By Amish Patel, MD, MBA

Founder & CEO, Verity XR | Board-Certified Anesthesiologist and Pain Management Physician

Throughout my career in pain medicine, I have learned that chronic pain is rarely solved by a single intervention.

A medication may help.

An injection may help.

Surgery may be necessary.

Physical therapy may be essential.

But lasting recovery usually requires something more comprehensive: helping the patient understand what is happening, regain confidence in movement, manage the physiologic and behavioral effects of persistent pain, and participate consistently in rehabilitation.

That is one of the reasons I find the Department of Veterans Affairs’ Whole Health model so compelling.

VA describes Whole Health as care centered on what matters to the Veteran, rather than simply what is the matter with the Veteran. The model emphasizes self-care, skill building and personalized goals across domains that include Moving the Body, Power of the Mind, Recharge and Mindful Awareness.

Those principles overlap closely with where I believe musculoskeletal rehabilitation is headed.

The future is not simply more treatment.

It is helping Veterans become more active participants in recovery.

Chronic Pain Is Especially Relevant in the Veteran Population

Pain is not a niche problem within Veteran healthcare.

Data from the 2019 National Health Interview Survey showed that 31.5% of U.S. Veterans reported chronic pain compared with 20.1% of non-Veterans. Among Veterans ages 20–34, chronic pain prevalence was 27.1% versus 9.4% among non-Veterans; among those ages 35–49 it was 27.7% versus 17.7%.

VA’s current Whole Health pain-management materials similarly cite chronic pain in approximately 31.5% of Veterans and note that severe pain is substantially more common among Veterans than the non-Veteran population.

These are not simply numbers about pain intensity.

Persistent pain can affect:

• movement;
• sleep;
• mood;
• confidence;
• social participation;
• physical conditioning;
• employment;
• independence; and
• quality of life.

For many Veterans, the real clinical objective therefore cannot be limited to reducing a numerical pain score.

It has to include restoring function.

VA Already Recognizes That Pain Requires More Than Biomedical Treatment

One of the most important aspects of VA’s Whole Health approach is its recognition that chronic pain is multidimensional.

VA’s own Whole Health clinical guidance states that chronic pain management should incorporate not only biomedical approaches but also psychosocial approaches, education, self-management and mind-body strategies. VA specifically identifies techniques including cognitive behavioral interventions, progressive muscle relaxation, meditation, biofeedback and other self-management skills.

This is not an abandonment of conventional medical care.

It is an acknowledgment that conventional interventions alone may not address every factor influencing persistent pain and disability.

VA’s Whole Health Library makes the movement component equally clear. Its chronic-pain guidance describes reduced movement as part of a cycle involving deconditioning, weakness, stiffness and increased pain sensitivity, and identifies exercise prescription as a vital component of chronic-pain management.

That is a philosophy I strongly share.

The purpose of pain treatment should often be to create an opportunity for movement and function—not to make movement unnecessary.

The VA/DoD Clinical Framework Is Already Evidence Based

The VA and Department of Defense have developed evidence-based clinical practice guidelines across pain and rehabilitation conditions for decades. Current guidelines include low-back pain, chronic opioid therapy, hip and knee osteoarthritis, stroke rehabilitation, limb rehabilitation and other conditions.

The 2022 VA/DoD Low Back Pain Clinical Practice Guideline alone contains 39 evidence-based recommendations spanning evaluation and management. Importantly, VA emphasizes that guidelines should support rather than replace clinician judgment.

That distinction is important for digital rehabilitation as well.

Technology should not independently determine how a Veteran is treated.

The clinician should remain responsible for diagnosis, patient selection, rehabilitation goals, precautions and progression.

Technology can help operationalize the clinician-directed plan.

Movement Is the Destination

I think one of the most important ideas in Whole Health is deceptively simple:

Move the body.

For persistent pain, movement can become psychologically difficult.

Patients may think:

If bending hurts, I shouldn’t bend.

If my back hurts, something must still be damaged.

Exercise made me sore, so I probably made the condition worse.

These reactions are understandable.

But over time, avoidance can contribute to decreased activity, deconditioning and loss of confidence.

VA’s own chronic-pain education reflects this issue. Its Whole Health material emphasizes that movement may break the cycle of inactivity, weakness and worsening physical capacity and recommends individualized physical activity based on the patient’s condition, preferences and barriers.

The goal therefore isn’t simply to tell Veterans to exercise.

The challenge is helping them feel capable of exercising and remain engaged long enough to benefit from it.

Behavioral Rehabilitation Can Help Patients Get Back to Movement

This is where behavioral rehabilitation becomes clinically relevant.

I use the term behavioral rehabilitation to distinguish it from formal behavioral-health treatment.

It includes concepts that directly affect physical recovery:

• pain neuroscience education;
• graded exposure;
• pacing;
• movement confidence;
• self-efficacy;
• goal setting;
• fear reduction; and
• self-management.

VA is already using many of these concepts.

Its chronic-pain self-management resources specifically describe cognitive behavioral interventions and goal-setting strategies as part of comprehensive pain management.

Recent Veteran-specific research also suggests that scalable behavioral approaches deserve continued exploration. In a VA-affiliated 2026 pilot of group-format telehealth pain reprocessing therapy, 46 Veterans with chronic back or neck pain participated in an eight-session group intervention designed to make a behavioral pain treatment more scalable.

Another pilot involving older Veterans with chronic musculoskeletal pain found high attendance with video-based emotional awareness and expression therapy: participants who initiated treatment attended an average of 7.4 of eight group sessions, and none discontinued the program. Although the study was small and uncontrolled, it demonstrates that Veterans can engage meaningfully with remotely delivered behavioral approaches to chronic pain.

These studies do not validate Verity.

They reinforce a broader principle:

Behavioral components can be integrated into pain rehabilitation, including through technology-enabled delivery.

Autonomic Regulation Is Another Piece of the Recovery Model

Persistent pain does not occur in isolation from the nervous system.

Stress, poor sleep, anxiety, hypervigilance and muscle tension can influence the pain experience and make rehabilitation more difficult.

VA Whole Health explicitly incorporates mind-body approaches such as meditation, relaxation, guided imagery and biofeedback. Its chronic-pain guidance describes mindfulness as a self-management option with potential benefits for pain, stress and coping.

VA facilities currently offer programs incorporating mindfulness, breathing exercises and stress management as part of Whole Health. For example, VA Houston describes virtual mindfulness programming, mindfulness-based stress reduction and chronic-pain education offered through VA Video Connect.

VA Ann Arbor also maintains dedicated mindfulness resources for Veterans and clinicians, including VA’s Mindfulness Coach platform.

Again, the purpose is not to substitute meditation for physical rehabilitation.

For appropriate patients, autonomic-regulation techniques may help create a more favorable state in which to engage with movement and recovery.

I think of the sequence as:

Behavioral Rehabilitation → Autonomic Regulation → Movement Rehabilitation

The first two support the third.

Movement remains the destination.

VA Is Already One of the Largest Real-World Laboratories for Immersive Healthcare

This is perhaps what makes the VA opportunity particularly interesting.

VA is not approaching immersive technology as a hypothetical future concept.

It is already deploying it.

As of April 2026, VA reported immersive-technology use across more than 90 VA medical centers and outpatient clinics, more than 40 documented use cases, and over 11,000 Veteran experiences.

Another January 2026 VA report described more than 4,700 VR headsets deployed across over 170 VA medical centers and outpatient clinics, spanning all 50 states, Puerto Rico, Guam and American Samoa.

Exact counts vary across VA publications because deployment has been expanding rapidly and different reports appear to describe different subsets of the program. The important point is clear:

VA has moved well beyond isolated experimentation with VR.

VA Immersive specifically lists use cases that include:

• pain management;
• anxiety;
• PTSD;
• neurological assessment;
• addiction recovery;
• physical rehabilitation;
• recreational therapy; and
• other clinical applications.

That infrastructure creates a unique environment in which rehabilitation-focused immersive technologies can potentially be evaluated within an existing innovation ecosystem rather than requiring health systems to build one from scratch.

VA’s Early Immersive Data Are Particularly Interesting for Engagement

VA has also begun collecting real-world data across its immersive implementations.

In February 2026, VA reported pre/post self-report data from more than 4,900 Veterans across its clinical VR implementations. VA reported an average 29% decrease in anxiety on the STAIS-5 and a 29% decrease in pain perception using the Defense and Veterans Pain Rating Scale. VA appropriately notes that these results were not derived from a controlled research study.

That limitation matters.

The findings should not be interpreted as proof that VR causes a 29% reduction in pain or anxiety.

But the same VA article contains an observation that I think is even more strategically relevant: VA Immersive explicitly describes immersive technology as a way to take established evidence-based or evidence-informed protocols and deliver them through a modality Veterans will actually engage with.

That gets directly to what I believe is the central opportunity for immersive rehabilitation.

The treatment principles do not have to be new. The delivery experience can be.

Home Deployment May Be Especially Important for Veterans

Access is another reason immersive rehabilitation may fit naturally within VA.

Veterans do not all live near major tertiary medical centers.

Some live in rural communities.

Some have mobility limitations.

Some have transportation barriers.

Some simply need rehabilitation support more frequently than an in-person healthcare system can reasonably provide.

VA already has significant experience extending care outside its facilities through telehealth and home-based technologies.

Immersive care is following the same path.

Gulf Coast VA reported in March 2025 that its standardized VR Home Use program had already provided home VR access to more than 250 Veterans for therapeutic efforts involving pain, anxiety and stress.

This is significant because home rehabilitation is where engagement often becomes hardest.

The therapist is no longer standing beside the patient.

There is no appointment to enforce participation.

The patient has to make the decision to engage.

That is exactly where the user experience matters.

The Goal Should Not Be “More VR”

This is an important distinction.

VA does not need more headsets simply because VR is innovative.

It needs tools that support its existing clinical objectives.

For rehabilitation, those objectives might include:

• helping Veterans participate consistently in prescribed movement;
• extending clinician-directed rehabilitation into the home;
• reinforcing pain education between visits;
• reducing fear of movement;
• providing relaxation and self-regulation skills;
• objectively tracking participation and movement;
• supporting clinician decision-making;
• and improving Veteran experience.

VR is simply one potential delivery mechanism.

The question should always be:

Does the technology make evidence-informed care easier to deliver or easier for the Veteran to engage with?

Where Verity Fits

This is where I believe Verity has a particularly natural alignment with the direction VA is already pursuing.

Verity XR is designed as a clinician-directed, immersive rehabilitation platform, not simply as a library of VR games.

The platform integrates three components.

Behavioral Rehabilitation

Verity includes immersive pain neuroscience education and concepts related to:

• pain modulation;
• graded exposure;
• pacing;
• recovery behaviors; and
• self-management.

These experiences are intended to reinforce the treating clinician’s rehabilitation plan and help patients become more informed and confident participants in recovery.

Autonomic Regulation

The platform includes immersive experiences involving:

• guided breathing;
• relaxation;
• mindfulness;
• meditation; and
• optional heart-rate feedback.

These modules are intended to complement rehabilitation by helping patients learn practical self-regulation strategies.

Movement Rehabilitation

Movement is the core of the platform.

Verity uses immersive, gamified therapeutic activities to facilitate clinician-directed:

• range-of-motion exercises;
• cervical and lumbar movement;
• shoulder and knee rehabilitation;
• functional reaching;
• squatting;
• balance;
• coordination; and
• progressive movement exposure.

The system also captures applicable movement, participation and performance data that can be reviewed over time.

Why the Three-Pillar Model Fits Whole Health

What makes this particularly relevant to VA is that Verity’s architecture does not require us to invent a new clinical philosophy.

The components already map closely to concepts VA has embraced:

Power of the Mind
→ behavioral rehabilitation and pain education.

Mindful Awareness / Recharge
→ breathing, relaxation and autonomic regulation.

Moving the Body
→ active rehabilitation and functional movement.

VA’s Whole Health framework describes all three of those domains as components of Veteran-centered self-care.

Verity’s opportunity is therefore not to replace Whole Health.

It is to explore whether immersive technology can become another way of operationalizing parts of it within clinician-directed rehabilitation.

What Published VR Research Tells Us

The broader literature provides additional rationale for studying this approach.

A 2024 open-label feasibility study evaluated a VR intervention combining virtual embodiment, graded motor imagery and functional rehabilitation in 24 patients with chronic pain. Participants completed eight sessions over four weeks. Individual sessions were associated with significant reductions in pain intensity, while Oswestry Disability Index scores improved over the four-week program. The investigators appropriately concluded that the results justified a larger randomized controlled trial rather than establishing definitive efficacy.

A randomized controlled trial in 80 older adults with chronic musculoskeletal pain compared VR-assisted tai chi with conventional tai chi, providing another example of immersive technology being combined with an already-established movement intervention rather than replacing the underlying rehabilitation principle.

That is the approach I find most compelling.

Don’t invent therapy for VR.

Take principles that already have scientific support and determine whether immersion improves how patients experience and engage with them.

 An Evidence Model for VA

I believe the right scientific framework is:

Published rehabilitation science

↓

VA Whole Health and evidence-based clinical pathways

↓

Evidence-informed immersive delivery

↓

Veteran engagement

↓

Greater rehabilitation participation

↓

Functional outcomes

↓

Healthcare value

Each step should be measured.

We should not skip from “Veterans enjoy VR” to “VR reduces healthcare costs.”

But we also should not wait for a decade of randomized trials before exploring technologies that have a strong clinical rationale, reasonable safety profile and measurable intermediate outcomes.

That is what implementation pilots are for.

Why VA May Be Uniquely Positioned to Lead

The VA has several advantages that make it one of the most interesting healthcare systems in which to study the future of rehabilitation.

It has:

• a large integrated population;
• clinicians across pain, rehabilitation, behavioral health and Whole Health;
• national telehealth infrastructure;
• an established immersive-technology program;
• experience deploying VR into Veteran homes;
• a culture of clinical research and evidence generation.

Few healthcare systems possess all of these capabilities within one organization.

This creates an opportunity to study not simply whether immersive rehabilitation works during a single therapy visit, but whether it can support a longitudinal rehabilitation journey.

• Clinic.
• Home.
• Behavioral education.
• Autonomic regulation.
• Movement.
• Objective monitoring.
• Clinician follow-up.

That is a far more interesting question.

The Future of Veteran Rehabilitation

I do not believe the future of Veteran rehabilitation will be defined by VR.

Nor will it be defined by artificial intelligence, wearables or any other individual technology.

It will be defined by whether we can use these tools to advance principles that already matter:

• helping Veterans understand their health;
• giving them practical skills to participate in recovery;
• supporting clinicians;
• improving access;
• making rehabilitation more engaging;
• ultimately restoring meaningful function.

The VA’s Whole Health framework already provides much of the philosophical foundation.

Immersive technology may provide another way to deliver it.

At Verity, our focus is straightforward:

Behavioral Rehabilitation.

Autonomic Regulation.

Movement Rehabilitation.

The first two are important. But movement remains the destination.

For Veterans living with chronic pain and musculoskeletal dysfunction, the most meaningful outcome is not simply spending less time thinking about pain.

It is being able to do more of what matters to them.

That is why I believe the future of rehabilitation in the VA should be measured not simply by pain relief, but by participation, function, independence and recovery.

Selected References and VA Resources

1. CDC / National Health Interview Survey. Percentage of Adults Aged ≥20 Years Who Had Chronic Pain, by Veteran Status and Age Group — United States, 2019. Veterans reported chronic pain at 31.5% compared with 20.1% among non-Veterans.
2. U.S. Department of Veterans Affairs. Whole Health Approach to Pain Management. VA describes chronic pain as more prevalent among Veterans and outlines a Whole Health model emphasizing whole-person, patient-centered pain care.
3. U.S. Department of Veterans Affairs, Whole Health Library. Self-Management of Chronic Pain. Describes CBT techniques, progressive muscle relaxation, meditation, biofeedback, education, goal setting and self-management within comprehensive pain care.
4. U.S. Department of Veterans Affairs, Whole Health Library. Chronic Pain. Describes movement as a critical element of chronic-pain treatment and discusses exercise, mindfulness, relaxation and other mind-body interventions.
5. VA/DoD Clinical Practice Guideline. Diagnosis and Treatment of Low Back Pain, 2022. Includes 39 evidence-based recommendations and emphasizes use of evidence alongside individual clinical judgment.
6. VA Immersive. VA reports immersive applications spanning pain, physical rehabilitation, mental health and other areas and maintains dedicated physical-rehabilitation and chronic-pain implementation programs.
7. U.S. Department of Veterans Affairs Digital Health Office. Improving Care Delivery With Immersive Technology. In more than 4,900 Veteran pre/post reports, VA observed average 29% decreases in self-reported anxiety and pain perception across clinical VR implementations; VA explicitly notes these were not controlled research results.
8. U.S. Department of Veterans Affairs. Using Virtual Reality at Home. Gulf Coast VA reported more than 250 Veterans participating in a standardized home VR program for pain, anxiety and stress by March 2025.
9. U.S. Department of Veterans Affairs. RelieVRx Offers Hope for Veterans With Chronic Pain. VA describes use of an FDA-authorized home VR program incorporating CBT, mindfulness and pain education and reports large-scale VA immersive deployment.
10. Saby A, et al. Effects of Embodiment in Virtual Reality for Treatment of Chronic Pain: Pilot Open-Label Study. JMIR Formative Research. 2024. Twenty-four chronic-pain patients completed eight VR functional-rehabilitation sessions; improvements were observed in session pain and ODI, supporting larger controlled evaluation.
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