Virtual Reality Relaxation Reduces Chronic Lower Back Pain, Anxiety

By Frances Morin

A virtual reality (VR) intervention focusing on progressive muscle relaxation shows significant improvements in multiple pain and disability measures, as well as anxiety measures, among patients with chronic lower back pain, according to a study presented here at the 2019 Annual Meeting of the Anxiety and Depression Association of American (ADAA).

“These data provide a useful, feasible and potentially effective model of pain management that does not use surgical or pharmacological approaches,” reported Alex Olasov Rothbaum, Case Western Reserve University, Cleveland, Ohio, and colleagues. “Virtual reality progressive muscle relaxation may also compliment these and other pain management approaches to adjunctively achieve greater outcomes.”

While conventional chronic lower back pain treatments, including surgery and pain medications, focus on the physical aspects of the back pain, emerging evidence shows that addressing psychiatric factors, including anxiety, can also be effective in pain management. Furthermore, virtual reality is increasingly showing efficacy as a mode of delivery for behavioural treatments in a variety of realms.

To investigate the effects of a virtual reality program designed to facilitate progressive muscle relaxation the researchers randomised 23 participants with chronic low back pain to 5 virtual reality sessions, conducted with a licensed psychologist, or to a waitlist control group.

Before and after treatment, pain was assessed with the State-Trait Anxiety Inventory (STAI), the Pain and Pain Treatment Questionnaire, the Visual Analogue Scales (VAS), and the Survey of Pain Attitudes (SOP).

Of 18 participants who completed pain and anxiety assessments prior to the treatment, the subjects receiving the virtual reality therapy reported significantly lower pain over 1 month in VAS pain scores (P = .05).

Those in the virtual reality group also reported a significantly greater sense of control over their pain (P< .05), a significantly decrease in the sense of being disabled by their pain (P = .01) and a significant reduction in believing that medications are the ideal treatment or cure for pain (P< .01).

Importantly, subjects who received virtual reality-progressive muscle relaxation also reported significantly lower state anxiety at the conclusion of the study (P< .05).

The authors noted that the improvements in anxiety along with the pain measures are consistent with previous research regarding the role of anxiety in pain.

“In light of the current opioid crisis, this is both needed and innovative,” the authors concluded. “Future studies should further validate the use of virtual reality for management and treatment of chronic pain.”