Decreasing Pain Ratings in Chronic Arm Pain Through Changing a Virtual Body: Different Strategies for Different Pain Types
Open accessAbstract
Modifying the visual aspect of a virtual arm that is felt as one's own using immersive virtual reality (VR) modifies pain threshold in healthy subjects, but does it modify pain ratings in chronic pain patients? Our aim was to investigate whether varying properties of a virtual arm co-located with the real arm modulated pain ratings in patients with chronic arm/hand pain because of complex regional pain syndrome (CRPS) type I (without nerve injury) or peripheral nerve injury (PNI). CRPS (n = 9) and PNI (n = 10) patients were immersed in VR and the virtual arm was shown at 4 transparency levels (transparency test) and 3 sizes (size test). We evaluated pain ratings throughout the conditions and assessed the virtual experience, finding that patients with chronic pain can achieve levels of ownership and agency over a virtual arm similar to healthy participants. All 7 conditions globally decreased pain ratings by half. Increasing transparency decreased pain in CRPS but did the opposite in PNI, whereas increasing size slightly increased pain ratings only in CRPS. We conclude that embodiment in VR can decrease pain ratings in chronic arm pain, although the type of pain determines which strategy to decrease pain is most useful. We discuss this through the interactions between body image and pain perception. PERSPECTIVE: "Embodiment" in VR is useful to decrease pain ratings in chronic pain patients, but the best strategy needs to be tuned to the pain etiology. This approach could potentially help patients with chronic pain and clinicians who seek alternatives to pain management for patients.
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Matamala-Gomez and colleagues found that multisensory interventions that manipulated body from VR modulated pain perceptions.
“Similar to results found within acute and procedural pain samples, Matamala-Gomez and colleagues [125] found that multisensory interventions that manipulated body from VR modulated pain perceptions.”
From Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) · cites this paper as [125]
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- Authors
- Matamala-Gomez, M., Diaz Gonzalez, A. M., Slater, M., & Sanchez-Vives, M. V.
- Affiliations
- Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES)
- Universitat de Barcelona (ES)
- Institució Catalana de Recerca i Estudis Avançats (ES)
- Corresponding author
- Sanchez-Vives, Maria V.
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2019-06
- Volume
- 20
- Issue
- 6
- Pages
- 685-697
- ISSN
- 1526-5900 (ISSN-L)
- OpenAlex
- W2904851038
- Cited by
- 118
- References
- 62
- Citations by year
- 2026: 11 · 2025: 13 · 2024: 14 · 2023: 19 · 2022: 18 · 2021: 14 · 2020: 23 · 2019: 6
- FWCI
- 10.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Funders
- Generalitat de Catalunya
- Topics
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- complex regional pain syndrome type I, peripheral nerve injury, virtual reality, embodiment, body image, pain perception, pain scores
- MeSH terms
- Virtual Reality, Adult, Arm, Female, Humans, Male, Middle Aged, Neuralgia, Complex Regional Pain Syndromes, Peripheral Nerve Injuries, Chronic Pain, Pain Management
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