Easing Pain with Virtual Reality

Aug. 17, 2001 -- While virtual reality can help gamers escape the simple cares of the everyday world, it can also serve a higher purpose: helping alleviate the pain of burn victims.

At the University of Washington in Seattle, doctors with the school's Harborview Burn Center are using a virtual reality system, which their colleagues in the Human Interface Technology Laboratory developed, to treat patients with severe burns.

According to Dr. David Patterson of the UW School of Medicine, the VR system works by taking a patient's attention away from the pain.

"Pain perception has a strong psychological component," Patterson said. "The same incoming pain signal can be interpreted as painful or not, depending on what the patient is thinking. Pain requires conscious attention."

Many of Harborview's patients have severe burns covering large portions of their bodies. Medicines like morphine are usually effective in dulling the pain when patients are resting, but during therapy sessions, when burned skin needs to be stretched and bandages changed, painkillers aren't enough.

Immersive Distractions

"I actually end up concentrating on what she's doing," said Mitchell Crazybull-Bertelsen of his sessions with therapist Dana Nakamura. Crazybull-Bertelsen was burned by a trash fire that raged out of control. "I end up watching her, and I know it's going to hurt if she moves the bandage a certain way."

Crazybull-Bertelsen isn't alone. Up to 86 percent of patients report severe to excruciating pain during therapy, Patterson said. Crazybull-Bertelsen said the virtual reality system has helped him shift his mental spotlight away from the pain.

Wearing a plastic helmet with a computer monitor inside, headphones, and a tracker that monitors the position of his fingers, Crazybull-Bertelsen enters a virtual world created with the help of multicolored 3D graphics, sound, and tactile feedback.

"We'll be done with the stretching and he'll say, 'Oh, when are we going to start?' And I'll say, 'We're already done'," Nakamura said of her patient's progress. "It's incredible how far into the virtual world they can get."

Worlds of Spiders and Snow

The UW researchers first tested their VR pain relief system in 1999 on two burn patients, one recovering from a skin graft and the other with burns covering 33 percent of his body. The patients were entertained with a program called SpiderWorld, which presented a virtual kitchen filled with appliances and wiggly legged arachnids.

An electromagnetic tracking system on the patients' fingers allowed them to feel as if they were picking up objects in the kitchen. According to Patterson, this tactile aspect of the VR technology has another benefit besides pain-distraction: It motivates burn victims to grasp at objects in the virtual world, giving them a reason to perform painful but necessary stretching motions.

After patients in the original study and 12 other burn victims in a follow-up study reported dramatic reductions in pain, Harborview began offering VR therapy in addition to painkillers to all its patients. The hospital said nearly 100 percent of eligible burn patients agree to participate.

Since patients often report reliving their original burn experience during wound care, the UW researchers have added another virtual realm: SnowWorld, which is designed to help put out the mental fire. Patients can now lose themselves in an icy, waterfall-filled world where they can shoot snowballs at snowmen and igloos.