Virtual Reality for Hip Pain

Overseen By Jasmine galloway, BS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Cedars-Sinai Medical Center

Disqualifiers: Minors, Pregnant, Prisoners, Seizures, others

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

Compensation: Varies

Number of Visits: 4

70 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on using virtual reality alongside standard pain management, which includes opioids and a local block, so it's likely you can continue your current medications.

What data supports the effectiveness of the treatment Immersive Virtual Reality for hip pain?

Research shows that virtual reality (VR) can help reduce pain by providing relaxation and distraction, which may decrease the need for pain medications like opioids. Studies have found that immersive VR significantly reduces pain in various conditions, suggesting it could be effective for managing hip pain as well. ^{1 2 3 4 5}

Is virtual reality generally safe for managing pain?

Virtual reality (VR) has been used in various studies to manage both acute and chronic pain, and while it shows promise in reducing pain, few studies have specifically examined its safety. However, the available research suggests that VR is generally safe, with no major adverse events reported, though more research is needed to fully understand its safety profile. ^{2 6 7 8 9}

How does the virtual reality treatment for hip pain differ from other treatments?

Virtual reality (VR) is unique because it uses computer simulations to help manage pain without medication. Unlike traditional treatments that often rely on drugs, VR offers a non-drug approach that can be used alongside other therapies to enhance pain relief. ^{2 4 10 11 12}

What is the purpose of this trial?

1. The purpose of the research is to assess the efficacy of postoperative immersive virtual reality (iVR) compared to a standard multimodal pain regimen including opioids and a local block on acute postoperative pain management following hip arthroscopy 2. The primary research procedures are medical record review for demographic information, head-mounted immersive virtual reality experience in PACU, and pre-operative and post-operative surveys 3. The study will enroll adult patients of all ages undergoing elective hip arthroscopy procedures for any diagnosis

Research Team

Karen Ladnier, MS

Principal Investigator

Cedar -Sinai Kerlan jobe orthopedic institute

Eligibility Criteria

This trial is for adults of any age who have hip pain due to a condition that hasn't improved with non-surgical treatments. They must be scheduled for their first elective hip arthroscopy and willing to complete questionnaires before and after the surgery.

Inclusion Criteria

My hip condition did not improve with non-surgical treatments.

I am 18 or older with a hip condition.

I am scheduled for a first-time, planned hip surgery for my hip condition.

Exclusion Criteria

Do not complete pre-operative and post-operative questionnaires

Pregnant women

Prisoners

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (in-person)

Pre-operative

Participants are consented, fill out pre-operative questionnaires, and are randomized into control or iVR therapy group

1 day

1 visit (in-person)

Operative and Post-operative

Participants undergo hip arthroscopy, receive local field block, and iVR therapy in PACU. Pain, anxiety, and nausea are assessed.

1 day

1 visit (in-person)

Follow-up

Participants complete post-operative questionnaires and are monitored for pain management effectiveness

3 weeks

1 visit (in-person)

Treatment Details

Interventions

• Immersive Virtual Reality
• Standard pain management regimen

Trial Overview The study is testing if using immersive virtual reality (iVR) after hip surgery can better manage pain compared to standard methods like opioids and local anesthesia. Participants will use a head-mounted iVR device in the post-anesthesia care unit.

Participant Groups

Group I: Standard regimen +iVR Group Experimental Treatment 2 Interventions

postoperative iVR therapy in addition to the standard multimodal pain regimen (including a preoperative local field block

Group II: Standard regimen Active Control 1 Intervention

hip arthroscopy patients who receive only the standard regimen (including field block) in the acute postoperative ambulatory setting

Who Is Running the Clinical Trial?

Cedars-Sinai Medical Center

Lead Sponsor

Trials

523

Recruited

165,000+

Findings from Research

In a study of 106 adults recovering from hip arthroplasty, the use of virtual reality for relaxation and distraction did not significantly reduce postoperative pain or opioid consumption compared to a control group watching nature films.

The results showed no meaningful differences in pain scores or opioid requirements, indicating that the virtual reality program tested may not be an effective analgesic intervention in this context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual Reality Distraction for Reducing Acute Postoperative Pain After Hip Arthroplasty: A Randomized Trial. Araujo-Duran, J., Kopac, O., Montalvo Campana, M., et al.[2023]

A systematic review of 122 randomized controlled trials involving 9,138 patients found that virtual reality (VR) significantly reduces pain, with a standardized mean difference of -0.65, indicating a strong effect across various types of pain, including acute, chronic, and procedural.

The effectiveness of VR in pain management was particularly notable in younger patients and those experiencing moderate to severe pain, suggesting that VR could be a valuable tool for these groups, although the studies showed considerable variability and moderate to high risk of bias.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect modifiers of virtual reality in pain management: a systematic review and meta-regression analysis. Lier, EJ., de Vries, M., Steggink, EM., et al.[2023]

In a study involving 103 hospitalized patients, both standard animated CGI VR and Video Capture VR significantly reduced pain by about 50% compared to a waitlist control group, with effects maintained at follow-up.

While both VR types were equally effective in pain reduction, patients found Video Capture VR to be more realistic and enjoyable, suggesting it may enhance the overall experience of pain management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nonpharmacologic Pain Management Among Hospitalized Inpatients: A Randomized Waitlist-Controlled Trial of Standard Virtual Reality (CGI VR) Versus Video Capture VR (360 degrees 3D/Stereoscopic Video Capture VR). Powers, MB., Carl, E., Levihn-Coon, A., et al.[2023]

Virtual reality (VR) has been found to be an effective method for reducing both acute and chronic pain, with significant improvements in pain intensity (72.1%) and quality (75.0%) observed across 70 studies involving 4105 participants.

The primary mechanism of pain relief through VR is distraction, especially for acute pain, while embodiment is more commonly associated with chronic pain, indicating that different types of pain may benefit from tailored VR approaches.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The State of Science in the Use of Virtual Reality in the Treatment of Acute and Chronic Pain: A Systematic Scoping Review. Baker, NA., Polhemus, AH., Haan Ospina, E., et al.[2023]

A case study demonstrated that immersive virtual reality (VR) significantly reduced pain intensity by 43% and anxiety by 43% during the removal of external fixator pins in a conscious patient, compared to standard care without VR.

Using VR as a non-pharmacologic analgesic not only improved patient satisfaction with pain management but also has the potential to lower opioid use and associated risks during outpatient orthopedic procedures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Case Report: Virtual Reality Analgesia in an Opioid Sparing Orthopedic Outpatient Clinic Setting: A Case Study. Firoozabadi, R., Elhaddad, M., Drever, S., et al.[2021]

Virtual reality (VR) has been shown to be an effective tool for managing acute pain, with 83% of the studies reviewed reporting decreased pain intensity when using VR compared to non-VR methods.

The effectiveness of VR in pain management is likely due to its ability to distract patients, highlighting the importance of creating immersive and engaging VR experiences to enhance therapeutic outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Systematic Review of Virtual Reality Therapeutics for Acute Pain Management. Dreesmann, NJ., Su, H., Thompson, HJ.[2023]

In a study involving 30 participants with chronic pain, a virtual reality application called Cool! significantly reduced pain levels, with a 33% decrease from pre-session to post-session and a remarkable 60% reduction during the session.

All participants experienced some level of pain relief during the VR session, and 33% reported complete pain relief, suggesting that VR could be a promising non-opioid treatment option for chronic pain management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of Virtual Reality on Chronic Pain. Jones, T., Moore, T., Choo, J.[2022]

Digital therapeutics, such as virtual reality apps, have been authorized by the FDA as effective treatments for chronic conditions like low back pain and can enhance the effectiveness of traditional medications like buprenorphine for opioid use disorder.

A review of randomized controlled trials showed that patients using digital interventions alongside opioid treatments generally reported better pain relief compared to those receiving standard care, highlighting the potential of these technologies in pain management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adjunct Digital Interventions Improve Opioid-Based Pain Management: Impact of Virtual Reality and Mobile Applications on Patient-Centered Pharmacy Care. Giravi, HY., Biskupiak, Z., Tyler, LS., et al.[2022]

Virtual reality (VR) therapies have shown promise in effectively distracting patients from both acute and chronic pain, suggesting a new approach to pain management beyond traditional methods like opioids and physical therapy.

Clinical studies indicate that VR can be beneficial for various pain conditions, including fibromyalgia and phantom limb pain, by immersing patients in interactive environments that reduce their perception of pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual Reality as a Clinical Tool for Pain Management. Pourmand, A., Davis, S., Marchak, A., et al.[2018]

References

1. United States pubmed.ncbi.nlm.nih.gov

Virtual Reality Distraction for Reducing Acute Postoperative Pain After Hip Arthroplasty: A Randomized Trial. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Effect modifiers of virtual reality in pain management: a systematic review and meta-regression analysis. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Nonpharmacologic Pain Management Among Hospitalized Inpatients: A Randomized Waitlist-Controlled Trial of Standard Virtual Reality (CGI VR) Versus Video Capture VR (360 degrees 3D/Stereoscopic Video Capture VR). [2023]

4. Netherlands pubmed.ncbi.nlm.nih.gov

Virtual Reality interventions for acute and chronic pain management. [2020]

5. Netherlands pubmed.ncbi.nlm.nih.gov

Scientific evidence for the effectiveness of virtual reality for pain reduction in adults with acute or chronic pain. [2018]

6. United States pubmed.ncbi.nlm.nih.gov

The State of Science in the Use of Virtual Reality in the Treatment of Acute and Chronic Pain: A Systematic Scoping Review. [2023]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Case Report: Virtual Reality Analgesia in an Opioid Sparing Orthopedic Outpatient Clinic Setting: A Case Study. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

A Systematic Review of Virtual Reality Therapeutics for Acute Pain Management. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

The Impact of Virtual Reality on Chronic Pain. [2022]

10. Canada pubmed.ncbi.nlm.nih.gov

Global Scientific Trends in Virtual Reality for Pain Treatment From 2000 to 2022: Bibliometric Analysis. [2023]

11. Switzerland pubmed.ncbi.nlm.nih.gov

Adjunct Digital Interventions Improve Opioid-Based Pain Management: Impact of Virtual Reality and Mobile Applications on Patient-Centered Pharmacy Care. [2022]

12. United States pubmed.ncbi.nlm.nih.gov

Virtual Reality as a Clinical Tool for Pain Management. [2018]