Virtual reality and chronic low back pain

Abstract

Aim

Chronic low back pain (CLBP) is a highly prevalent and significant cause of disability which is often resistant to pharmacological management. Virtual reality (VR) is an emerging technology with the potential to influence CLBP, and has been suggested as an alternative to opioids for pain management. VR is a goalfocused, computer-simulated reality allowing modification of the user’s experience of their perceived world.

Materials/Methods

A narrative review of peer-reviewed literature using a systematic search strategy, and sole reviewer for data extraction.

Conclusions

VR has demonstrated effectiveness in reducing acute, experimental and chronic pain. This review describes the theoretical basis of the therapeutic effects of VR on CLBP via three distinct mechanisms: distraction, neuromodulation and graded exposure therapy. Furthermore, clinical application will be considered, including discussion of ethical issues associated with the technology.

Implications for rehabilitation

• Virtual reality (VR) is suggested as an alternative for opioids in the management of acute and chronic pain.

• The therapeutic mechanisms of VR in chronic low back pain (CLBP) are equivocal but include distraction, neuromodulation of body perception and graded exposure therapy.

• VR may show greater efficacy in patients with CLBP with associated kinesiophobia.

• VR may show greater effect with increased immersion.

Keywords:

• Virtual reality
• assistive technology
• back pain
• graded exposure therapy
• distraction
• neuromodulation

Acknowledgements

The author thanks the Guy’s and St Thomas’ NHS Foundation Trust physiotherapy department for their continued support and inspiration.

Disclosure statement

I affirm that I have no financial affiliation (including research funding) or involvement with any commercial organization that has a direct financial interest in any matter included in this manuscript, except as disclosed in an attachment and cited in the manuscript.

I report no conflict of interest.