Virtual Reality Enters Multimodal Pain Care in Germany
More than 12 million people in Germany experience long-term chronic pain. Treatment usually combines medicine, psychotherapy, and physiotherapy, working closely together. System issues currently limit access to these services. Patients face a known shortage of local therapists. Treatment costs are often not fully covered. Patients must endure long travel times and wait times. Population changes make this problem worse and keep a steady gap in patient care.
Virtual reality technology offers a way to address these gaps in treatment. Stefan Lindner, a physiotherapist and sports scientist at the Centre for Interdisciplinary Pain Medicine at the University Hospital Würzburg, presented this use at a joint press conference of the German Pain Society and the German Migraine and Headache Society. The digital format can include all parts of multimodal therapy. These parts include exercise therapy, patient education, relaxation, and behavioural therapy.
Clinical research supports the medical use of virtual reality. A review of 122 controlled trials with 9,138 patients showed a clear reduction in pain. The average effect size was -0.65, with a P-value < .001. Patients with higher initial pain levels saw bigger benefits. Treatments for sudden pain mainly focus on pain relief. Treatments for long-term pain focus on mental and behavioural aspects. These include patient movement, relaxation, motivation, and social skills.
Digital pain treatments have moved from early medical prototypes to therapies people can use at home. The United States Food and Drug Administration approved EaseVRx in November 2021. This prescription virtual reality program treats adults with chronic lower back pain. It combines cognitive-behavioural therapy ideas with immersive exercises. Meanwhile, hardware has shifted from large, computer-connected headsets to smaller, wireless devices. Meta released the Quest 3 in 2023 as a standalone headset. It has built-in sensors to track user movement and position. Prices, availability, and features differ by region. Extended reality apps also help patients move safely in real spaces.
The Centre for Interdisciplinary Pain Medicine in Würzburg is currently testing an application called ReliefVR. The program changes how patients feel their bodies to adjust brain connections, reduce avoidance behaviours, and help patients learn new ways to move. It includes customised physiotherapy exercises. A patient with chronic back pain uses a handheld joystick while wearing a headset. The patient chases coloured balls in the virtual world. This game-like setup encourages people to do physical movements they usually avoid. During sessions, patients squat, bend, stretch, and turn. The technology combines several therapy methods based on specific goals. Systems range from fully virtual apps to devices that combine physical and digital components.
Several German medical centres currently use virtual reality devices for patient care. The Psycho-Oncology Department at Saarland University Medical Centre in Homburg gives headsets to bedridden patients after surgery. Psycho-oncologist Wolfgang Merda leads this project for patients with back pain. Patients choose 360-degree scenes, such as forests, beaches, or space, to reduce anxiety and help them relax. The Sana Klinikum Coburg uses the technology in a 5-week outpatient pain program. Chief physician Klaus Post manages this treatment plan. The program aims to restore patients’ abilities through positive experiences. The University Medical Centre Schleswig-Holstein offers headsets to reduce patient stress. A specialised nurse shared this practice in a TikTok video, showing staff giving the devices to patients in pain.
The München Klinik in Schwabing uses headsets during painful scar treatments for children. The hospital received six virtual reality headsets as a donation in February. Children interact with virtual underwater worlds featuring dolphins and octopuses. They also use the headsets during regular hospital stays to enjoy virtual Ferris wheel rides. Medical staff notice that these visual distractions reduce patients’ pain. The amount of anaesthetics or pain medicine often decreases.
Evidence supporting virtual reality therapies remains limited. Treatment methods differ between institutions. Research challenges make clinical conclusions difficult, including the fact that participants cannot be unaware of their treatment group. Long-term effects need more study. The hardware can cause cybersickness, with symptoms like dizziness, headaches, and nausea. Visual impairment is a common reason for patient exclusion. Standard headsets don’t work with regular glasses, and blurry vision often triggers cybersickness symptoms. Meta plans to release ultra-lightweight glasses in spring 2027. Developers aim to make the devices comfortable for long daily use.
