

As long as humans have walked this planet, there has been sickness that ravaged populations. The very first treatments were extremely primitive, consisting of a mixture of herbal medicines. Additionally, groups of people believed that black magic caused diseases; they attempted to treat patients using their own magic. As time passed on, the quality of medical treatment greatly improved and doctors could diagnose patients and create treatments. However, diseases continued to mutate and new treatments needed to be created to treat these ever-changing diseases. New technologies and methods were discovered to treat specific diseases, but innovation is required to be successful in the medical field. Originally created as a new form of entertainment, virtual reality has more uses than thought. In first world countries, the future of alternate medicine to treat pain, anxiety disorders and select diseases may not be in medicine, but in the use of virtual reality due to the effect it has on neural processes in the brain.  

Pain has been an ailment that has plagued humans since the beginning of time. It is crucial to fully understand what pain is. Pain can be defined as: physical suffering or discomfort caused by illness or injury (Merriam Webster). There are two different types of pain that people suffer from: acute pain and chronic pain (Keogh). Acute pain is typically short lived and can generally be treated using pain killers. Chronic pain is lingering pain that pain killers will only temporary help. Before the creation of virtual reality, pain killers were thought to be the only form of treatment for acute pain. However, that is no longer the case. 

 Virtual reality has recently gained attention due to its ability to treat acute pain. Research has shown that “psychology plays an important part in how people experience both acute and chronic pain, and that painful sensations can be manipulated by what they think and feel” (Keogh). Virtual reality forces the user to focus on things other than their pain, helping to alleviate their symptoms. Edmund Keogh states “this is successful because when patients are using virtual reality, they immerse themselves into a virtual world and are distracted from the pain” (Keogh). When virtual reality is being used, the user is distracted from what is occurring and are unaware of the painful procedure that is occurring. 

In Medicine Meets Virtual Reality, Liu Li states “research is being conducted on the use of virtual reality to treat burn pain, cancer pain and pain associated with routine medical procedures. The use of virtual reality for pain and anxiety during burn care is one of the most researched forms of virtual reality treatment” (Li). As outlined in Medicine meets Virtual Reality, two simple experiments were conducted to determine if virtual reality during these procedures is effective in reducing the pain. The first experiment determined that virtual reality was able to decrease the pain felt, the amount of anxiety, and the amount of time thinking about the pain (Li). The second experiment was associated with using virtual reality to enhance the effectivity of physical therapy. Patients, in the group who were allowed to use VR, reported a less painful experience with a greater range of motion than those who didn’t.  (Li). 

Secondly it was found that virtual reality, in cancer treatment, had the ability to decrease pain, unpleasantness and anxiety associated with chemotherapy (Li). A study was conducted by Schneider and Workman where they examined eleven children receiving chemotherapy, with a portion of them receiving virtual reality therapy. 82% of the children stated that receiving chemotherapy with virtual reality was more pleasant than the treatment without it (Li). The results of these test indicated that the use of virtual reality allowed their treatments to become more manageable.

 Lastly, the pain associated with routine medical procedures decreased when virtual reality was introduced. An experiment was conducted using virtual reality during root canals, where thirty-eight patients underwent the procedure. Some were allowed to use virtual reality, and others were only allowed to watch movies. It was concluded that the group with virtual reality reported significantly lower pain scores than the group that was only allowed to watch movies (Li). All of the experiments were able to prove that virtual reality can be a successful form of pain treatment, but the question of how is still unanswered. 

 There are two possible explanations for the effect that virtual reality has on the brain in acute pain treatment. Initially, Ronald Melzack and Patrick Wall proposed their idea called “The gate control theory” (Li). In their theory, they suggest: “the level of attention paid to the pain, emotional responses associated with the pain, and past experiences with the pain all play an important role in how pain is interpreted” (Li). They later altered theory to state “humans have to attend to the painful stimulus in order for it to be interpreted as painful” (Li). However, if there is another stimulus that the brain needed to attend to, such as something from a virtual reality game, the painful stimulus will be less severe (Li). More recently, Gold et al. proposed “virtual reality analgesia, the inability to feel pain, originates from the signaling pathways of the pain matrix through attention, emotion, and memory” (Li).

Pain treatment is not the only medical application of virtual reality. Another popular use is with the treatment of anxiety disorders. Anxiety disorders cover vast amounts of diseases and conditions spanning from phobias to depression. The use of virtual reality is popular in helping patients overcome their fears. In order to test this, Mark Powers and Paul Emmelkamp conducted an experiment to test the correlation of virtual reality exposure therapy and the symptoms of anxiety disorders. Through various experiments, the authors were able to determine that virtual reality treatment was far more successful than in vivo treatment (Emmelkamp). Additionally, they were able to use virtual reality to help patients overcome their fears in a more rational, successful manner. A survey was conducted with students who suffered from arachnophobia and determined that 90% would prefer virtual reality exposure rather than in vivo exposure, (actually being exposed to the spider). (Emmelkamp). 

Fibromyalgia is a chronic disease that has the following symptoms: pain, fatigue and decreased energy, anxiety, depression, and nervousness (WebMD). Claims have been made that virtual reality can help alleviate the symptoms associated with fibromyalgia. However, one of the more debilitating symptoms is decreased quality of life and an increase in the negative emotion of the patient. (Herrero). The body copes with this by avoiding activities, which may include receiving treatment (Herrero). The easiest way to reverse these emotions and thoughts is by promoting positive emotions, encouraging patients to begin completing meaningful activities and ultimately increase their quality of life. In order to test this, the authors created an experiment testing forty patients, all women whom had been diagnosed with fibromyalgia. Of the forty women, 52% had an additional diagnosis of an anxiety disorder and 65% had a diagnosis of another depressive disorder (Herrero). The following factors were going to be tested in order to determine if the virtual reality treatment was successful in the patients: mood state, pain and fatigue intensity, motivation and the intensity of joy, sadness, anger and surprise (Herrero). The patients were presented different images that had either exercises or motivational messages as part of their virtual reality therapy. Once all forty women had undergone the therapy treatment, it was determined that the virtual reality treatment was met with a high satisfaction and many of the participants would actually recommend the treatment to others suffering from fibromyalgia (Herrero). The data from the experiment also determined that the patient’s mood significantly improved after the use of virtual reality. Additionally, there was a significant increase in the self-motivation to complete meaningful activities, such as receiving treatment (Herrero). Lastly, significant decreases in the patient’s sadness and anxiety were observed after the virtual reality treatment (Herrero). In conclusion, 52.63% of the women who participated in the trail admitted to feeling somewhat better after their treatment (Herrero). The manner in which virtual reality is able to help patients overcome their symptoms associated with fibromyalgia is comparable to the way pain is treated. The therapy is able to distract the brain from the depression, anxiety and pain that is experienced due to fibromyalgia, which alleviates the suffering the patient is experiencing.          

Virtual Reality exposure therapy can also be used to improve the quality of life for chronic smokers who have the intent of helping destroy from their addiction. They may now turn to virtual reality to aid them. James D. Westwood attempted to create an experiment that could test the effectiveness of virtual reality in aiding the cessation of smoking in chronic smokers. A group of sixty randomly selected chronic smokers were divided into three groups of twenty. Each group was presented with different variations of a game that required the participants to throw away virtual cigarettes (Westwood). The differing factor in the games was the presence of an avatar. The first group’s game did not have an avatar where the second and third group’s games had avatars that resembled the participant (Westwood). Three factors were tested and they were: a measure of the intent to quit smoking, a measure of the motivation to quit smoking and a measure of satisfaction. After all of the participants played the game for ten minutes it was concluded that smokers were able to improve their confidence, their intentions to stop smoking improved and the urges to smoke decreased (Westwood). The use of this type of therapy is effective, as the virtual reality is able to generate synthetic environments that will represent the risk situations that the patient will face if they relapse. This in return causes the brain to focus on the negative side effects rather than the reward that is associated with smoking. 

Virtual reality has the capabilities to play a crucial role in the rehabilitation of patients who have suffered a stroke. Traditional methods such as physiotherapy and occupational therapy were useful, but had limitations; time consumption, patient compliance, limited resources and low recovery outcomes. However, virtual reality has recently sparked an interest in researchers and doctors as an alternate form of treatment. Virtual reality is considered an alternate form of treatment because it promotes neuroplasticity, which leads to repetition of tasks, an increased intensity to complete them and task-orientated training (Westwood). 

Previous studies have shown that virtual reality therapies have been successful in treating chronic neurological disorders in patients (Westwood). An example of research that has been conducted to prove this can be found in Yang’s et al. study where they used virtual reality to help rehabilitation in stroke patients (Westwood). They were able to show that virtual reality therapy paired with treadmill exercises were able to increase the walking speed of patients who have suffered from a stroke (Westwood). 

Research is currently being completed that combines virtual reality with a mirror illusion therapy to help patients regain motor movement in limbs that have been paralyzed due to stroke (Westwood). The first step in the therapy was placing a tube sock over the limb that was affected. This was done so the patient does not see the limb they cannot move. Then the therapy transitions into the virtual reality therapy. The patient views a virtual limb where their limb is supposed to be. However, with the virtual reality, they can visualize their limb moving which creates neuroplasticity and the hope that they will be able to eventually regain some motor movement in the limb (Westwood). Preliminary research has shown that this type of therapy is feasible, however, more research needs to be conducted to confidently claim this as a viable form of treatment.      

A further application of virtual reality that is not directly related with treated patients, is actually training and preparing surgeons. A medical school located in Basel, Switzerland is using virtual reality to prepare their students for upcoming surgeries and allowing them to practice without the need for cadavers. Within the virtual reality application, the user is exposed to a virtual body that can easily be manipulated to fit their needs. Additionally, virtual reality is being used to help students learn how to diagnose patients, and may even allow them to complete this tasks without needing to perform surgery. If they have been exposed to similar symptoms using virtual reality, they could recognize the illness and avoid the need for surgery. The virtual operating room that the students have access to allows them to simulate operations using different tools, completing different tests and diagnosing patients. Lastly, the program has an operating room light. This is crucial because in an actual operation, the light casts shadows on the body and the surgeon needs to be flexible and work around the shadows. The inclusion of this feature allows the students to simulate every aspect of surgery, even the ones that are often disregarded.  

Although there is a plethora of applications for virtual reality, there are hindrances that prevent virtual reality from becoming a true therapy option for pain and many other diseases: one being cost. This type of technology is not cheap and requires additional funding to install the programs and time to train employees on how to use it. Secondly, given that the technology is still relatively new, there has not been enough research conducted to prove that virtual reality can be used as an alternate form of treatment. Lastly, virtual reality is known to cause sicknesses in people who use it. Scott Stein, senior editor of the wearable tech section of CNET used virtual reality and provided a review on it. He claims that using the virtual reality caused him, and others that he interviewed to become sick. He claims that virtual reality induced nausea is real. After using the virtual reality, he felt dizzy and sick (Stein). If this is the case for everyone who uses it, the patients may be better off sticking with traditional treatment methods. Lastly, when using the virtual reality goggles, there is a small screen inches away from the user’s eyes at all times. This is detrimental to the health of our eyes and may lead to the user requiring treatment to improve the health of their eyes. 

After reviewing both the positive and negative applications of virtual reality, it can be determined that the use of virtual reality in medicine is an application that should be researched further as it has the potential to help patients around the world with their illnesses. 

Conducting research on this topic has opened my eyes on the ever-changing medical field and the advancements that are being made on an everyday basis. A technology that was originally created as a form of entertainment has quickly developed into something that can be used in other fields such as medicine for the treatment of pain and other diseases due to its ability to “trick” the brain into thinking that the pain is absent. I believe that this treatment is successful because people are not ingesting medication but are instead using technology to treat their ailments. If further researched and pursed, I believe that virtual reality has the ability to become an everyday form of treatment, such as painkillers are today. As the medical field continues to evolve and become more and more diverse, so will our forms of treatment, paving the way for virtual reality.   
