Case Report: Pain Neuroscience Education Using Virtual Reality

This case study describes the delivery of pain neuroscience education (PNE) in conjunction with breathing and mindfulness strategies using virtual reality (VR) for a patient suffering from chronic neck pain. The patient was an 18-year-old high school girl, following a motor vehicle collision 10 months ago. The patient has previously not responded to massage, exercise and therapeutic modalities (ultrasound and electrical stimulation). Baseline assessment revealed pain ratings of 5/10 for neck pain and 6/10 for upper back pain (Numeric Pain Rating Scale - NPRS); a pain catastrophization score of 31 (Pain Catastrophization Scale - PCS), indicating "high" levels of catastrophising and a neck disability score of 21 (Neck Disability Index - NDI) indicating moderate disability. She underwent three sessions of PNE using VR, in combination with breathing and/or mindfulness. Pre- to post-treatment measurements showed reductions in neck and upper back pain, pain catastrophization, and positive shifts in pressure pain thresholds of the lower back. Overall NDI scores improved 29%. This case study indicates that VR-delivered PNE provides comparable results to what might be expected with therapist-delivered PNE and this combined approach warrants further investigation as a means to make PNE more accessible.