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The Promise of Virtual Reality Therapy

Virtual reality is slowly becoming a very popular concept. It is believed to be able to alleviate pain. Severe burn injuries are among the most intense painful experiences, and getting through the rehabilitation process without great alleviations of pain is sure to take a long period of time. First off, what is virtual-reality? Virtual-reality is a program designed to imitate the surrounding environment to help patients get through their troubles. Therefore, it establishes the key causal question: Why is virtual reality so effective in alleviating pain?

A few hypotheses were generated to answer this question: Immersive virtual reality techniques could be used to distract patients from their pain; Virtual reality changes the way patients interpret incoming pain signals and reduces the amount of pain-related brain activity.

Pain has a strong psychological component. The same incoming pain signal can be interpreted differently depending on the patient’s thoughts. In addition to influencing the way patients interpret such signals, psychological factors can even influence the amount of pain signals allowed to enter the brain’s cortex. Introducing distractions has long been known to reduce pain for some people. Virtual reality is a very effective new form of a distraction, which makes it ideal for pain control. To test this concept, an experiment was carried out.

The experiment consisted of studying two teenage boys who had suffered gasoline burns. The first patient had a severe burn across his leg, while the other had deep burns covering one-third of this body, including his face, neck, back, arms, hands, and legs. Both had received skin-graft surgery and staples to hold the grafts in place. A study was performed during the removal of the staples from the skin grafts. The two boys received their usual opioid medication before the treatment. Also, each spent part of the treatment session immersed in a virtual-reality program and an equal amount of time playing a Nintendo video game. The virtual-reality program was called SpiderWorld and created the illusion that the patient was wandering though a kitchen with cabinets and windows that were able to be opened. In addition, an image of a tarantula was set inside the kitchen, and enhanced even further with a suspended furry spider toy with wiggly legs over the patient’s bed so he could actually feel the virtual spider. All this took place inside a stereoscopic, position-tracked headset that presented three-dimensional computer graphics.

The two boys reported severe to excruciating pain while playing the Nintendo games but reported large drops in pain while immersed in SpiderWorld. Although Nintendo could hold the patient’s attention for a long time, the illusion of going into the two-dimensional video game was proved to be much weaker than the illusion of going into virtual reality.

An “Ifthen” statement can thus be formulated. If immersive virtual reality techniques could be used to distract patients from their pain, and an experiment of two severely burned boys was undergone with a treatment session of playing Nintendo games, and another of a virtual reality program, then the virtual reality program would alleviate much more pain than that of playing Nintendo games. And the boys reported a lot less pain when immersed in the virtual reality program, so therefore, the hypothesis was supported.

When a patient was burned, he participated in a virtual-reality program to relieve the pain of his wounds. He was put into a world that was a simulation of SnowWorld. He could travel through this world distracting him from the excruciating wound care the nurse was working on. Reports show that patients experiencing the virtual-reality program dramatically decrease the pain.

An alternate hypothesis is: Virtual reality changes the way patients interpret incoming pain signals and reduces the amount of pain-related brain activity. Studies of the brain and pain in the brain reaped many results. Pain-related brain activity was measured using functional magnetic resonance imaging (fMRI). Healthy volunteers underwent a brain scan while receiving brief pain stimulation through an electrically heated element applied to the foot. When the volunteers received the thermal stimuli without the distraction of virtual reality, they reported severe pain intensity and unpleasantness and spent the majority of the time thinking about their pain. The fMRI scans showed a large increase in pain-related activity in five regions of the brain that are known to be involved in the perception of pain: the insula, the thalamus, the primary and secondary somatosensory cortex, and the affective division of the anterior cingulate cortex.

However, when the volunteers engaged in SnowWorld, another virtual reality program, during the thermal stimuli, the pain-related activity in their brains decreased significantly and the volunteers also noted large reductions in subjective pain ratings. The fMRI results suggest that virtual reality is not just changing the way patients interpret incoming pain signals; the programs actually reduce the amount of pain-related brain activity.

This leads us to another “Ifthen” statement. If virtual reality changes the way patients interpret incoming pain signals and reduces the amount of pain-related brain activity, and patients received the thermal stimuli without virtual reality then engaged in a virtual reality program with the thermal stimuli, then the pain-related activity in their brains would be reduced tremendously with virtual reality. And patients immersed in a virtual reality program did experience a reduction of pain-related brain activity. Therefore, the hypothesis was supported.