Dose-responses of virtual reality exposure on chronic pain phenotypes: A pilot study

Abstract Background For individuals with spinal cord injury (SCI), chronic pain interferes with physical health, function, and quality of life. Virtual reality (VR) is a promising intervention that has been effective in reducing neuropathic pain for individuals with SCI, however there is no standardization for dosage of VR administered, and the efficacy of VR for chronic nociceptive pain is unclear. The objective of this study was to evaluate the responses between chronic pain and exposure time to virtual reality (VR) in two pain phenotypes in SCI. Methods A prospective, repeated measures study was conducted with 17 individuals with SCI who engaged with VR for a five-minute and ten-minute bout. Pain intensity ratings were assessed at baseline and after each bout of VR. Results Responses to VR were different for each pain phenotype. A statistically significant decrease in neuropathic pain was achieved within a five-minute bout, and this decrease was maintained at the end of both VR sessions, whereas no change in nociceptive pain level was observed. Conclusion These findings suggest that different mechanisms of pain modulation are activated through VR exposure in each pain phenotype, and that five-minute sessions may be clinically sufficient for modulation of neuropathic pain in individuals with SCI. Trial registration NCT05236933