Virtual reality in healthcare: therapeutic applications, measured benefits and real risks

Three mechanisms of action are now scientifically validated: attentional distraction for pain, controlled exposure for anxiety, and multisensory stimulation for motor rehabilitation. These neurophysiological foundations explain why virtual reality produces measurable effects, rather than solely subjective ones.

Attentional distraction and pain reduction

Pain demands attention. This is precisely where virtual reality comes in. According to limited attentional capacity theory, if a significant proportion of cognitive resources is engaged by immersion in a virtual environment, the patient responds more slowly to nociceptive signals. Virtual reality does not interrupt the transmission of pain signals through nerve fibres, but acts on their perception through attention, emotion and concentration.

A study using functional magnetic resonance imaging demonstrated a reduction of more than 50 % in pain-related brain activity in 5 areas of the brain[1] in patients using virtual reality during a painful stimulus. Another study comparing virtual reality with opioid analgesics obtained similar results for pain reduction, with a significant additional reduction when the two approaches were combined.

Gradual exposure and habituation in anxiety disorders

The principle is that of cognitive behavioural therapies, applied in an immersive setting. Patients are gradually exposed to the object of their fear in a safe environment fully controlled by the practitioner. The intensity, context and stimuli can be adjusted in real time according to the reactions observed.

This process of habituation allows the brain to modify its emotional response: through repeated exposure to an anxiety-provoking stimulus without real consequences, it learns to stop triggering a disproportionate fear response. According to published research in psychiatry, virtual reality exposure therapy (VRET) proves more effective than third-wave CBT for certain indications, particularly addictions.

Multisensory stimulation and neuroplasticity in rehabilitation

Visual, auditory and sometimes haptic immersion stimulates several sensory channels simultaneously. This multisensory engagement reinforces motor learning by drawing on mechanisms of neuroplasticity: the brain reorganises its neural connections in response to repeated, structured experiences.

After a stroke, patients practise everyday movements in virtual environments that make training tangible and motivating. Since 2022, this approach has been recommended by the Haute Autorité de Santé[2] as an adjunct to conventional therapy to improve post-stroke motor function, with a moderate level of evidence.

Three areas account for most of the evidence: pain management, mental health and functional rehabilitation. In each, controlled studies or official recommendations support clinical use.

Acute and chronic pain management

The most extensively documented results concern patients with severe burns. During particularly painful treatment procedures, immersion in virtual reality reduces perceived pain by up to 60 %. This non-pharmacological approach has a decisive advantage: it limits the side effects and risks of dependence associated with opioids, which have an unfavourable safety profile in children.

In paediatric patients, the evidence is encouraging. A Cochrane review covering 17 studies and 1008 children aged 4 to 18 years[3] assessed the effectiveness of virtual reality distraction during medical procedures: injections, blood draws, dressing changes and physical exercise. Fully immersive virtual reality proved beneficial in reducing pain assessed on the basis of children's behaviour, more effectively than non-virtual distraction. The evidence remains of low to very low certainty, highlighting the need for larger studies.

For chronic pain (back, neck, postoperative), virtual reality is used alongside usual treatments, with the same mechanism of attentional distraction.

Treatment of anxiety disorders and phobias

This is the field in which therapeutic virtual reality has accumulated the most clinical data. Flying phobia, agoraphobia, specific phobias (spiders, heights, enclosed spaces), post-traumatic stress disorder: virtual environments make it possible to recreate situations that are difficult to reproduce in the consulting room, with a degree of precision and gradual progression impossible to achieve otherwise.

Dr Éric Malbos, a psychiatrist at the hôpital de la Conception in Marseille, has treated patients with tobacco dependence using VRET. According to his data, 72 % of patients had not relapsed after treatment, compared with 50 % with conventional CBT. The practitioner controls the intensity of exposure in real time, adjusting the context according to the patient's reactions. VRET is not used alone: it forms part of comprehensive treatment that includes motivational interviewing and, if necessary, medication.

Motor and functional rehabilitation after stroke

Virtual reality transforms rehabilitation exercises into structured, motivating activities. For the upper limbs, it helps patients regain everyday movements: grasping an object, opening a door, pouring a drink. For the lower limbs, it trains balance, walking and coordination by simulating real-life situations such as crossing a street or climbing stairs.

Patient adherence is a key factor. Conventional exercises can seem repetitive; virtual reality introduces clear goals and immediate feedback, improving sustained engagement. In patients with Parkinson's disease, virtual reality improves balance, walking, coordination and certain cognitive functions, and reduces the depressive symptoms frequently associated with this condition. The 2022 HAS recommendation for post-stroke rehabilitation confirms institutional recognition of this approach.

Virtual reality does not benefit patients alone. It is also transforming the training of healthcare professionals by providing a setting for practice that poses no risk to actual patients.

In surgery, virtual reality simulators allow residents to practise complex techniques, precise incisions or endoscopic procedures under reproducible, assessable conditions. Mistakes become learning opportunities rather than dangers. Controlled studies have shown that virtual reality simulation training can supplement, or even partially replace, initial patient-based training in gastrointestinal endoscopy.

Simulating emergency situations is another major application. Managing cardiac arrest, coordinating a team in a recovery room, delivering a difficult diagnosis: these scenarios can be repeated as often as necessary, with configurable variations. Professionals develop automatic responses and stress management skills that then transfer to actual practice.

A less expected use concerns developing empathy. Some programmes immerse healthcare professionals in the perspective of an older patient, a person with a disability or a patient at the end of life. This experience has a lasting effect on how professionals perceive and support their patients.

This application concerns professionals, rather than patients directly. But it helps improve the quality of care: a better-trained surgeon, a more responsive emergency physician and a more attentive healthcare professional make a tangible difference to patient care.

Virtual reality has documented adverse effects. They are generally reversible and short-lived, but certain populations remain at risk and contraindications exist.

Cybersickness: nausea, dizziness and balance problems

Cybersickness is the best-documented adverse effect. It encompasses symptoms similar to motion sickness: nausea, dizziness, sweating, pallor and loss of balance. In susceptible individuals, these symptoms can appear within the first few minutes of use. Its prevalence is estimated at 10 to 30% of users, depending on the study, according to the adverse effects documented by Anses[4].

The good news is that cybersickness disappears when exposure stops. It does not cause lasting after-effects. The recommendation is to stop use immediately as soon as the first symptoms appear.

Eye strain, visual disturbances and blue light

The LED screens in virtual reality headsets emit blue light which, when viewed in the evening or at night, disrupts biological rhythms: delayed sleep onset and disrupted sleep. Eye strain and migraines are also possible after prolonged sessions.

Anses recommends avoiding all screen exposure for two hours before bedtime, particularly for children and adolescents, who are more sensitive to blue light. In therapeutic settings, sessions are supervised and time-limited, which reduces this risk.

Temporary impairment of sensory and motor abilities

After a session, virtual reality can cause temporary changes in sensory, motor and perceptual abilities: impaired manual dexterity and bodily disorientation. These effects are reversible.

Anses recommends a rest period of one to two hours before resuming an activity that requires a high level of concentration, such as driving. Patients must always be informed of this precaution before any session.

At-risk populations and contraindications

Certain profiles require particular vigilance or constitute a formal contraindication. Temporal modulation of the light emitted by LED screens can trigger epileptic seizures in susceptible individuals. Use is also not recommended, or must be medically supervised, for pregnant women, people who experience motion sickness, those with balance disorders or those prone to migraines.

Good to know: Anses recommends stopping use immediately if symptoms appear (nausea, dizziness, sweating) and always informing users about risks and good practices before any session.

Access to virtual reality therapy requires a medical prescription. The process begins with a doctor or specialist (psychiatrist, neurologist, rehabilitation physician), who assesses the indication and refers the patient to an equipped facility or practitioner.

Many French facilities have acquired this equipment in recent years. Among the most active are la Pitié-Salpêtrière and l'hôpital Cochin in Paris, l'hôpital de la Conception in Marseille, and CHU in Lyon and Bordeaux. In total, more than 350 French facilities are equipped in 2026, according to C2Care, a French company in the sector that also supports around thirty CHU.

Financial coverage varies by setting. In hospitals, sessions are integrated into the care pathway. In private practice, reimbursement depends on the services billed and the patient's supplementary health insurance. Some mutual health insurers offer packages that partially cover non-drug therapies.

Professional solutions are available for private practitioners wishing to incorporate virtual reality into their practice. C2Care offers a unified platform for controlling exposure in real time, adjusting parameters according to the patient's reactions and accessing more than 250 exposure situations covering phobias, addictions, relaxation and cognitive stimulation. More than 700 practitioners have already been trained in this approach. The flexible subscription at €99/month, with no commitment, makes it easier to incorporate into private practice without a long-term commitment.

Therapeutic virtual reality is no longer a promise. It is a validated clinical tool, deployed in more than 350 French facilities and recommended by HAS for post-stroke rehabilitation.

Its benefits are measured: pain reduction of up to 60% in patients with severe burns, greater effectiveness than conventional CBT for certain addictions, and improved balance and walking in patients with Parkinson's disease. These results are based on documented neurophysiological mechanisms, not placebo effects.

Adverse effects do exist. Cybersickness, eye strain and temporary impairment of motor abilities affect 10 to 30% of users, but remain reversible. Certain populations (people with epilepsy, pregnant women and people prone to migraines) require particular precautions or constitute a formal contraindication.

Medical support remains essential. Virtual reality does not replace the healthcare professional: it provides an additional tool to personalise treatment, monitor progress and adjust the intensity of sessions. Healthcare professionals now have structured solutions for incorporating this technology into their practice, with full control over the course of each session.