Helping Vets deal with chronic pain without opioids

A double amputee Veteran looks through his special headset and suddenly is scuba diving under the sea, and sees fish swimming all around.  Another Veteran in a wheelchair is mountain climbing and can see trails and wild animals along the way. And another Veteran suffering from chronic pain is fishing and can be seen casting his lines in the water.

These are a few examples of how Veterans dealing with various injuries are experiencing a special virtual reality rehabilitation therapy program that is proving to be successful in helping them cope with their physical, cognitive and psychosocial issues.

“These therapies build confidence and develop coping skills.” 

In the photo above, Jamie Kaplan, a recreation therapist who oversees the virtual program at the James Haley Tampa VA Medical Center, helps guide Veteran Geoff Hopkins through his chosen virtual reality scenario.

The special program provides Veterans with varied medical issues resulting from traumatic brain jury, spinal cord injury, stroke, amputees, ALS or other similar areas with an alternative to the use of drugs such as opioids. They use a virtual reality headset or can watch on a large monitor screen to experience virtual scenic settings with music and narration individualized to each patient’s interests.

“Virtual reality is able to take the user someplace else they’d rather be,” said Kaplan. “For example, virtual games and activities can allow the wheelchair user to experience freedom from the limitations they face in everyday life.”

Special apps and computer programs are utilized through virtual reality headsets in the Virtual Reality Clinic and at the patient’s bedside.  Veterans can choose from 20 scenarios, ranging from mountains and oceans. Veterans can fish, ski, go scuba diving or even play golf.

One of the main goals is to help Veterans who suffer from chronic pain reduce their reliance on medications, such as opioids.  Relaxation and guided imagery programs are also used to address stress, anxiety, frustration, anger, and pain.  Heart rate and self-reporting from the Veteran are used to determine effectiveness. The measures, taken at the beginning and end of each session, have proven to reduce an average of 5 to 7 heart beats per minute while pain levels dropped 2-3 levels during the 10-minute use.

“What is truly exciting is that it is showing measurable results in helping reduce chronic pain while using the program,” Kaplan said. Kaplan said the idea came about through his interest in computer-based video games. He extended the idea based on video games to develop the virtual reality scenarios.

At first, virtual reality was targeted for use by younger Veterans who are more proficient in the use of technology and social media. However, older Veterans are embracing its use as well. About 200 Veterans, both inpatient and outpatient, have gone through the program.

The Virtual Reality program at James A. Haley VAMC is recognized as part of February as National Therapeutic Recreation Month.  VHA has more than 900 recreation therapists and creative arts therapists serving Veterans.

Jamie Kaplan, VA recreation therapist, and Veteran Geoff Hopkins

“Recreation therapy and creative arts therapy provide a spectrum of services, opportunities, and choice for Veterans to maximize their rehabilitation potential, increase independence and sustain a healthy and meaningful leisure lifestyle,” said Lucille Beck, Ph.D., VHA’s Deputy Under Secretary for Health for Policy and Services.  “These therapies provide opportunities to build confidence, develop coping skills, and integrate the skills learned in treatment settings into community settings.”

Guided imagery, meditation, and relaxation programs promote decreased muscle tension, stress, anxiety and blood pressures. This, in turn, can increase function abilities, decrease pain behaviors and increase activity.

More about VA’s Recreation Therapy Service

About the author: William N. Outlaw is a Communications Specialist with the Office of Patient Care Services