Formerly confined to the gaming industry, Virtual Reality (VR) has recently emerged as an innovational impetus in the healthcare industry. This has turned the tables for healthcare, promising a future devoid of suffering.

Could you imagine a world devoid of prolonged pain or anxiety? We’re getting there! Yes, we actually are. Technological advancements have now reached the juncture where they can ease and mitigate the pain or anxiety of an individual without the problematic side effects of conventional treatment options. Formerly confined to the gaming industry, Virtual Reality (VR) has recently emerged as an innovational impetus in the healthcare industry. This has turned the tables for healthcare, promising a future devoid of suffering. Before we get into the use of VR and how it works, let’s understand the nature of pain and anxiety at both, a psychological and biological level.

When there is potential harm to a part of the body, certain signals are dispatched from that part to the brain (Osterweis et al., 1987). These signals are carried out by nerve receptors called “nociceptors'' and the process is termed “sensory input” (Osterweis et al., 1987). The brain then discerns the location and intensity of the pain which leads to one feeling the conscious sensation of pain (Osterweis et al., 1987). Several emotions like anxiety, fear, discomfort, anger, etc. are triggered at an emotional level (Osterweis et al., 1987). These emotions manifest themselves in each individual differently depending on the individual’s past experiences with pain. How we cope with pain is also divergent for each person. Focusing on the pain may cause the pain to intensify for someone while for another it could mitigate the pain. Apart from past experiences, numerous other factors could affect the pain perception of an individual — like genetics, upbringing, culture, etc. At a biological level, when tissue damage or potential damage is detected, nociceptors are activated and they transmit electrical signals to the brain (Thalamus and somatosensory cortex) and spinal cord through two sets of nerves (A-delta fibers and C-delta fibers) (Osterweis et al., 1987). After the brain interprets the level and severity of the threat it will release an emotional response like fear, anger, anxiety, etc. To modulate the pain, the brain signals the deployment of neurotransmitters like Glutamate and substance P (Osterweis et al., 1987). Apart from these, endorphins and enkephalins are also released which enhance or suppress pain perception (Osterweis et al., 1987). 

Anxiety ensues when the body senses a threatening situation. The amygdala in the brain’s pivot stimulates the release of cortisol (hormone), which activates the sympathetic nervous system of the body plunging it into a “fight or flight” response (Northwestern Medicine, 2020). This gradually manifests into feelings of a rapid heartbeat, dilated pupils, excess perspiration, etc. The prefrontal cortex, responsible for decision-making and rationalizing is compromised in such a situation (Northwestern Medicine, 2020). All of this leads to an imbalance of neurotransmitters, especially GABA (gamma-aminobutyric acid) (Northwestern Medicine, 2020).

To combat the struggles of excruciating pain and anxiety with minimal pharmacological interventions, VR has made an entry into the picture. For instance, Harborview Burn Centre at the University of Washington commenced the use of VR in the treatment of burn patients (Hoffman et al., 2011). The patients often talk about reliving their traumatic experience during the wound dressing process (Hoffman et al., 2011). In order to mitigate this complaint, they started using VR headsets. The patients would be given a VR set immersing them in a virtual world, thus distracting them from the pain (Hoffman et al., 2011). Pain is a psychological concept that is interpreted differently by the brain depending on the patient’s cognitive process. The experience of entering a computer-generated world would draw a large portion of the patient’s attention (Hoffman et al., 2011). The medical journal titled “Pain” included a study that examined the effect of VR on two severely burned patients (Hoffman et al., 2011). They were made to engage in VR games like Nintendo during their staple removal procedures (Hoffman et al., 2011). Both patients reported a drastic reduction in pain levels during the otherwise excruciating process (Hoffman et al., 2011). 

Similarly, we all know how agonizing childbirth can be for a woman and sadly there is no medication that can be used to help with the ordeal of discomfort. VR to modulate labor pain has proven to be quite effective. This was reported by Cedars-Sinai Medical Center in Los Angeles. They made use of VR sets personalized to their patients, which served as a distraction and provided tranquillity to their nerves, thus reducing pain and anxiety (Kindelan, 2019). It made the soon-to-be mothers feel a semblance of control (Kindelan, 2019). Several of them reported a much more comfortable birthing experience with the incorporation of VR as compared to those who experienced a conventional birthing experience (Kindelan, 2019).

The hospice and palliative care realm also makes use of VR to allow patients to visit places they’ve always wanted to but didn’t get to or even experience certain things they didn’t get the chance to live. This aimed to instil within the patients a sense of fulfillment and gratification in their life. Rowcroft Hospice in Devon, UK created a program for their patients called “Bucket List” (E; 2021). In this program too, they enabled patients to feel things they could not experience during their lifetime through a VR set (E; 2021). It was reported to reduce social isolation and elevate happiness levels (E; 2021).

In an upcoming field, exposure therapy provides a sense of relief to people who have suffered a traumatic experience. It enables the patients to confront their traumatic experience in a more controlled environment that would foster reduced anxiety and at the same time allow them to process the situation at their own pace. Social anxiety too can benefit from the VR approach. People grappling with social anxiety can make use of a VR-based approach to practice socializing in settings that trigger their anxiety. By doing so, they will be more prepared and less anxious in a real-world intervention. It could help with confidence building too. University of Southern California, USA, has an Institute for Creative Technologies that created a program called “Bravemind” (Rizzo et al., 2023). Initially, it was designed to help patients deal with PTSD (Post-traumatic stress disorder) but later on, it was upgraded to help individuals with social anxiety too, by placing them in situations they would normally be afraid of or awkward in (Rizzo et al., 2023). “Virtually Better”, a VR-specializing company created an identical program called “SPARX”.

Multiple phobia treatments could use VR to help desensitize an individual from their phobia by allowing them to experience a phobic situation. Gradually, they will get over the phobia and eliminate their phobic responses to some extent if not entirely. This will also equip them with techniques to cope with their fear. 

While VR is already being incorporated, it’s still an evolving frontier and has a rather wide scope for improvement. A personalized approach, increased accessibility, and its integration into traditional treatments could render VR a more approachable and sustainable method to enhance life for many. The potential VR has is undefined yet. With a growing emphasis on holistic healthcare,  VR, a non-pharmacological technique could dominate.

This article has been co-authored by Prof. Garima Rajan, Faculty of Psychology, FLAME University and Bhavika Devjani, Undergraduate Student, FLAME University.