Telehealth and Virtual Reality Technologies in Chronic Pain Management: A Narrative Review

Ivo H Cerda; Alexandra Therond; Sacha Moreau; Kachina Studer; Aleksy R Donjow; Jason E Crowther; Maria Emilia Mazzolenis; Min Lang; Reda Tolba; Christopher Gilligan; Sait Ashina; Alan D Kaye; R Jason Yong; Michael E Schatman; Christopher L Robinson

doi:10.1007/s11916-023-01205-3

Telehealth and Virtual Reality Technologies in Chronic Pain Management: A Narrative Review

Curr Pain Headache Rep. 2024 Mar;28(3):83-94. doi: 10.1007/s11916-023-01205-3. Epub 2024 Jan 4.

Authors

Ivo H Cerda^#¹, Alexandra Therond^#², Sacha Moreau^#³, Kachina Studer^{4

5}, Aleksy R Donjow³, Jason E Crowther⁶, Maria Emilia Mazzolenis⁷, Min Lang^{8

9}, Reda Tolba¹⁰, Christopher Gilligan^{8

11}, Sait Ashina^{8

12

13}, Alan D Kaye¹⁴, R Jason Yong^{8

11}, Michael E Schatman^{15

16}, Christopher L Robinson¹³

Affiliations

¹ Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA. ivocerda@hms.harvard.edu.
² Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada.
³ Massachusetts Institute of Technology, Boston, MA, USA.
⁴ Department of Earth and Planetary Science, Harvard University, Cambridge, MA, USA.
⁵ Department Mechanical Engineering, Cambridge, Massachusetts Institute of Technology (MIT), Cambridge, MA, USA.
⁶ Department of Anesthesiology and Perioperative Medicine, University of Massachusetts, Worcester, MA, USA.
⁷ Paulson School of Engineering and Applied Sciences, John A, Harvard University, Boston, MA, USA.
⁸ Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
⁹ Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
¹⁰ Pain Management Department in the Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
¹¹ Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA.
¹² Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
¹³ Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
¹⁴ Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, USA.
¹⁵ Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA.
¹⁶ Department of Population Health-Division of Medical Ethics, NYU Grossman School of Medicine, New York, NY, USA.

^# Contributed equally.

PMID: 38175490
DOI: 10.1007/s11916-023-01205-3

Abstract

Purpose of review: This review provides medical practitioners with an overview of the present and emergent roles of telehealth and associated virtual reality (VR) applications in chronic pain (CP) management, particularly in the post-COVID-19 healthcare landscape.

Recent findings: Accumulated evidence points to the efficacy of now well-established telehealth modalities, such as videoconferencing, short messaging service (SMS), and mobile health (mHealth) applications in complementing remote CP care. More recently, and although still in early phases of clinical implementation, a wide range of VR-based interventions have demonstrated potential for improving the asynchronous remote management of CP. Additionally, VR-associated technologies at the leading edge of science and engineering, such as VR-assisted biofeedback, haptic technology, high-definition three-dimensional (HD3D) conferencing, VR-enabled interactions in a Metaverse, and the use of wearable monitoring devices, herald a new era for remote, synchronous patient-physician interactions. These advancements hold the potential to facilitate remote physical examinations, personalized remote care, and innovative interventions such as ultra-realistic biofeedback. Despite the promise of VR-associated technologies, several limitations remain, including the paucity of robust long-term effectiveness data, heterogeneity of reported pain-related outcomes, challenges with scalability and insurance coverage, and demographic-specific barriers to patient acceptability. Future research efforts should be directed toward mitigating these limitations to facilitate the integration of telehealth-associated VR into the conventional management of CP. Despite ongoing barriers to widespread adoption, recent evidence suggests that VR-based interventions hold an increasing potential to complement and enhance the remote delivery of CP care.

Keywords: Biofeedback; Haptics; Persistent pain; Precision medicine; Remote care; Telemedicine; Wearable devices.

Publication types

Review

MeSH terms

COVID-19*
Chronic Pain* / therapy
Humans
Telemedicine* / methods
Virtual Reality*