Virtual Reality for Musculoskeletal Pain

Overseen By Antonios Likourezos, MA, MPH

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: Antonios Likourezos

Disqualifiers: Epilepsy, Seizure disorder, Vertigo, others

Stay on Your Current Meds You can continue your current medications while participating

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 2

Duration: 2 hours

180 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if virtual reality (VR) can reduce pain, anxiety, and stress for elderly patients in the emergency department with sudden, painful muscle or joint conditions. Researchers will compare traditional pain treatments with the addition of VR to assess its impact. Patients aged 65 or older with muscle or joint pain requiring medication might be suitable for this trial. Participants will be divided into two groups: one will receive standard pain care, and the other will experience VR therapy alongside regular care. This study could demonstrate whether VR is a useful tool for managing pain in busy emergency settings. As an unphased trial, it offers a unique opportunity to explore innovative pain management techniques in a real-world setting.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It seems to focus on adding virtual reality to your existing pain management plan, so you may not need to stop your current meds.

What prior data suggests that this virtual reality therapy is safe for geriatric patients?

Research has shown that virtual reality (VR) treatments are generally safe and can help reduce pain. Studies indicate that VR can moderately lower pain and anxiety levels. For instance, one study found that VR reduced pain scores by about one point on a scale, with 25% of participants experiencing a noticeable drop in pain. Another study showed that people using VR had a significant reduction in pain over 21 days compared to those who only listened to audio.

VR is mostly used in a controlled environment, like a clinic, and has been effective without causing serious side effects. While VR often provides short-term relief, there is potential for long-term benefits as well. Overall, existing research supports the safety of VR as a treatment for pain, but more studies are needed to fully understand its effects on older adults in emergency situations. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using Virtual Reality (VR) for managing musculoskeletal pain because it offers a novel, non-invasive way to enhance pain relief. Unlike traditional options that mainly rely on medications, VR immerses patients in a virtual environment, which can distract and reduce their perception of pain. This method leverages engaging, age-appropriate content specifically designed for older adults, making it an attractive complement to existing analgesic treatments. The potential for VR to provide quick and noticeable pain relief without additional medication is a key reason why this approach is generating interest.

What evidence suggests that virtual reality is effective for musculoskeletal pain?

Research has shown that virtual reality (VR) can reduce pain in individuals with muscle and joint issues. For instance, VR has proven particularly effective in alleviating knee pain and chronic pain. Studies also indicate that VR can decrease anxiety and stress, aiding overall pain management. Some findings reveal a moderate reduction in both pain and anxiety levels, with noticeable improvements in certain patients. In this trial, one group will receive standard care, while another will receive VR therapy alongside standard care. This suggests that VR could be a promising tool for managing pain, especially when combined with standard treatments. ^{2 4 6 7 8}

Who Is on the Research Team?

Sergey Motov, MD

Principal Investigator

Maimonides Medical Center

Are You a Good Fit for This Trial?

This trial is for geriatric patients aged 65 or older in the emergency department with acute non-traumatic musculoskeletal pain, scoring at least a 4 on the pain scale. Participants must understand the study and be alert. They should require parenteral analgesia as determined by their doctor and be able to complete assessments.

Inclusion Criteria

Emergency Medicine patients

Comprehension of informed consent process and study related content

I have a painful condition in my muscles or bones not caused by injury.

Exclusion Criteria

I have a seizure disorder.

Motion sickness

I am experiencing changes in my thinking or awareness.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive either Standard of Care (SOC) or SOC plus Virtual Reality (VR) therapy for pain management

2 hours

1 visit (in-person)

Follow-up

Participants are monitored for pain reduction, anxiety, stress, and adverse effects

2 hours

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Virtual Reality

Trial Overview

The trial is testing if adding Virtual Reality (VR) to standard care can better manage pain for elderly emergency department patients compared to standard care alone. It's a randomized study where participants are put into either the control group receiving only standard care or an intervention group getting VR plus standard care.

How Is the Trial Designed?

Group I: Standard of Care (SOC) Active Control 1 Intervention

Analgesia as determined by the treating physician

Group II: Virtual Reality (VR) + Standard of Care (SOC) Active Control 1 Intervention

Analgesia as determined by the treating physician and Virtual Reality experience that will use a geriatric-focused VR platform that has age appropriate VR content and will run for approximately 5-10 minutes

Who Is Running the Clinical Trial?

Antonios Likourezos

Lead Sponsor

Trials

41

Recruited

8,600+

Published Research Related to This Trial

Virtual Reality (VR) shows promise as a noninvasive therapy for both acute and chronic pain, potentially offering an alternative to traditional analgesics that often have side effects or are insufficient for chronic pain management.

Mechanisms of pain relief through VR include distraction and cognitive behavioral changes, with immersive experiences enhancing effectiveness, making it a viable option for conditions like complex regional pain syndrome and phantom limb pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Use of Virtual Reality as a Component of Acute and Chronic Pain Treatment]. Lindner, S., Latoschik, ME., Rittner, H.[2020]

Shoulder pain is a common issue that significantly impacts daily life, and while exercise is crucial for rehabilitation, the specific types and amounts of exercise needed are not well defined.

This study aims to explore physiotherapists' views on using virtual reality (VR) as a new tool for assessing and rehabilitating shoulder pain, potentially improving patient adherence to exercise programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physiotherapist beliefs and perspectives on virtual reality-supported rehabilitation for the assessment and management of musculoskeletal shoulder pain: a focus group study protocol. Brady, N., Lewis, J., McCreesh, K., et al.[2022]

A scoping review of 14 randomized controlled trials found that virtual reality (VR) significantly alleviates pain and improves functional capacity in patients with chronic musculoskeletal disorders compared to standard care.

VR treatment also showed notable effectiveness in providing pain relief for burn patients with acute pain, but it was less effective for non-chronic pain conditions like total knee replacements or ankle sprains.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Scoping Review of The Efficacy of Virtual Reality and Exergaming on Patients of Musculoskeletal System Disorder. Lin, HT., Li, YI., Hu, WP., et al.[2020]

A systematic review of 46 studies involving 1456 participants found that virtual, augmented, or mixed reality (VR/AR/MR) technology improved pain-related outcomes in 78% of randomized controlled trials (RCTs) for individuals with chronic pain.

Most positive effects were observed immediately or up to one month after treatment, highlighting the need for further RCTs to evaluate long-term benefits and accessibility for those facing pain management disparities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use and efficacy of virtual, augmented, or mixed reality technology for chronic pain: a systematic review. Matthie, NS., Giordano, NA., Jenerette, CM., et al.[2023]

Citations

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pmc.ncbi.nlm.nih.gov

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Effectiveness of Virtual Reality for Pain Management in ...

VR shows potential for managing pain in MSK disorders, particularly knee conditions, with significant effectiveness using specialised non‐immersive VR.

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Self-Administered Skills-Based Virtual Reality Intervention for ...

A significant reduction in pain outcomes over the course of the 21-day treatment both within the VR group and compared with an audio-only ...