Medically Approved

Virtual reality is now approved to treat your back pain

Man wearing virtual reality goggles.

VR offers a new way to treat chronic pain without using medication. Here’s what you should know about the exciting technology.

Matt Villano

By Matt Villano

Imagine you’re sitting beside a campfire on a warm night. You’re doing deep-breathing exercises, and every time your lungs fill with air, a floating ring glows brighter over the flame in front of you.

It’s an odd visual effect, but it’s calming. More important, it’s therapeutic. As you breathe, you feel pain leaving your lower back and drifting away into the night.

This is the promise of using virtual reality (VR) to treat pain. With VR, you put on video goggles to enter a computer-generated world. The technology is often used to play video games with consoles such as Oculus Quest.

But researchers have also been working to create VR programs that take the place of medication. Many of them combine proven therapy techniques with visual effects that help users maintain focus and follow along. Recently, the U.S. Food and Drug Administration (FDA) approved a program called RelieVRx (originally called EaseVRx), which has been shown to reduce chronic back pain.

If you’re taking medication for pain, Optum Perks can help you save money. See how the prescription discount program works.

To better understand how VR pain relief might be able to help you, keep reading.

How effective is VR for pain relief?

While RelieVRx is the first VR program approved by the FDA, VR overall is showing promise to treat pain of all types.

“VR provides an evidence-based, non-pharmacological approach to leveraging principles of mind-body medicine in a reproducible and fun way,” says Brennan Spiegel, MD. He’s a VR researcher and the director of health service research at Cedars-Sinai Medical Center in Los Angeles.

In 2019, Dr. Spiegel published research he conducted on 120 people. They were admitted for a variety of reasons, but all were in pain. By using VR for 10 minutes, 3 times a day, the patients reduced their pain by 1.7 points on a 10-point scale.

In another study, Dr. Spiegel’s team calculated a 24% drop in pain scores. And in more recent research, they demonstrated that virtual reality could reduce labor pain without using an epidural.

In these cases, VR essentially distracts patients from thinking about pain, says Dr. Spiegel. The technology works by making the brain focus on a pleasant experience — rather than the suffering.

Much of the research has been done on adults, but VR is also proving to be effective for children, says Thomas Caruso, MD. He’s a professor at the Stanford School of Medicine and a pediatric anesthesiologist at Lucile Packard Children’s Hospital in Palo Alto, California.

“Attention is a limited resource,” says Dr. Caruso. “So when children are following a game or focused on a virtual world, they often barely feel a needle or an IV going in.”

As an example, Dr. Caruso cites a VR application that they routinely use called “Pebbles the Penguin.” It helps kids relax while they control a penguin that slides down a wintry wonderland collecting pebbles.

Most kids become so transfixed by the challenge of the gameplay that they barely realize what’s happening in the real world. By the time the IV is in, the child has been so distracted that they’re surprised to find that it’s already been placed.

Related reading: How to ease fears about coping with post-surgery pain.

How does EaseVRx work?

RelieVRx is an 8-week program built around 56 sessions that last 2 to 16 minutes. It uses a VR headset that contains goggles, a controller and a breathing amplifier that directs your breath toward a microphone.

The goal goes beyond just easing pain in the moment. The Centers for Disease Control and Prevention (CDC) defines chronic back pain as lasting more than 3 months. RelieVRx aims to teach you meditative breathing and mental strategies that you can use anytime, even outside of VR.

The program is built on principles of cognitive behavioral therapy. This type of therapy aims to change thought patterns. It can teach people to turn their minds away from pain, according to Kaiser Permanente. And it does this without the side effects that can come from medication. (Related: Is it safe to take over-the-counter pain medication every day?)

To test RelieVRx, the FDA assigned 179 people with chronic back pain to treatment with VR. Half the people used RelieVRx, and the other half looked at nature content through a VR headset.

After treatment, those using RelieVRx reported a 43% reduction in pain, on average. This is compared with a 25% reduction for those viewing the nature scenes. The treatment also led to improvements in mood, pain-free activity and sleep quality.

Unfortunately, the program isn’t commercially available yet. But it will be soon. Applied VR, the company that makes RelieVRx, expects the program to be ready for release by mid-2022.

In the meantime, try these 7 stretches that can help you feel better in 7 minutes.

What can you expect for the future of VR and pain relief?

Virtual reality has huge potential for changing how you and your doctor treat pain, says Dr. Spiegel.

The Optum Perks App displayed on a mobile phone
Get access to thousands of prescription coupons instantly.

For starters, the technology could replace potentially addictive medication. According to the CDC, opioids are commonly prescribed for back pain, but the evidence showing whether they help for this condition is weak.

What’s more, VR is portable and easy to use. So patients can do their treatments at home, rather than going to a hospital or clinic.

Dr. Spiegel is overseeing 3 studies using VR for various forms of pain. One is for people with chronic lower back pain, the second is for pain in advanced gastrointestinal cancers and the third is for any sort of pain. This one focuses on people in rural communities, where the portability of a VR headset can make a big impact.

Limitations of VR for pain

Dr. Caruso and Dr. Spiegel both note that while VR can help many people manage their pain, it’s not right for everybody.

For starters, about 5% to 10% of people using VR experience vertigo, says Dr. Spiegel. Researchers call this “cybersickness.”

Meanwhile, other patients are simply too anxious to relax to the point where VR can distract them, says Dr. Caruso. “We like to say immersive technology is a tool for some patients but not all patients,” he says. “These technologies can be helpful, but we also should all be careful not to oversell them as cure-alls for everyone.”

If medication is part of your treatment plan, you may be looking for ways to reduce your costs. The free Optum Perks mobile app lets you search for coupons that could save you up to 80% on your prescription medication.


Additional sources
Overview of RelieVRx:
RelieVRx approval for back pain: FDA news release
CBT and chronic pain: Kaiser Permanente
Back pain overview: Centers for Disease Control and Prevention
Effectiveness of RelieVRx: Journal of Medical Internet Research (2021). “An 8-Week Self-Administered At-Home Behavioral Skills-Based Virtual Reality Program for Chronic Low Back Pain: Double-Blind, Randomized, Placebo-Controlled Trial Conducted During COVID-19"
VR leads to a 24% reduction in pain: Journal of Medical Internet Research (2017). “Virtual Reality for Management of Pain in Hospitalized Patients: Results of a Controlled Trial
VR eases pain for all causes: PLOS One (2019). “Virtual reality for management of pain in hospitalized patients: A randomized comparative effectiveness trial
VR for labor pain: American Journal of Perinatology (2021). “Virtual Reality Reduces Pain in Laboring Women: A Randomized Controlled Trial