Virtual Reality in the Future of Pain Care

September 14, 2017

by Vivian Feng, MS-PREP Student

Virtual Reality (VR) is the computer-generated simulation of a three-dimensional environment which people can interact with using special electronic equipment. Through a portable headset with built-in screen and motion gloves, the audiences can discover an alternate universe. VR technology has piqued the interest of major companies like Google, Facebook, Microsoft, and Sony, as each of these companies has released its own VR products over the past years.

In an article published in Recode, author Jason Brush (2016) explains the success of VR and its impact in the digital-tech industry. Brush asserts that VR has the power to fully immerse its audiences into the virtual world. In addition, VR demands its audiences to be fully aware of their surroundings, and encourages them to mindfully engage in the experiences. No prior art or technology has make anyone feel so strongly present in another time and space.

Recently, VR has been suggested to be a potential tool for pain management. Based on the gate theory of pain processing, some researchers postulate that VR can reduce acute pain by triggering other senses to overwrite the original pain signal. Other researchers hypothesize that VR can reduce pain via cognitive attentional mechanisms, or it can lessen the anxiety related to pain with its psychotherapeutic property (Jones, Moore, & Choo, 2016). While the mechanism remains to be unclear, some studies have support the use of VR in acute pain management. For example, a study shows that VR has significantly reduced the amount of opioid medication administered during painful wound care procedures (McSherry et al., 2017). This suggests that VR may be the effective alternatives to opioid medication, and a suitable treatment regimen for the integrated pain management program. There are no valid evidences for the support of VR in managing chronic pain. Nevertheless, VR is generally viewed with great potential in helping pain management and supporting physical rehabilitation.

While acknowledging the potential of VR, we should be aware that the technology is still in its early stage of development. It is uncertain to what extent VR can impact its audiences after long-term use. Since VR can create the powerful illusion that leads people into accepting another reality, it may increase the risk of depersonalisation. To put it in another way, the physical body and actual surrounding may seem unreal to individuals after extended immersion in a virtual environment (Ananthaswamy, 2016). We do not know whether VR is safe for everyone. Without knowing the possible risks, it is inappropriate to introduce VR into pain treatment or any integrative pain management program.
There is also the ethical conundrum of deciding the rightful boundaries of human experiences with VR technology. Should all kinds of experience be available through VR? What happens when people can cross into unethical territory with VR’s strong manipulation of perception? Is it acceptable if the experience is for a good cause? As VR blurred the line between fantasy and reality, using the technology while abiding with ethical principals becomes a real challenge (West, 2016). This challenge may be even more complex when we consider the parallel nature between virtual and authentic reality. Based on the observations in neuroscience, we understand our physical surrounding through the processing of sensory information. Neural signals encoded by our various sense organs are transduced through neurons to the organizing network in our brains. The same biological mechanism is triggered when we perceived sensory information from both the virtual reality and the reality we exist in. Does this mean that we are merely comparing biological virtual reality that is generated by our brain with the artificial virtual reality that is generated by technology? Can we even consider one experience to hold more value than the other based on the provider of that experience?

The practicality and safety of VR remains to be determined, and some ethical questions need to be addressed before fully introducing VR into the world of novel technologies. Nevertheless, we can see the future direction of pain treatment through the example of VR. Researchers have relied less on biochemical solution, and shifted their interest to cognitive and psychological intervention for pain relief. Researchers are also becoming more creative, as they attempt to integrate current technology into therapy and symptom management. There is no doubt that digital technology can be a positive driving force for future medicine. However, it is equally important to make sure that our good intention doesn’t hurt the interest of others. We should be cautious with novel technologies, but keep our faith in their potential to benefit future medical treatments.

Bibliography

Ananthaswamy, A. (2016, March 4). Virtual reality could be an ethical minefield – are we ready? Retrieved July 24, 2017, from https://doi.org/10.3389/frobt.2016.00003

Brush, J. (2016, July 19). Why virtual reality matters. Retrieved July 24, 2017, from https://www.recode.net/2016/6/28/12046730/virtual-reality-vr-creative-content-industry-investment

Jones, T., Moore, T., & Choo, J. (2016). The impact of virtual reality on chronic pain. PLoS ONE, 11(12), 1–10. https://doi.org/10.1371/journal.pone.0167523

McSherry, T., Atterbury, M., Gartner, S., Helmold, E., Searles, D. M., & Schulman, C. (2017). Randomized, Crossover Study of Immersive Virtual Reality to Decrease Opioid Use During Painful Wound Care Procedures in Adults. Journal of Burn Care & Research, Published Ahead of Print(). https://doi.org/10.1097/BCR.0000000000000589

West, D. (2017 July 20). The ethical dilemmas of virtual reality. Retrieved July 24, 2017, from https://www.brookings.edu/blog/techtank/2016/04/18/the-ethical-dilemmas-of-virtual-reality/

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