Abstract
The present chapter explores how immersive virtual reality (VR) systems can be used for pain research and treatment. Pain is a universal, yet entirely subjective and multifaceted unpleasant experience. One of the earliest VR studies on pain highlighted the role of attention in pain modulation. However, the role of body representation in pain modulation has also been described as a crucial factor. Through virtual reality systems, it is possible to modulate both attention to pain and body representation. In this chapter, first we define how immersive VR can be used to create the illusion of being present in immersive VR environments and argue why VR can be an effective tool for distracting patients from acute pain. However, distraction seems to be less useful in chronic pain treatment. Chronic pain can be highly disabling and can significantly impact not only the sufferer’s quality of life, but also their perceptions of the bodily self. Close neural connections between the body matrix and pain open a chance for influencing pain through bodily illusions. This chapter explores approaches to inducing body ownership illusions in VR and discusses how they have been applied in pain research. The present chapter also covers a set of practical indications and methodological caveats of immersive VR and solutions for overcoming them. Finally, we outline several promising future research directions and highlight several yet unexplored areas.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Al-Ghamdi NA, Meyer WJ, Atzori B, Alhalabi W, Seibel CC, Ullman D, Hoffman HG (2020) Virtual reality analgesia with interactive eye tracking during brief thermal pain stimuli: a randomized controlled trial (crossover design). Front Hum Neurosci 13:467. https://doi.org/10.3389/fnhum.2019.00467
Apps MA, Tsakiris M (2014) The free-energy self: a predictive coding account of self-recognition. Neurosci Biobehav Rev 41:85–97
Arzy S, Overney LS, Landis T, Blanke O (2006a) Neural mechanisms of embodiment: asomatognosia due to premotor cortex damage. Arch Neurol 63(7):1022–1025. https://doi.org/10.1001/archneur.63.7.1022
Arzy S, Thut G, Mohr C, Michel CM, Blanke O (2006b) Neural basis of embodiment: distinct contributions of temporoparietal junction and extrastriate body area. J Neurosci 26(31):8074–8081. http://www.jneurosci.org/content/26/31/8074.short
Austin PD, Siddall PJ (2021) Virtual reality for the treatment of neuropathic pain in people with spinal cord injuries: a sco** review. J Spinal Cord Med 44(1):8–18. https://doi.org/10.1080/10790268.2019.1575554
Banakou D, Beacco A, Neyret S, Blasco-Oliver M, Seinfeld S, Slater M (2020) Virtual body ownership and its consequences for implicit racial bias are dependent on social context. R Soc Open Sci 7(12):201848
Banakou D, Groten R, Slater M (2013) Illusory ownership of a virtual child body causes overestimation of object sizes and implicit attitude changes. Proc Natl Acad Sci 110(31):12846–12851
Banakou D, Hanumanthu PD, Slater M (2016) Virtual embodiment of white people in a black virtual body leads to a sustained reduction in their implicit racial bias. Front Hum Neurosci 601
Bani Mohammad E, Ahmad M (2019) Virtual reality as a distraction technique for pain and anxiety among patients with breast cancer: a randomized control trial. Palliat Support Care 17(1):29–34. https://doi.org/10.1017/S1478951518000639
Barrett LF (2017) The theory of constructed emotion: an active inference account of interoception and categorization. Soc Cogn Affect Neurosci 12(1):1–23. https://doi.org/10.1093/scan/nsw154
Barsalou LW (2010) Grounded cognition: past, present, and future. Top Cogn Sci 2(4):716–724
Berlucchi G, Aglioti S (1997) The body in the brain: neural bases of corporeal awareness. Trends Neurosci 20(12):560–564
Best P, Meireles M, Schroeder F, Montgomery L, Maddock A, Davidson G, Galway K, Trainor D, Campbell A, Van Daele T (2022) Freely available virtual reality experiences as tools to support mental health therapy: a systematic sco** review and consensus based interdisciplinary analysis. J Technol Behav Sci 7(1):100–114. https://doi.org/10.1007/s41347-021-00214-6
Birckhead B, Eberlein S, Alvarez G, Gale R, Dupuy T, Makaroff K, Fuller G, Liu X, Yu KS, Black JT, Ishimori M, Venuturupalli S, Tu J, Norris T, Tighiouart M, Ross L, McKelvey K, Vrahas M, Danovitch I, Spiegel B (2021) Home-based virtual reality for chronic pain: protocol for an NIH-supported randomised-controlled trial. BMJ Open 11(6):e050545. https://doi.org/10.1136/bmjopen-2021-050545
Blanke O, Metzinger T (2009) Full-body illusions and minimal phenomenal selfhood. Trends Cogn Sci 13(1):7–13. https://doi.org/10.1016/j.tics.2008.10.003
Blount RL, Piira T, Cohen LL (2003) Management of pediatric pain and distress due to medical procedures. In: Roberts MC (ed) Handbook of pediatric psychology, 3rd edn. The Guilford Press
Bondin L, Dingli A (2021) Automating pain reduction using biosensors and realtime adaptive VR. In: Musiolik T, Cheok A (eds) Analyzing future applications of AI, sensors, and robotics in society. IGI Global, pp 132–140. https://doi.org/10.4018/978-1-7998-3499-1.ch008
Botella C, Palacios AG, Baños R, Quero S, Breton-Lopez J (2008) Virtual reality in the treatment of pain. J Cyberther Rehabil 1(1):93–100. https://search.proquest.com/docview/622073106?accountid=16562
Brydon M, Kimber J, Sponagle M, MacLaine J, Avery J, Pyke L, Gilbert R (2021) Virtual reality as a tool for eliciting empathetic behaviour in carers: an integrative review. J Med Imaging Radiat Sci 52(3):466–477. https://doi.org/10.1016/j.jmir.2021.04.005
Buckelew SP, Degood DE, Schwartz DP, Kerler RM (1986) Cognitive and somatic item response pattern of pain patients, psychiatric patients, and hospital employees. J Clin Psychol 42(6):852–860. https://doi.org/10.1002/1097-4679(198611)42:6<852::AID-JCLP2270420603>3.0.CO;2-R
Carter GT, Duong V, Ho S, Ngo KC, Greer CL, Weeks DL (2014) Side effects of commonly prescribed analgesic medications. Phys Med Rehabil Clin N Am 25(2):457–470. https://doi.org/10.1016/j.pmr.2014.01.007
Cassani R, Novak GS, Falk TH, Oliveira AA (2020) Virtual reality and non-invasive brain stimulation for rehabilitation applications: a systematic review. J Neuroeng Rehabil 17(1):147. https://doi.org/10.1186/s12984-020-00780-5
Chan F, Suen H, Jackson T, Vlaeyen J, Barry T (2020) Pain-related attentional processes: a systematic review of eye-tracking research. Clin Psychol Rev 80:101884. https://doi.org/10.1016/j.cpr.2020.101884
Chirico A, Lucidi F, De Laurentiis M, Milanese C, Napoli A, Giordano A (2016) Virtual reality in health system: beyond entertainment. A mini-review on the efficacy of VR during cancer treatment. J Cell Physiol 231(2):275–287
Cîmpean AI (2019) A pilot study to compare cognitive behavioral therapy with virtual reality vs. standard cognitive behavioral therapy for patients who suffer from cervical cancer. J Evid Based Psychothér 19(1):115–127. https://doi.org/10.24193/jebp.2019.1.7
Corbetta D, Imeri F, Gatti R (2015) Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review. J Physiother 61(3):117–124. https://doi.org/10.1016/j.jphys.2015.05.017
Crombez G, Eccleston C, Baeyens F, Eelen P (1996) Disruptive nature of pain: an experimental investigation. Behav Res Ther 34(11–12):911–918. https://doi.org/10.1016/S0005-7967(96)00058-7
D’Amour S, Bos JE, Keshavarz B (2017) The efficacy of airflow and seat vibration on reducing visually induced motion sickness. Exp Brain Res 235(9):2811–2820. https://doi.org/10.1007/s00221-017-5009-1
Dahlquist L (1999a) Commentary on “Treatments that work in pediatric psychology: Procedure-related pain.” J Pediatr Psychol 24(2):153–154. https://psycnet.apa.org/record/1999-13153-010
Dahlquist L (1999b) Pediatric pain management. https://books.google.it/books?hl=it&lr=&id=eIvA9aFUCqUC&oi=fnd&pg=PR11&dq=Pediatric+pain+management,+1999,+Dahlquist&ots=PhK1cb5p81&sig=1PmLxcs8vmLMZp-euAOaZbXy66g
De Oliveira EC, Bertrand P, Lesur MER, Palomo P, Demarzo M, Cebolla A, Banos R, Tori R (2016) Virtual body swap: a new feasible tool to be explored in health and education. In: Proceedings - 18th symposium on virtual and augmented reality, SVR 2016, pp 81–89. https://doi.org/10.1109/SVR.2016.23
de Preester H, Tsakiris M (2009) Body-extension versus body-incorporation: is there a need for a body-model? Phenomenol Cogn Sci 8(3):307–319. https://doi.org/10.1007/s11097-009-9121-y
De Vignemont F (2011) Embodiment, ownership and disownership. Conscious Cogn 20(1):82–93. https://doi.org/10.1016/j.concog.2010.09.004
Derbyshire SWG, Vogt BA, Jones AKP (1998) Pain and Stroop interference tasks activate separate processing modules in anterior cingulate cortex. Exp Brain Res 118(1):52–60. https://doi.org/10.1007/s002210050254
Di Pietro F, Stanton TR, Moseley GL, Lotze M, Mcauley JH (2015) Interhemispheric somatosensory differences in chronic pain reflect abnormality of the healthy side. Hum Brain Mapp 36(2):508–518. https://doi.org/10.1002/hbm.22643
Diers M, Zieglgänsberger W, Trojan J, Drevensek AM, Erhardt-Raum G, Flor H (2013) Site-specific visual feedback reduces pain perception. Pain 154(6):890–896. https://doi.org/10.1016/j.pain.2013.02.022
Dilgul M, Hickling LM, Antonie D, Priebe S, Bird VJ (2021) Virtual reality group therapy for the treatment of depression: a qualitative study on stakeholder perspectives. Front Virtual Real. https://doi.org/10.3389/frvir.2020.609545
Donegan T, Ryan BE, Swidrak J, Sanchez-Vives MV (2020) Immersive virtual reality for clinical pain: considerations for effective therapy. Front Virtual Real 1(9):9. https://doi.org/10.3389/frvir.2020.00009
Eccleston C, Crombez G (1999) Pain demands attention: a cognitive-affective model of the interruptive function of pain. Psychol Bull 125(3):356–366. https://doi.org/10.1037/0033-2909.125.3.356
Fernandes AS, Feiner SK (2016) Combating VR sickness through subtle dynamic field-of-view modification. IEEE symposium on 3D user interfaces
Flor H (2003) Cortical reorganisation and chronic pain: implications for rehabilitation. J Rehabil Med Suppl 41. https://doi.org/10.1080/16501960310010179
Flor H, Elbert T, Knecht S, Wienbruch C, Pantev C, Birbaumers N, Larbig W, Taub E (1995) Phantom-limb pain as a perceptual correlate of cortical reorganization following arm amputation. Nature 375(6531):482–484. https://doi.org/10.1038/375482a0
Flor H, Braun C, Elbert T, Birbaumer N (1997) Extensive reorganization of primary somatosensory cortex in chronic back pain patients. Neurosci Lett 224(1):5–8. https://doi.org/10.1016/S0304-3940(97)13441-3
Flor H, Nikolajsen L, Jensen TS (2006) Phantom limb pain: a case of maladaptive CNS plasticity? Nat Rev Neurosci 7(11):873–881. https://doi.org/10.1038/nrn1991
Fulvio JM, Ji M, Rokers B (2019) Variability in sensory sensitivity predicts motion sickness in virtual reality. BioRxiv 488817. https://doi.org/10.1101/488817
Gallagher S (2001) The practice of mind. Theory, simulation or primary interaction? J Conscious Stud 8(5–6):83–108
Gentile E, Brunetti A, Ricci K, Delussi M, Bevilacqua V, de Tommaso M (2020) Mutual interaction between motor cortex activation and pain in fibromyalgia: EEG-fNIRS study. PLoS One 15(1):e0228158. https://doi.org/10.1371/journal.pone.0228158
Giummarra MJ, Gibson SJ, Georgiou-Karistianis N, Bradshaw JL (2007) Central mechanisms in phantom limb perception: the past, present and future. Brain Res Rev 54(1):219–232. https://doi.org/10.1016/j.brainresrev.2007.01.009
González-Zamorano Y, Fernández-Carnero J, Sánchez-Cuesta FJ, Arroyo-Ferrer A, Vourvopoulos A, Figueiredo P, Serrano JI, Romero JP (2021) New approaches based on non-invasive brain stimulation and mental representation techniques targeting pain in Parkinson’s disease patients: two study protocols for two randomized controlled trials. Brain Sci 11(1):65. https://doi.org/10.3390/brainsci11010065
Gorman JM (2006) Virtual reality: a real treatment option. CNS Spectr 11(1):12–13. https://doi.org/10.1017/S1092852900024081
Graziano MS, Botvinick MM (2002) How the brain represents the body: insights from neurophysiology and psychology. In: Common mechanisms in perception and action: attention and performance XIX, vol 19, pp 136–157
Gutierrez-Maldonado J, Gutierrez-Martinez O, Cabas-Hoyos K (2011) Interactive and passive virtual reality distraction: effects on presence and pain intensity. Annu Rev Cyberther Telemed 9(1)
Gutiérrez-Martínez O, Gutiérrez-Maldonado J, Loreto-Quijada D (2011) Control over the virtual environment influences the presence and efficacy of a virtual reality intervention on pain. Annu Rev Cyberther Telemed 9(1)
Hegedüs G, Darnai G, Szolcsányi T, Feldmann Á, Janszky J, Kállai J (2014) The rubber hand illusion increases heat pain threshold. Eur J Pain 18(8):1173–1181. https://doi.org/10.1002/j.1532-2149.2014.00466.x
Hoffman HG (2021) Interacting with virtual objects via embodied avatar hands reduces pain intensity and diverts attention. Sci Rep 11(1):10672. https://doi.org/10.1038/s41598-021-89526-4
Hoffman HG, Doctor JN et al (2000a) Use of virtual reality for adjunctive treatment of adolescent burn pain during wound care. Pain 85:305–309
Hoffman HG, Doctor JN, Patterson DR, Carrougher GJ, Furness TA (2000b) Virtual reality as an adjunctive pain control during burn wound care in adolescent patients. Pain 85(1-2):305–309. https://doi.org/10.1016/S0304-3959(99)00275-4
Hoffman HG, Patterson DR, Carrougher GJ (2000c) Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: a controlled study. Clin J Pain 16(3):244–250. https://doi.org/10.1097/00002508-200009000-00010
Hoffman HG, Garcia-Palacios A, Patterson DR, Jensen M, Furness T, Ammons JF (2001) The effectiveness of virtual reality for dental pain control: a case study. CyberPsychol Behav 4(4):527–535. https://doi.org/10.1089/109493101750527088
Hoffman HG, Richards TL, Coda B, Bills AR, Blough D, Richards AL, Sharar SR (2004a) Modulation of thermal pain-related brain activity with virtual reality: evidence from fMRI. Neuroreport 15(8):1245–1248. https://doi.org/10.1097/01.wnr.0000127826.73576.91
Hoffman HG, Sharar SR, Coda B, Everett JJ, Ciol M, Richards T, Patterson DR (2004b) Manipulating presence influences the magnitude of virtual reality analgesia. Pain 111(1–2):162–168. https://doi.org/10.1016/j.pain.2004.06.013
Hoffman HG, Richards TL, Van Oostrom T, Coda BA, Jensen MP, Blough DK, Sharar SR (2007) The analgesic effects of opioids and immersive virtual reality distraction: evidence from subjective and functional brain imaging assessments. Anesth Analg 105(6):1776–1783. https://doi.org/10.1213/01.ane.0000270205.45146.db
Hoffman HG, Chambers GT, Meyer WJ, Arceneaux LL, Russell WJ, Seibel EJ, Richards TL, Sharar SR, Patterson DR (2011) Virtual reality as an adjunctive non-pharmacologic analgesic for acute burn pain during medical procedures. Ann Behav Med 41(2):183–191. https://doi.org/10.1007/s12160-010-9248-7
Hoffman HG, Meyer WJ, Ramirez M, Roberts L, Seibel EJ, Atzori B, Sharar SR, Patterson DR (2014) Feasibility of articulated arm mounted oculus rift virtual reality goggles for adjunctive pain control during occupational therapy in pediatric burn patients. Cyberpsychol Behav Soc Netw 17(6):397–401. https://doi.org/10.1089/cyber.2014.0058
Holmes NP, Spence C (2004) The body schema and multisensory representation(s) of peripersonal space. Cogn Process 5(2):94–105. https://doi.org/10.1007/s10339-004-0013-3
Hurd A (2021) Integration of morphine and virtual reality: pain management for adult hospice cancer patients. Walden University
Iannetti GD, Mouraux A (2010) From the neuromatrix to the pain matrix (and back). Exp Brain Res 205(1):1–12. https://doi.org/10.1007/s00221-010-2340-1
Indovina P, Barone D, Gallo L, Chirico A, De Pietro G, Giordano A (2018) Virtual reality as a distraction intervention to relieve pain and distress during medical procedures: a comprehensive literature review. Clin J Pain 34(9):858–877
Kemeny A, George P, Merienne F, Colombet F, Mérienne F (2017) New VR navigation techniques to reduce cybersickness. Eng Real Virtual Real. https://doi.org/10.2352/ISSN.2470-1173.2017.3.ERVR-097ï
Kilteni K, Groten R, Slater M (2012) The sense of embodiment in virtual reality. Presence Teleop Virt 21(4):373–387. https://doi.org/10.1162/PRES_a_00124
Kocur M, Graf S, Schwind V (2020) The impact of missing fingers in virtual reality. In: 26th ACM symposium on virtual reality software and technology, pp 1–5. https://doi.org/10.1145/3385956.3418973
Kokkinara E, Slater M, López-Moliner J (2015) The effects of visuomotor calibration to the perceived space and body, through embodiment in immersive virtual reality. ACM Trans Appl Percept (TAP) 13(1):1–22
Krupić D, Žuro B, Corr PJ (2021) Anxiety and threat magnification in subjective and physiological responses of fear of heights induced by virtual reality. Personal Individ Differ 169:109720. https://doi.org/10.1016/j.paid.2019.109720
Kumru H, Soler D, Vidal J, Navarro X, Tormos JM, Pascual-Leone A, Valls-Sole J (2013) The effects of transcranial direct current stimulation with visual illusion in neuropathic pain due to spinal cord injury: an evoked potentials and quantitative thermal testing study. Eur J Pain 17(1):55–66. https://doi.org/10.1002/j.1532-2149.2012.00167.x
Laghlam D, Naudin C, Coroyer L, Aidan V, Malvy J, Rahoual G, Estagnasié P, Squara P (2021) Virtual reality vs. Kalinox® for management of pain in intensive care unit after cardiac surgery: a randomized study. Ann Intensive Care 11(1):74. https://doi.org/10.1186/s13613-021-00866-w
LaViola JJ (2000) A discussion of cybersickness in virtual environments. ACM SIGCHI Bull 32(1):47–56. https://doi.org/10.1145/333329.333344
Lenggenhager B, Tadi T, Metzinger T, Blanke O (2007) Video ergo sum: manipulating bodily self-consciousness. Science 317(5841):1096–1099. https://doi.org/10.1126/science.1143439
Lewis JS, Kersten P, McCabe CS, McPherson KM, Blake DR (2007) Body perception disturbance: a contribution to pain in complex regional pain syndrome (CRPS). Pain 133(1–3):111–119. https://doi.org/10.1016/j.pain.2007.03.013
Llobera J, Gonzalez-Franco M, Perez-Marcos D, Valls-Solé J, Slater M, Sanchez-Vives M (2012) Virtual reality for assessment of patients suffering chronic pain: a case study. Exp Brain Res 225(1):105–117. https://doi.org/10.1007/s00221-012-3352-9
Llobera J, González-Franco M, Perez-Marcos D, Valls-Solé J, Slater M, Sanchez-Vives MV (2013) Virtual reality for assessment of patients suffering chronic pain: a case study. Exp Brain Res 225(1):105–117. https://doi.org/10.1007/s00221-012-3352-9
Longo MR, Betti V, Aglioti SM, Haggard P (2009) Visually induced analgesia: seeing the body reduces pain. J Neurosci 29(39):12125–12130. https://doi.org/10.1523/JNEUROSCI.3072-09.2009
Longo MR, Iannetti GD, Mancini F, Driver J, Haggard P (2012) Linking pain and the body: neural correlates of visually induced analgesia. J Neurosci 32(8):2601–2607. https://doi.org/10.1523/JNEUROSCI.4031-11.2012
Lopez C, Halje P, Blanke O (2008) Body ownership and embodiment: vestibular and multisensory mechanisms. Neurophysiol Clin 38(3):149–161. https://doi.org/10.1016/j.neucli.2007.12.006
Lugrin JL, Latt J, Latoschik ME (2015) Avatar anthropomorphism and illusion of body ownership in VR. In: IEEE virtual reality conference, VR 2015 - proceedings, pp 229–230. https://doi.org/10.1109/VR.2015.7223379
Macaluso E, Maravita A (2010) The representation of space near the body through touch and vision. Neuropsychologia 48(3):782–795. https://doi.org/10.1016/j.neuropsychologia.2009.10.010
Maihöfner C, Handwerker HO, Neundörfer B, Birklein F (2003) Patterns of cortical reorganization in complex regional pain syndrome. Neurology 61(12):1707–1715. https://doi.org/10.1212/01.WNL.0000098939.02752.8E
Malloy KM, Milling LS (2010) The effectiveness of virtual reality distraction for pain reduction: a systematic review. Clin Psychol Rev 30(8):1011–1018. https://doi.org/10.1016/j.cpr.2010.07.001
Mancini F, Longo MR, Kammers MPM, Haggard P (2011) Visual distortion of body size modulates pain perception. Psychol Sci 22(3):325–330. https://doi.org/10.1177/0956797611398496
Mancini F, Longo MR, Canzoneri E, Vallar G, Haggard P (2013) Changes in cortical oscillations linked to multisensory modulation of nociception. Eur J Neurosci 37(5):768–776. https://doi.org/10.1111/ejn.12080
Mancini F, Wang AP, Schira MM, Isherwood ZJ, McAuley JH, Iannetti GD, Sereno MI, Moseley GL, Rae CD (2019) Fine-grained map** of cortical somatotopies in chronic complex regional pain syndrome. J Neurosci 39(46):9185–9196. https://doi.org/10.1523/JNEUROSCI.2005-18.2019
Mariano TY, Wan L, Edwards RR, Lazaridou A, Ross EL, Jamison RN (2021) Online group pain management for chronic pain: preliminary results of a novel treatment approach to teletherapy. J Telemed Telecare 27(4):209–216. https://doi.org/10.1177/1357633X19870369
Martini M (2016) Real, rubber or virtual: the vision of “one’s own” body as a means for pain modulation. A narrative review. Conscious Cogn 43:143–151. https://doi.org/10.1016/j.concog.2016.06.005
Maselli A, Slater M (2013) The building blocks of the full body ownership illusion. Front Hum Neurosci 7:83. https://doi.org/10.3389/fnhum.2013.00083
Matamala-Gomez M, Diaz Gonzalez AM, Slater M, Sanchez-Vives MV (2019a) Decreasing pain ratings in chronic arm pain through changing a virtual body: different strategies for different pain types. J Pain 20(6):685–697. https://doi.org/10.1016/j.jpain.2018.12.001
Matamala-Gomez M, Donegan T, Bottiroli S, Sandrini G, Sanchez-Vives MV, Tassorelli C (2019b) Immersive virtual reality and virtual embodiment for pain relief. Front Hum Neurosci 13:279. https://doi.org/10.3389/fnhum.2019.00279
Matamala-Gomez M, Maselli A, Malighetti C, Realdon O, Mantovani F, Riva G (2020a) Body illusions for mental health: a systematic review. https://doi.org/10.31234/osf.io/mk69x
Matamala-Gomez M, Nierula B, Donegan T, Slater M, Sanchez-Vives MV (2020b) Manipulating the perceived shape and color of a virtual limb can modulate pain responses. J Clin Med 9(2):291. https://doi.org/10.3390/jcm9020291
Matamala-Gomez M, Bottiroli S, Realdon O, Riva G, Galvagni L, Platz T, Sandrini G, De Icco R, Tassorelli C (2021a) Telemedicine and virtual reality at time of COVID-19 pandemic: an overview for future perspectives in neurorehabilitation. Front Neurol 12:646902. https://doi.org/10.3389/fneur.2021.646902
Matamala-Gomez M, Maselli A, Malighetti C, Realdon O, Mantovani F, Riva G (2021b) Virtual body ownership illusions for mental health: a narrative review. J Clin Med 10:139. https://doi.org/10.3390/jcm10010139
May A (2008) Chronic pain may change the structure of the brain. Pain 137(1):7–15. https://doi.org/10.1016/j.pain.2008.02.034
McCaul KD, Malott JM (1984) Distraction and co** with pain. Psychol Bull 95(3):516–533. https://doi.org/10.1037/0033-2909.95.3.516
Medina J, Coslett HB (2010) From maps to form to space: touch and the body schema. Neuropsychologia 48:645–654. https://doi.org/10.1016/j.neuropsychologia.2009.08.017
Meißner M, Pfeiffer J, Pfeiffer T, Oppewal H (2019) Combining virtual reality and mobile eye tracking to provide a naturalistic experimental environment for shopper research. J Bus Res 100:445–458. https://doi.org/10.1016/j.jbusres.2017.09.028
Melzack R (1996) Gate control theory: on the evolution of pain concepts. Pain Forum 5(2):128–138. https://doi.org/10.1016/S1082-3174(96)80050-X
Melzack R (1999a) Pain and stress: a new perspective. In: Psychosocial factors in pain
Melzack R (1999b) From the gate to the neuromatrix. Pain 82(Suppl 1):S121–S126. https://doi.org/10.1016/S0304-3959(99)00145-1
Melzack R (2001) Pain and the neuromatrix in the brain. J Dent Educ 65(12):1378–1382. https://doi.org/10.1002/j.0022-0337.2001.65.12.tb03497.x
Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150(3699):971–979. https://doi.org/10.1126/science.150.3699.971
Merskey H (2002) Clarifying definition of neuropathic pain. Pain 96(3):408–409. https://journals.lww.com/pain/fulltext/2002/04000/Clarifying_definition_of_neuropathic_pain.27.aspx?casa_token=r02BmOE73rMAAAAA:69fDIRxE4XBSlIb5eAGNDlY7Ur4pFa6i_ZUbvNg229QTDclDl5aAihozgA2iO_ePjsCGUNmepVTosFuCLXNeoGI
Moseley GL (2003) A pain neuromatrix approach to patients with chronic pain. Man Ther 8(3):130–140. https://doi.org/10.1016/S1356-689X(03)00051-1
Moseley GL (2007) Using visual illusion to reduce at-level neuropathic pain in paraplegia. Pain 130(3):294–298. https://doi.org/10.1016/j.pain.2007.01.007
Moseley GL, Parsons TJ, Spence C (2008) Visual distortion of a limb modulates the pain and swelling evoked by movement. Curr Biol 18(22):R1047–R1048. https://doi.org/10.1016/J.CUB.2008.09.031
Moseley GL, Gallace A, Spence C (2012) Bodily illusions in health and disease: physiological and clinical perspectives and the concept of a cortical “body matrix.”. Neurosci Biobehav Rev 36(1):34–46. https://doi.org/10.1016/j.neubiorev.2011.03.013
Newport R, Preston C (2010) Pulling the finger off disrupts agency, embodiment and peripersonal space. Perception 39(9):1296–1298. https://doi.org/10.1068/p6742
Newport R, Pearce R, Preston C (2010) Fake hands in action: embodiment and control of supernumerary limbs. Exp Brain Res 204(3):385–395. https://doi.org/10.1007/s00221-009-2104-y
Nierula B, Martini M, Matamala-Gomez M, Slater M, Sanchez-Vives MV (2017) Seeing an embodied virtual hand is analgesic contingent on colocation. J Pain 18(6):645–655
Petkova VI, Ehrsson HH (2008) If I were you: perceptual illusion of body swap**. PLoS One 3(12):e3832
Pleger B, Tegenthoff M, Schwenkreis P, Janssen F, Ragert P, Dinse HR, Völker B, Zenz M, Maier C (2004) Mean sustained pain levels are linked to hemispherical side-to-side differences of primary somatosensory cortex in the complex regional pain syndrome I. Exp Brain Res 155(1):115–119. https://doi.org/10.1007/s00221-003-1738-4
Ploghaus A, Tracey I, Gati JS, Clare S, Menon RS, Matthews PM, Rawlins JNP (1999) Dissociating pain from its anticipation in the human brain. Science 284(5422):1979–1981. https://doi.org/10.1126/science.284.5422.1979
Pozeg P, Palluel E, Ronchi R, Solcà M, Al-Khodairy AW, Jordan X, Kassouha A, Blanke O (2017) Virtual reality improves embodiment and neuropathic pain caused by spinal cord injury. Neurology 89(18):1894–1903. https://doi.org/10.1212/WNL.0000000000004585
Preston C, Newport R (2011) Analgesic effects of multisensory illusions in osteoarthritis. Rheumatology 50(12):2314–2315. https://doi.org/10.1093/rheumatology/ker104
Price D (1999) Psychological mechanisms of pain and analgesia. Soc Esp Dolor 8:283–285. http://revista.sedolor.es/pdf/2001_04_10.pdf
Ramachandran VS, Altschuler EL (2009) The use of visual feedback, in particular mirror visual feedback, in restoring brain function. Brain 132(7):1693–1710. https://doi.org/10.1093/brain/awp135
Ramachandran VS, Hirstein W (1998) The perception of phantom limbs. The D. O. Hebb lecture. Brain 121(9):1603–1630. https://doi.org/10.1093/brain/121.9.1603
Ramachandran VS, Brang D, McGeoch PD (2009) Size reduction using mirror visual feedback (MVF) reduces phantom pain. Neurocase 15(5):357–360. https://doi.org/10.1080/13554790903081767
Rehm IC, Foenander E, Wallace K, Abbott J-AM, Kyrios M, Thomas N (2016) What role can avatars play in e-mental health interventions? exploring new models of client–therapist interaction. Front Psychiatry 7:186. https://doi.org/10.3389/FPSYT.2016.00186
Ribu L, Holmen H, Torbjornsen A, Wahl AK, Grottland A, Smastuen MC, Elind E, Bergmo TS, Breivik E, Arsand E (2013) Low-intensity self-management intervention for persons with type 2 diabetes using a mobile phone-based diabetes diary, with and without health counseling and motivational interviewing: protocol for a randomized controlled trial. JMIR Res Protoc 2(2):e34. https://doi.org/10.2196/resprot.2768
Riva G, Mantovani F, Capideville CS, Preziosa A, Morganti F, Villani D, Gaggioli A, Botella C, Alcañiz M (2007) Affective interactions using virtual reality: the link between presence and emotions. Cyberpsychol Behav. https://doi.org/10.1089/cpb.2006.9993
Riva G, Wiederhold BK, Mantovani F (2019) Neuroscience of virtual reality: from virtual exposure to embodied medicine. Cyberpsychol Behav Soc Netw 22(1):82–96. https://doi.org/10.1089/cyber.2017.29099.gri
Rivier C (1995) Luteinizing-hormone-releasing hormone, gonadotropins, and gonadal steroids in stress. Ann N Y Acad Sci 771(1):187–191. https://doi.org/10.1111/j.1749-6632.1995.tb44680.x
Romano D, Maravita A (2014) The visual size of one’s own hand modulates pain anticipation and perception. Neuropsychologia 57(1):93–100. https://doi.org/10.1016/j.neuropsychologia.2014.03.002
Salomons TV, Iannetti GD, Liang M, Wood JN (2016) The “pain matrix” in pain-free individuals. JAMA Neurol 73(6):755–756. https://doi.org/10.1001/JAMANEUROL.2016.0653
Scates D, Dickinson JI, Sullivan K, Cline H, Balaraman R (2020) Using nature-inspired virtual reality as a distraction to reduce stress and pain among cancer patients. Environ Behav 52(8):895–918. https://doi.org/10.1177/0013916520916259
Schneider SM, Workman ML (1999) Effects of virtual reality on symptom distress in children receiving chemotherapy. CyberPsychol Behav 2(2):125–134. https://doi.org/10.1089/cpb.1999.2.125
Schneider SM, Ellis M, Coombs WT, Shonkwiler EL, Folsom LC (2003) Virtual reality intervention for older women with breast cancer. Cyberpsychol Behav 6(3):301–307. https://doi.org/10.1089/109493103322011605
Scuteri D, Matamala-Gomez M, Bottiroli S, Corasaniti MT, De Icco R, Bagetta G, Tonin P (2020) Pain assessment and treatment in dementia at the time of coronavirus disease covid-19. Front Neurol 11:890. https://doi.org/10.3389/fneur.2020.00890
Serino A, Haggard P (2010) Touch and the body. Neurosci Biobehav Rev 34(2):224–236. https://doi.org/10.1016/j.neubiorev.2009.04.004
Serino A, Noel JP, Mange R, Canzoneri E, Pellencin E, Ruiz JB et al (2018) Peripersonal space: an index of multisensory body–environment interactions in real, virtual, and mixed realities. Front ICT 4:31
Sharar SR, Alamdari A, Hoffer C, Hoffman HG, Jensen MP, Patterson DR (2016) Circumplex model of affect: a measure of pleasure and arousal during virtual reality distraction analgesia. Games Health J 5(3):197–202. https://doi.org/10.1089/g4h.2015.0046
Slater M (2009) Place illusion and plausibility can lead to realistic behaviour in immersive virtual environments. Philos Trans R Soc Lond B Biol Sci 364(1535):3549–3557. https://doi.org/10.1098/rstb.2009.0138
Slater M (2014) Grand challenges in virtual environments. Front Robot AI 1. https://doi.org/10.3389/frobt.2014.00003
Slater M (2018) Immersion and the illusion of presence in virtual reality. Br J Psychol 109(3):431–433. https://doi.org/10.1111/bjop.12305
Slater M, Sanchez-Vives MV (2016) Enhancing our lives with immersive virtual reality. Front Robot AI 3:74. https://doi.org/10.3389/frobt.2016.00074
Slater M, Usoh M (1993) Representations systems, perceptual position, and presence in immersive virtual environments. Presence Teleop Virt 2(3):221–233. https://doi.org/10.1162/pres.1993.2.3.221
Slater M, Pérez Marcos D, Ehrsson H, Sanchez-Vives MV (2008) Towards a digital body: the virtual arm illusion. Front Hum Neurosci 6
Slater M, Spanlang B, Corominas D (2010) Simulating virtual environments within virtual environments as the basis for a psychophysics of presence. In: ACM SIGGRAPH 2010 papers, SIGGRAPH 2010. https://doi.org/10.1145/1778765.1778829
Solcà M, Ronchi R, Bello-Ruiz J, Schmidlin T, Herbelin B, Luthi F, Konzelmann M, Beaulieu JY, Delaquaize F, Schnider A, Guggisberg AG, Serino A, Blanke O (2018) Heartbeat-enhanced immersive virtual reality to treat complex regional pain syndrome. Neurology 91(5):e1–e11. https://doi.org/10.1212/WNL.0000000000005905
Soler MD, Kumru H, Pelayo R, Vidal J, Tormos JM, Fregni F, Navarro X, Pascual-Leone A (2010) Effectiveness of transcranial direct current stimulation and visual illusion on neuropathic pain in spinal cord injury. Brain 133(9):2565–2577. https://doi.org/10.1093/brain/awq184
Stanton TR, Gilpin HR, Edwards L, Moseley GL, Newport R (2018) Illusory resizing of the painful knee is analgesic in symptomatic knee osteoarthritis. PeerJ 6:e5206. https://doi.org/10.7717/peerj.5206
Stasolla F, Matamala-Gomez M, Bernini S, Caffò AO, Bottiroli S (2021) Virtual reality as a technological-aided solution to support communication in persons with neurodegenerative diseases and acquired brain injury during COVID-19 pandemic. Front Public Health 8:635426. https://doi.org/10.3389/fpubh.2020.635426
Tajadura-Jiménez A, Grehl S, Tsakiris M (2012) The other in me: interpersonal multisensory stimulation changes the mental representation of the self. PLoS One 7(7):14. https://doi.org/10.1371/journal.pone.0040682
Tanja-Dijkstra K, Pahl S, White MP, Andrade J, Qian C, Bruce M, May J, Moles DR (2014) Improving dental experiences by using virtual reality distraction: a simulation study. PLoS One 9(3):e91276. https://doi.org/10.1371/journal.pone.0091276
Themelis K, Newport R (2018) An investigation of contextual factors in the application of multisensory illusions for analgesia in hand osteoarthritis. Rheumatol Adv Pract 2(2):1–10. https://doi.org/10.1093/rap/rky019
Thériault R, Olson JA, Krol SA, Raz A (2021) Body swap** with a Black person boosts empathy: using virtual reality to embody another. Q J Exp Psychol 74(12):2057–2074
Triberti S, Repetto C, Riva G (2014) Psychological factors influencing the effectiveness of virtual reality–based analgesia: a systematic review. Cyberpsychol Behav Soc Netw 17(6):335–345. https://doi.org/10.1089/cyber.2014.0054
Trost Z, France C, Anam M, Shum C (2021) Virtual reality approaches to pain: toward a state of the science. Pain 162(2):325–331. https://doi.org/10.1097/j.pain.0000000000002060
Tsakiris M, Prabhu G, Haggard P (2006) Having a body versus moving your body: how agency structures body-ownership. Conscious Cogn 15(2):423–432. https://doi.org/10.1016/j.concog.2005.09.004
Tsay A, Allen TJ, Proske U, Giummarra MJ (2015) Sensing the body in chronic pain: a review of psychophysical studies implicating altered body representation. Neurosci Biobehav Rev 52:221–232. https://doi.org/10.1016/j.neubiorev.2015.03.004
Valeriani M, Betti V, Le Pera D, De Armas L, Miliucci R, Restuccia D, Avenanti A, Aglioti SM (2008) Seeing the pain of others while being in pain: a laser-evoked potentials study. NeuroImage 40(3):1419–1428. https://doi.org/10.1016/j.neuroimage.2007.12.056
Watkins LR, Maier SF (2000) The pain of being sick: implications of immune-to-brain communication for understanding pain. Annu Rev Psychol 51:29–57. https://doi.org/10.1146/annurev.psych.51.1.29
Wender R, Hoffman HG, Hunner HH, Seibel EJ, Patterson DR, Sharar SR (2009) Interactivity influences the magnitude of virtual reality analgesia. J Cyber Ther Rehabil 2(1):27–33
Wesslein AK, Spence C, Frings C (2014) Vision affects tactile target and distractor processing even when space is task-irrelevant. Front Psychol 5:84. https://doi.org/10.3389/fpsyg.2014.00084
Wiederhold BK, Wiederhold MD (2012) Managing pain in military populations with virtual reality. Pain syndromes – from recruitment to returning troops. NATO Sci Peace Secur Ser E Hum Soc Dyn 91:75–93
Wiederhold BK, Gao K, Sulea C, Wiederhold MD (2014a) Virtual reality as a distraction technique in chronic pain patients. Cyberpsychol Behav Soc Netw 17(6):346–352. https://doi.org/10.1089/cyber.2014.0207
Wiederhold MD, Gao K, Wiederhold BK (2014b) Clinical use of virtual reality distraction system to reduce anxiety and pain in dental procedures. Cyberpsychol Behav Soc Netw 17(6):359–365. https://doi.org/10.1089/cyber.2014.0203
Won AS, Pandita S, Kruzan KP (2020) Social interaction and pain threshold in virtual reality. Cyberpsychol Behav Soc Netw 23(12):829–845. https://doi.org/10.1089/cyber.2020.0055
Yang S, Chang MC (2019) Chronic pain: structural and functional changes in brain structures and associated negative affective states. Int J Mol Sci 20(13):3130
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Matamala-Gomez, M., Donegan, T., Świdrak, J. (2023). VR for Pain Relief. In: Maymon, C., Grimshaw, G., Wu, Y.C. (eds) Virtual Reality in Behavioral Neuroscience: New Insights and Methods. Current Topics in Behavioral Neurosciences, vol 65. Springer, Cham. https://doi.org/10.1007/7854_2022_402
Download citation
DOI: https://doi.org/10.1007/7854_2022_402
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-42994-1
Online ISBN: 978-3-031-42995-8
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)