05). Higher pain at baseline predicted susceptibility to the stretch illusion and mean susceptibility ratings were greatest after the stretch illusion.ConclusionThe current study highlights the importance of the context in which pain occurs and in which potential treatments may be applied. In this case, virtual and physical stretching modulated pain, but not viewing the hand alone. The research opens important implications for future research, including the use of contextual control conditions and the development of visual feedback interventions for a range of similarly visible chronic conditions for which pain, body image disturbances and body dissatisfaction may be apparent.
Highlights
The association between radiographic signs of OA and reported pain and disability is low [1, 2], suggesting that additional underlying mechanisms are responsible
Virtual stretching led to changes in body perception (P < 0.05) with no changes in pressure pain threshold
A virtual view of the painful hand leads to changes in body perception in hand OA (HOA)
Summary
The association between radiographic signs of OA and reported pain and disability is low [1, 2], suggesting that additional underlying mechanisms are responsible. Research suggests a disruption of body representation in patients with OA [4, 5] as well as in many other chronic pain conditions [6, 7]. This may present itself in the form of body perception disturbances, in which the size or shape of the affected body part can be misperceived [8,9,10]. Individuals with OA present with high levels of body dissatisfaction, which has a major functional and psychological impact on everyday life [11]
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