virtual reality guided imagery for chronic pain

Conditions: Complex Regional Pain Syndromes; Back Pain

Summary: to assess treatment with an at-home virtual reality guided imagery (vr-gi) intervention, 36 patients with chronic pain (18 with chronic back pain, cbp, and 18 with complex regional pain syndrome, crps) will complete a 2-week intervention with at-home daily practice of vr-gi (n = 24) or audio-only gi (n = 12). pre-post treatment measures of pain intensity, opioid use, functional outcomes, and mood will be collected. intervention feasibility and patient satisfaction will be evaluated post-treatment via questionnaire and qualitative interview.

○ chronic pain affects over 100 million adults in the us, resulting in disability, loss of work productivity, and overall reductions in health, making chronic pain a major public health problem with an economic burden estimated at $560-635 billion annually. opioids, the most frequently prescribed class of drugs to control pain, lack evidence supporting their long-term efficacy and carry a 15-26% risk of misuse and abuse among pain patients, highlighting a critical need to develop effective non-pharmacological interventions for pain. guided imagery (gi), a cognitive-behavioral technique for guiding patients to create multisensory, imagined scenes to increase well-being, is an effective non-pharmacological intervention for reducing pain. however, its effectiveness is limited by patients' imaging abilities. the long-term objective of this project is to reduce chronic pain and opioid use by developing an at-home virtual reality (vr)-gi intervention to improve chronic pain management using the limbix vr kit. given the enhanced immersiveness and interactivity of vr, vr-gi is expected to reduce pain and reliance on opioids, as well as improve functional outcomes and mood, compared to traditional audio-only gi and usual care. the specific aims are to evaluate feasibility and usability of an at-home vrgi intervention in a 2-week clinical trial. two 15-min vr-gi experiences that guide patients through psychoeducation, relaxation exercises, and interactive virtual worlds that allow them to control their experience of pain will be evaluated. to assess feasibility of an at-home vr-gi intervention, 36 patients with chronic pain (18 with chronic back pain, cbp, and 18 with complex regional pain syndrome, crps) will complete a 2-week intervention with at-home daily practice of vr-gi (n = 24) or audio-only gi (n = 12). pre-post treatment measures of pain intensity, opioid use, functional outcomes, and mood will be collected. intervention feasibility and patient satisfaction will be evaluated post-treatment via questionnaire and qualitative interview. this research directly addresses the need to improve pain treatment to prevent opioid use disorder.

Eligibility criteria:
inclusion criteria: * must be a patient at the university of southern california pain center * - english fluency * diagnosis of chronic back pain or complex regional pain syndrome * average pain intensity of 5 on a 0 to 10 scale for more than 3 month * access to a device with video and audio capability and sufficient wifi to participate in on-line sessions exclusion criteria: * history of significant motion sickness * active nausea/vomiting * epilepsy * significant movement problems * significant vision or hearing impairment