Abstract

One of the most socially impactful applications of virtual reality (VR) is its use as a non-pharmacological remedy for both acute and chronic pain. Yet, despite robust findings establishing the analgesic effects of VR, use cases almost exclusively involve (a) patients with acute/chronic pain, which are often difficult to access and vary widely in terms of pain location/severity, or (b) experimentally induced pain, which can have low lab-to-life generalizability. One understudied pain context that may reconcile these limitations is body modification, specifically tattoo procedures. Examining the use of VR during a tattoo offers several benefits to VR and pain research. First, tattoo recipients as a participant pool are more accessible. Second, tattoo pain is presumably more standardized and uniform as it is administered by a machine at a consistent force. Thus, to test these assumptions and expand the scope of VR applications in this domain, we present a mixed-methods investigation testing the effects of VR on pain experienced during a tattoo. Leveraging qualitative interviews with tattoo artists and customers, a 3-month on-site field experiment at a tattoo parlor was conducted. Customers' self-reported pain ratings (N = 16) were collected during 1-h tattooing sessions and compared between a treatment (VR) and control group. As expected, VR significantly reduced pain ratings during the procedure, and increased pain resilience. By suggesting that the analgesic effects of VR extend to volitional pain during a tattoo, we argue that tattoo pain warrants attention by both VR content developers and researchers interested in studying how immersive content influences real-world pain perception. The study also yields specific guidelines to help designers create and deploy VR experiences for this context. Overall, the results suggest that tattoo sessions present a promising context worthy of further investigation across a variety of VR research programs.

Highlights

  • Growing reliance on pharmaceuticals for pain management has contributed to an opioid addiction epidemic that continues to worsen (Lyapustina and Alexander, 2015)

  • Considering the aforementioned justification of tattoo pain as a viable methodological substitute for other, more experimentally variant forms of pain, the fundamental prediction that we test in this study is that virtual reality (VR) use will reduce perceived pain during a tattoo. To test this hypothesis and lend credence to the use of tattoo recipients as a subject pool with which to test the efficacy of VR-based pain interventions, we present findings from a mixedmethods field experiment

  • Should the customer exhibit no signs of an adverse reaction to pain beyond what is deemed normal, the tattooing proceeds uninterrupted for the remaining 45 min or so

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Summary

Introduction

Growing reliance on pharmaceuticals for pain management has contributed to an opioid addiction epidemic that continues to worsen (Lyapustina and Alexander, 2015). By replacing the real-world sensory information (i.e., audiovisual) with computer-generated information in the head-mounted display (HMD), VR experiences elicit a sense of being in the virtual rather than physical world. This sense of “presence” impedes the cognitive ability to process pain signals generated in the real world (Hoffman et al, 2008; Li et al, 2011; Gupta et al, 2018; Scheffler et al, 2018). It is because of this that VR has long been considered “a promising non-pharmacologic analgesic, especially for patients who must undergo brief painful procedures” It is because of this that VR has long been considered “a promising non-pharmacologic analgesic, especially for patients who must undergo brief painful procedures” (see Hoffman et al, 2004, p. 167)

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