A couple of weeks from now I will be in hospital undergoing a knee replacement. It will be the most extreme surgery I’ve ever experienced and I’m pretty scared. I’ve been told that I can expect to endure excruciating pain afterwards but I won’t be allowed to lie in bed feeling sorry for myself. In order to ensure a good recovery I have to get up and exercise the new joint numerous times a day. Make no mistake, this is going to hurt.
It may not be too long, however, until patients like me will be able to ward off their agonies simply by playing virtual reality games. This surprising advance is already being tested, but the premise behind it is not new.
As neuroscientist David Linden recently explained on NPR, the brain has more control over pain than we might at first imagine. It can say “hey that’s interesting, turn up the volume on this pain information that’s coming in”, or it can say “turn down the volume on that and pay less attention to it”. In Linden’s book Touch: The Science of Hand, Heart, and Mind, he discusses how our perception of pain relies on the brain and how it processes information coming from the nervous system.
Lieutenant Sam Brown
Researchers are now attempting to see if this process can be manipulated through gaming. In the US, a group of patients suffering from severe burns were invited to play SnowWorld, a virtual reality computer game devised by two cognitive psychologists, Hunter Hoffman and Dave Patterson, to persuade the brain to ignore pain signals in favour of more compelling scenarios. Their motivation, Hoffman said was because opioids (morphine and morphine-related chemicals) can control burn pain when the patient is at rest, they are nowhere near adequate to quench the agony of daily bandage changes, wound cleaning and staple removals.
The best-known SnowWorld player is lieutenant Sam Brown who, during his first tour of duty in Kandahar, Afghanistan, in 2008, suffered third degree burns over 30% of his body. An IED buried in a road hit the vehicle he was travelling in and exploded into a fireball, engulfing Brown in flames. His injuries were so severe he had to be kept in a medically induced coma for several weeks. Back in the US, Brown endured more than two dozen painful surgeries, but none were as bad as the daily ritual of caring for his wounds. When nurses attended to his burns and helped him perform the necessary physical therapies, he experienced the most excruciating pain.
In 2012, NBC News reported on Brown’s experience and how the pain of dressing burn wounds could be so intense it could make patients relive the original trauma. In Brown’s case the procedures were so unbearable that on some occasions his superior officers had to order him to undergo treatment.
For Brown, help arrived not in the form of new kinds of medicines or dressings, but by a video game. Brown was one of the first participants in SnowWorld’s pilot study, which was designed in conjunction with the US military, to test whether it really could help wounded soldiers.