Application of Virtual Reality in Pain Management of Patients with Postherpetic Neuralgia: A Randomized Controlled Trial

INTRODUCTION: Postherpetic neuralgia (PHN) is the most frequent chronic complication of herpes zoster (HZ), the incidence of PHN gradually increases with age, and the persistent pain brings a heavy burden to patients with PHN. Virtual reality (VR) is an emerging tool for relieving acute and chronic pain. However, there is currently no research on applying VR to patients with PHN. This study aimed to explore the effectiveness and safety of VR in reducing the pain levels of patients with PHN. Providing an evidence-based medical rationale for the use of VR in pain management for patients with PHN. METHODS: Fifty patients with PHN were randomly divided into the experimental group and the control group, with 25 cases in each group. The control group received PHN conventional therapy. The experimental group received VR therapy plus conventional therapy, namely 10-min VR sessions twice daily for five consecutive days (T1~T5). Primary outcome measure was patients reported pain levels at the sixth day after admission (T6). We also measured anxiety, depression and self-efficacy levels, as well as inflammatory factor levels of patients in both groups. Patients reported side effects and satisfaction in the experimental group were also recorded. RESULTS: Significant improvements were observed for pain (2.48 ± 1.23 vs 3.28 ± 1.37, P = 0.035), anxiety (31.44 ± 3.89 vs 33.72 ± 3.80, P = 0.041), depression (34.00 ± 5.91 vs 37.64 ± 5.02, P = 0.023), self-efficacy (32.68 ± 3.60 vs 29.92 ± 5.38, P = 0.038), IL-2 (3.30 ± 0.59 vs 2.67 ± 0.27, P<0.001), IL-6 (2.94 ± 1.38 vs 4.13 ± 2.43, P = 0.038), IL-10 (6.36 ± 1.03 vs 5.26 ± 1.09, P = 0.001), TNF-α (1.76 ± 0.48 vs 2.10 ± 0.59, P = 0.033), and INF-γ (3.82 ± 1.06 vs 3.00 ± 0.48, P = 0.001). No participants complained of severe side effects and patients' satisfaction with VR reached 80%. CONCLUSIONS: This study suggests that VR can be efficacious and safe for patients with PHN. This clinical trial has been registered in the Chinese Clinical Trial Registry with the registration number: ChiCTR2400085999.