AppliedVR has launched a unique non-pharmacological treatment, RelieVRx, which utilizes virtual reality (VR) to specifically target chronic lower back pain in workers’ compensation patients. This innovative therapy, previously known as EaseVRx, received marketing approval from the US Food and Drug Administration (FDA) in 2021. RelieVRx is designed to provide an immersive in-home experience, equipping patients with skills to effectively manage and alleviate their pain.
Following its FDA authorization, RelieVRx has been incorporated into various federal health programs, including the Veterans Health Administration. The treatment is also recognized by the Centers for Medicare and Medicaid Services, underlining its potential for broad adoption within the workers’ compensation community.
RelieVRx offers a cost-effective option for managing chronic lower back pain, which is prevalent in workers’ compensation cases due to the physical nature of many jobs.
From the comfort of their homes, patients can immerse themselves in a sequential series of sessions with RelieVRx. This innovative therapy promotes the neuroplasticity of the brain, harnessing its ability to rewire connections in response to stimulation, particularly after an injury. This process offers hope and relief to those suffering from chronic lower back pain.
RelieVRx VR therapy uses diaphragmatic breathing, mindful escapes, exercises to distract from and cope with pain and guided sessions that educate the user on their body’s responses to pain. This self-administered device comes with preloaded content of 56 chapters, averaging six minutes per chapter, that builds on previous lessons as the therapy progresses.
Related: FDA Approves First Virtual Reality Pain Treatment
Chronic Lower Back Pain: A Universal Problem and an Economic Burden
Low back pain can affect anyone. It can manifest at any age, with prevalence observed in women, elderly populations and those within the ages of 50 to 55 years. According to the World Health Organization (WHO), about 843 million people are estimated to be afflicted by lower back pain by 2050.
A leading cause of disability, chronic pain had contributed significantly to the US’s opioid crisis and — according to an analysis conducted by the Medical Expenditure Panel Survey (MEPS) in 2008 — incurs around $635 billion annually. It is a serious issue that affects an individual’s quality of life and impacts their work productivity.
A systematic review published in the journal Frontiers in Public Health investigated the clinical and economic burden of low back pain in high-income countries. The study showed that both direct and indirect costs per population were in the range of several billions of dollars annually. The clinical data highlighted that low back pain led to significant rates of hospitalization and healthcare utilization across different regions.
Clinical Benefits of RelieVRx
The development of RelieVRx is supported by findings that show significant reductions in both pain intensity and interference in daily activities — including sleep, mood and stress — compared to a control group using a sham VR program. Over eight weeks, participants used a VR headset at home to engage in various pain management exercises, such as diaphragmatic breathing and mindfulness.
The therapy, rooted in cognitive behavioral therapy and other pain education strategies, had promoted neuroplastic changes, offering potential long-lasting pain relief. Previous research had indicated that the effects of the RelieVRx program were durable, lasting up to 24 months post-treatment.
The study noted that while pain education and cognitive behavioral therapy were the current first-line treatments for patients, there have been barriers to the effective delivery of this therapy.
“Pain is a complex condition that requires a multidisciplinary treatment approach. However, traditional clinical guidelines have over-relied on medications or surgical procedures, which can be costly and ineffective over the long term,” said Dr. Beth Darnall, chief science advisor at AppliedVR in a recent press release elaborating on the clinical outcomes of the study.
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A Non-Pharmacological Approach to Chronic Lower Back Pain
Non-pharmacological pain management therapies offer a variety of alternatives to medication, enhancing patient quality of life by reducing pain and increasing control over it.
Techniques include heat and cold therapy, massage, physical therapy, electrical stimulation devices like transcutaneous electrical nerve stimulation units (TENS) and spinal cord stimulators, as well as behavioral techniques such as relaxation, guided imagery, self-hypnosis and biofeedback.
RelieVRx is a practical, non-pharmacological approach that addresses the significant issue of opioid addiction among workers’ compensation patients.
“The RelieVRx program is a safe and effective alternative to common treatment modalities without any of the risks that opioids and surgeries carry,” said Josh Sackman, co-founder and president of AppliedVR, on the topic of RelieVRx offering a promising alternative to conventional pain management strategies.
Implementing RelieVRx could lead to substantial cost savings for worker’s compensation programs by reducing expensive medical procedures and minimizing long-term medication costs.
The VR therapy provides a comprehensive treatment that not only targets pain reduction but also aids in functional recovery. This approach can significantly improve overall patient outcomes, helping individuals return to work sooner and with better health.
WHO Guidelines for Healthcare Workers
In 2023, the WHO had issued comprehensive guidelines for the management of chronic lower back pain for healthcare workers in primary and community care settings. Highlighting the importance of non-surgical interventions, these guidelines recommend educational programs, exercise routines, selected physical therapies and psychological treatments such as cognitive behavioral therapy.
The guidelines emphasize a person-centered approach and advise against certain interventions like lumbar braces and opioid medications, which may pose more harm than benefit.
Virtual Reality for Pain Management
Virtual reality could become a potential alternative pain management therapy, especially in clinical settings where traditional pharmacological treatments are limited or undesirable. Studies are underway to test the effectiveness of VR therapy for pain control for medical use and chronic pain conditions.
But RelieVRx is one of many pain management VR therapies, with others gaining approval and recognition in this field.
OxfordVR’s gameChange earned the FDA’s Breakthrough Device designation in 2022 for its innovative approach to treating serious mental illnesses using automated cognitive behavioral therapy in virtual reality. This VR therapy addresses intense anxiety in patients with psychosis. gameChange provides a scalable solution to the clinician shortage by enabling a broader range of healthcare staff to deliver support.
The National Institutes of Health (NIH)’s Heal Initiative is dedicated to overcoming the opioid crisis by supporting several VR therapy projects that target chronic lower back pain, post-operative pain and even facilitating recovery from opioid use.
In addition, complementary therapies such as acupuncture, yoga and meditation are also employed to support holistic pain management, providing healthcare professionals with diverse tools to address pain without relying solely on pharmaceuticals.
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