How scientists are using virtual reality to treat chronic pain
Once used mainly for distraction, VR is now being studied as a way to retrain the brain’s pain pathways—especially for people with chronic and hard-to-treat conditions.
It was a late afternoon in September when Leona Bell was heading home from her job as a senior systems engineer for a company that designs defibrillators and resuscitation equipment in Seattle. The company had just moved offices, and the new workstations had built-in laptop chargers. When she went to grab her computer, she yelped in pain. “I got shocked,” she says. “It changed my life.”
When Bell woke the next morning, her right hand, injured by the electrical shock, was swollen and purple. She couldn’t move her arm. “The pain was so extreme,” she says. “It just felt like someone had put my hand in the fire and there were flames coming out of my hand.” That was seven years ago, and Bell’s life is still defined by what is called “Complex Regional Pain Syndrome,” or CRPS, a chronic pain condition that can arise after injury and is known among many patients for its severity and relentlessness.
Bell’s case is extreme. But she is far from alone. An estimated 50 million Americans live with chronic pain, according to the U.S. Pain Foundation. It remains one of the leading causes for long-term disability in the United States and is the most common reason people seek medical care.
For decades, and now especially in the wake of the opioid crisis, treatment options have been limited, expensive, or inaccessible. But a new wave of digital tools—ranging from virtual reality to smartphone apps and artificial intelligence—is beginning to change how scientists understand chronic pain, and how patients learn to live with it.
How virtual reality hijacks the brain’s pain signals
Pain is not just a signal from injured tissue. Decades of neuroscience show that attention, expectation, and perception play a decisive role in how pain is experienced. That insight has led researchers to an unlikely testing ground: virtual reality.
One of the earliest scientists to explore VR’s potential for pain relief is Hunter Hoffman, a psychologist who has been studying immersive environments for more than a quarter century.
At the University of Washington in Seattle, he developed an immersive environment called “SnowWorld” to help children undergoing burn wound care—a notoriously painful medical procedure. In the virtual landscape, patients threw snowballs at penguins while listening to music. The program, which has since been exhibited at the Cooper Hewitt, Smithsonian Design Museum in New York, has been shown in multiple clinical studies to reduce both pain and anxiety during burn wound care.
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“The driving factor is distraction,” says Zina Trost, a VR pain researcher at Texas A&M who calls “SnowWorld” the “origin story” of VR for pain. She is the author of one of several literature reviews showing the evolution of evidence for this modality. “The visual system is so primary in people. And if pain does not have your attention, you are not in pain. It’s a compelling thing.”
This kind of immersive distraction works especially well for short-term, procedural pain. VR has been used in place of chemical sedation for colonoscopies, blood draws, and dental care.
But to help chronic pain patients like Leona Bell, Hoffman needed a different strategy, one that went beyond distraction alone. Bell is one of seven CRPS patients who participated in Hoffman’s pilot study, which was submitted to Frontiers in Neurology. She took home a VR headset that transported her to an ancient wizard’s laboratory. She spent four months practicing some of the same movements from her physical therapy, such as grasping and stirring.
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Hoffman introduced a simple “mixed reality” innovation that, Bell says, helped her literally immerse herself in the VR world. “When you dip your virtual hands into the cauldron, you’re actually putting your hand in the real world into this warm water,” she explains. “It was really weird. Before that, I just was like, these are fake hands, you know? And as soon as I did that, I could attach to the avatar’s hands.”
Because she had the VR headset at home, Bell could use it as often as she wanted. She soon reported improvements after practicing PT exercises, such as dipping her hand into a bowl of dry lentils—a sensation that can be unbearable for the hypersensitive CRPS patient. “It felt painful, I’m not gonna lie, but I could do it for maybe a minute in VR, where I could do it for, like, 10 seconds in the real world.”
Over the course of the small pilot study, Bell observed a reduction in her pain and sensitivity to cold. Her ability to move her hand increased, and her anxiety and depression improved, too. (The experiment also asked participants to use the VR headset to practice mindfulness.) The same was true of 6 of the 7 participants, with improvements maintained at a one-year follow-up.
Again, this was a small, pilot study for a particularly intractable condition. But it is one of many studies over the last decade suggesting that VR may offer modest benefits for some people with chronic pain.
“It’s amazing what happens to a person with pain just by seeing an avatar of themselves,” says Trost. “It allows potential morphing of reality and trying on other experiences, and it can facilitate things that you didn’t think you could previously do.”
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Trost now studies the use of VR for people with spinal cord injuries who experience chronic pain in paralyzed limbs. In these environments, participants can experience walking again by controlling their virtual lower limbs through head movement and arm swinging.
Trost, who herself lives with chronic pain and orthopedic deformity, has also found that perceived injustice intensifies pain, meaning the more unfair an experience feels, the worse it hurts. Given this psychological evidence, she suspects the “super special sauce” of VR lies in restoring “volitional control”—the ability to exert one’s will, something often stripped away when pain and weakness limit the body.
In unpublished work, Trost has seen corresponding changes on brain scans—and, in a subset of participants, an increase in GABA, the neurotransmitter that helps dampen pain. This is early-stage research, but it could provide a hint at the mechanism involved. “My pants fell off a little bit,” she says when she saw that result, though she cautions that the findings are preliminary.
When imagining relief is enough
Virtual reality isn’t the only way to tap into the brain’s pain-processing systems. Jian Kang, a researcher at Harvard University, is exploring whether something even simpler—watching a video—can ease chronic pain.
In a November 2025 study, Kang and his colleagues recruited people with chronic lower back pain and asked them to watch short, computer-animated videos. In one version, an avatar underwent acupuncture. In another, participants watched a video of a lower back being gently touched with cotton swabs. In both cases, subjects were asked to imagine feeling the sensation themselves.
The cotton-swab video was meant to serve as a control. What surprised the researchers was that both videos helped. The effect was more substantial in the video acupuncture group—an average of 1.7 points lower in perceived pain on a 10-point pain scale—but the cotton-swab videos also produced meaningful relief. This is comparable to some results for real acupuncture, Kang says. The cotton swab results offer an exciting alternative, as not everyone can tolerate acupuncture needles, even in imagination.
“Neuroscience has found that sensory imagery and real body sensation often engage the same brain network,” Kang says, by way of explaining how the video could be working. That network, he says, is the primary and secondary somatosensory cortex, found in the center of the brain, in a region known as the parietal lobe. “The better they can imagine, the better result,” he adds.
VR and video-based approaches are still being studied, but their relatively low cost–especially with newer VR devices–and ease of use could make them easier to scale than some in-person, non-drug pain treatments. For now, their reach remains limited by awareness and access.
“We don’t have a good system in place to make sure individuals have access to the care they need,” says Nicole Hemmenway, CEO of the U.S. Pain Foundation. “There’s a lot of interesting, amazing digital health tools, but I think it works different for every single person. At the end of the day pain is so individualized.” Insurance companies, she adds, are unlikely to cover experimental treatments.
Why psychotherapy still matters for chronic pain
For patients navigating chronic pain, finding the right combination of care can be overwhelming. The U.S. Pain Foundation has tried to help patients navigate that complexity through an interactive tool called My Pain Plan, which walks users through options ranging from breathwork to chiropractors to medication to digital tools. They also host free online peer support groups. “This isn’t therapy,” says Hemmenway, who is also a CRPS patient. “It’s to help individuals think about tools, coping strategies, and community building.”
Psychotherapy itself, however, is a well-supported treatment for chronic pain, and technology is making that more accessible as well. Beth Darnall, a pain psychologist at Stanford University, developed a single-session, two-hour pain-relief skills intervention called Empowered Relief, which is supported by four randomized controlled trials. Participants can also use an accompanying app to continue practicing what they’ve learned. “I found that my patients could not access the treatments I recommended they receive in their communities,” Darnall says.
Even when care is available, psychological approaches can be a hard sell. Framing a patient’s experience as “psychological” can feel dismissive or invalidating, note Hemmenway and Trost, who are both patients themselves—especially for people who have spent years trying to convince doctors that their suffering is real. That’s one reason Empowered Relief is described as skills training rather than psychotherapy, Darnall says.
Still, there is evidence-based support for several therapeutic approaches to chronic pain, including cognitive-behavioral therapy, pain reprocessing therapy, and “Emotional Awareness and Expression Therapy” (EAET), a method developed by Mark Lumley, a psychology professor at Wayne State University. The last two methods are referred to as “interoceptive,” meaning they focus on helping patients recognize how internal bodily signals and emotional states influence one another.
However, even for those willing to try psychotherapy to help mitigate pain, demand for pain therapy far exceeds the number of clinicians trained to provide it, says Darnall.
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Lumley agrees. “My training is talking to people one on one or through little boxes,” via video chat, he says. “I have bias toward that method, but we need more options.”
That gap in access is increasingly shaping how patients seek help. In one recent case, a patient with fibromyalgia contacted Lumley. He was booked solid and spent weeks trying to find a referral. By the time he followed up, she said she didn’t need help anymore. She told him, “I decided to ask ChatGPT, how would Mark Lumley treat my fibromyalgia? And it spat out a five-page treatment program.” She reported seeing improvement by following the prompts and exercises.
Lumley and other experts stress that AI tools have not been clinically validated for pain treatment and should not be used as a substitute for any medical care. AI is “an uncontrolled and untested Wild West,” says Lumley. But given the great need, he is open to exploring how AI could one day assist with pain management, as people continue to find relief when in-person care is out of reach.
Control, not cure
For Trost, technology’s most promising role may not be replacing therapy, but helping people engage with it. She is interested in using the novelty and gamification of VR environments to “give people a little push,” she says, to overcome their resistance to EAET and other therapeutic methods.
None of these treatments is a silver bullet that eradicates 100 percent of pain for all patients. But the growing range of therapeutic and digital approaches is bringing momentum to a field more often defined by stigma, shame, and isolation.
For Leona Bell, chronic pain took away her career. It took away her hobbies of hiking and traveling. And when she lost those, she lost many of her friends as well. Being part of a research study contributing to new approaches to pain gave her not only relief but also hope.
“When you have an illness, a lot of stuff really feels out of your control, and so doing VR felt like something that I could contribute to my own health,” Bell says, explaining why she believes her mental outlook has improved. “VR just gave me a little bit of purpose. It might help other people, in ways they can’t imagine.”
