The potential of virtual reality (VR) in healthcare

Introduction

The term 'extended reality' (XR) consists of three concepts: augmented reality, mixed reality and virtual reality (VR).

The Oxford English Dictionary defines VR as a 'computer-generated simulation of a lifelike environment that a person can interact with in a seemingly real or physical way'.

When you think of VR, you might think of headsets, goggles and gaming. However, you might not know that VR can have huge potential in healthcare as a non-pharmacological intervention.

Research has shown that active VR, where patients interact and engage more with the virtual environment, becoming immersed, works better than passive VR, where patients just view content.

In this article, I will look at the use of VR in two cases: for pain management and mental health treatment.

VR for pain management

VR-based treatments for pain management work by attention modulation, also known as focus-shifting, providing distraction analgesia (pain relief) by shifting a patient’s focus away from the pain to the virtual environment. To access the VR set-up, patients use a head-mounted display (HMD) and hardware.

VR uses technology that stimulates the senses, particularly sight, sound, and touch, reducing the amount of pain a patient feels by changing the pain intensity; it is especially useful when a patient experiences sharp and sudden pain, including pain during labour or post-surgery. Additionally, VR changes how the brain processes pain by affecting the pain-control system, which includes regions like the periaqueductal grey (PAG) and the anterior cingulate cortex (ACC).

Specifically for chronic pain (persistent pain that lasts for more than three months), VR can help patients develop techniques to manage their pain better over time, such as by improving their physical abilities, like moving their arms or legs more easily and improving their muscular endurance.

For example, Merlot et al. (2023) found that for women with endometriosis-related pelvic pain who used Endocare (a VR software designed to reduce pain for those with endometriosis), women reported that it reduced pain intensity, with Endocare's maximum pain reduction being 51.58% compared to 27.37% in the sham control group.

VR for mental health treatment

VR-based treatments have also proven to be effective in treating mental health conditions, helping patients to manage conditions such as anxiety and depression. This is because they can replicate a negative environment within a controlled and safe VR setting, helping patients manage and confront their triggers.

The Institute for Health Metrics and Evaluation has stated that as of 2019, 301 million people were living with an anxiety disorder, and 58 million of them (about 20% of those with anxiety) were children and adolescents. Regarding depression, the statistic was 280 million people, including 23 million (nearly 10% of those with anxiety) children and adolescents.

For anxiety, VR-based treatments use exposure treatment, where patients are confronted with the stimuli, but the expected outcome does not occur. Repeating the exposure leads to patients’ anxiety decreasing over time since their perception of the stimuli leading to the feared outcome does not come true. For example, someone with a fear of heights would undergo VR-based exposure treatment where they would be exposed to heights. They would be guided through a learning process, and after multiple exposures, they would think of heights as being safe, leading to less fear of heights overall.

For depression, VR-based treatments use behavioural activation so that individuals can reconnect with activities they enjoy. This can help patients develop and learn coping strategies, improving their mood and reducing depressive symptoms.

VR-based treatments will be particularly helpful for children and adolescents. The statistics by the Institute for Health Metrics and Evaluation clearly show that a high percentage of those with mental health conditions are young people, and general research has shown that they will be less likely to seek professional help and receive appropriate care. VR could help this group by becoming a more appealing therapy method, especially through gamification, making children and adolescents more motivated and more likely to participate in treatment. This method would provide an immersive environment and could be a personalised form of therapy.

Implications for the future

It is important to note that there are still limitations stopping a wider roll-out of VR within healthcare. For example, VR can cause cybersickness, the virtual equivalent of motion sickness, resulting in nausea, disorientation, and headaches. In addition, within the use of VR for young people, more research needs to be conducted on whether gamified therapies are safe and effective.

Nevertheless, these limitations can be mitigated. Technology is advancing rapidly, and newer hardware have a better field of vision and refresh rates of visual content. The VR environment is also being designed better, accounting for individual patient preferences. With further research, scientists can examine in more detail the factors that make VR-based therapies effective and implement them in a way that addresses ethical concerns and increases their effectiveness.

Written by Naoshin Haque

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