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By Jess Erion

I can’t tell you how many times I‘ve heard the iconic opening line: “Hey you, you’re finally awake,” as my TV screen filled with a view of Skyrim’s massive Nordic landscape. My high school English teacher was the first one to get me into digital RPGs (role-playing games) when he introduced me to Dragon Age. At the time, I loved the genre for its wealth of stories and complex worlds, but it soon took on greater meaning as games became my primary tool for pain management.

In my early teens, I sustained a shoulder injury that has since taken 10 years, two orthopedic surgeons, and several physical therapists to treat – and I still need regular physical therapy and daily medication to keep pain levels manageable. When I was younger, I didn’t have the same access to health care that I do now. I’m lucky to have been treated by so many qualified specialists, but when I went to the local clinic with this injury as a kid, the doctor told me to take some Advil and walk it off. With no guidance or medication, I turned to the one thing that reliably alleviated my pain: games.

There have been several articles and studies in the past couple of decades regarding games and their capacity to diminish pain through active distraction. In 2020, one study showed that patients experiencing pain associated with chemotherapy reduced their pain by 30% by playing video games. However, few of these studies capture the experience of disabled folks and others with chronic pain who use games the same way I did – not as something prescribed, but something we discovered ourselves as a tool to improve our pain.

How Do Games Help With Pain?

Games that are highly immersive, as well as games that are absorbing and repetitive, offer relief in moments of intense pain. Tiberius, who has a bone disease, told me how games became a refuge. Tiberius—and several other people interviewed for this story—chose not to disclose their last names to maintain privacy about their medical conditions. “Historically I have not had much access to health care at all. Possibly the most important thing games could offer was escapism, having high-concept worlds to inhabit, especially when I was younger and not yet diagnosed [with a bone disease]. It helped me stop thinking about my own body for long periods of time.”

Alex Roberts, a game designer and graduate student who experiences chronic pain, also cites the hypnotic nature of games. “When the pain is severe and immediate, a video game that’s intense and repetitive and consuming will really completely divorce me from my pain, like Mario Kart or Tetris or Puyo Puyo.”

However, both these interviewees and many others explained that different games help with pain in different ways. Some games alleviate pain by allowing players to build community with each other, particularly tabletop role-playing games like Dungeons & Dragons that involve multiple players coming together to create a story collaboratively.

“If I’m not at the top of the pain scale,” Roberts says, “one of the best ongoing things I can do for my pain is being in a tabletop role-playing game campaign, just playing with my friends every week. It keeps me from feeling trapped inside my body and feeling bad about what my body is doing, but it also is part of a meaningful and fulfilling life. … Games also make it possible for people who are experiencing very different levels of pain to connect.

“When I was in the hospital, one of the best things was when my friend visited and ran a one-player tabletop campaign for me or brought their Switch to play Mario Kart, because it allowed us to experience something fun without making too many demands of one of us as a disabled person and another as a caregiver. We knew it was doable for both of us, and it helped so much with my pain. … Tabletop games in particular often reward you for caring about others and noticing things about others. Usually, it makes the game better or more interesting.”

Haley, a college student with hydrocephalus, notes that tabletop games and gaming communities enable a level of representation and self-expression for disabled people that is rare in most forms of media. “There are really good mechanics and elements in tabletop like the combat wheelchair [created by Sara Thompson]. There’s a whole community of disabled tabletop players who are figuring out: How can we bring a disabled adventurer to life in these settings? While I’m not a wheelchair user, I find a lot of empowerment in having that identity represented in games.” Other tabletop games have been intentionally designed to center disabled players and characters, like Survival of the Able, which was written by blind game designer Jacob Wood and focuses on a cast of disabled characters as they try to survive a zombie apocalypse.

 

Do Games Have a Future in Health Care?

Najmeh Khalili-Mahani, PhD, a neuroscientist, biomedical engineer, and interdisciplinary researcher across Concordia and McGill universities who has proposed a digital strategy for large-scale qualitative health research, explained that incorporating games into traditional medicine isn’t on the immediate horizon.

Existing studies have been small, she said, and larger sample sizes are necessary to justify what is seen as an unconventional treatment. “Most of the evidence that exists to prove that games reduce pain is coming from extreme cases, like burn victim units or cancer patients. There is existing literature, but the samples are very small. For a larger sample size, someone will have to invest much more money in it. So we are stuck with morphine being the cheapest, fastest, and most immediately effective pain treatment, with all of its unwanted consequences.”

In addition, “games” as a subject of medical inquiry is difficult to pin down with so many genres, forms, and cultural nuances. “Games are informed by culture, and they aren’t going to impact everyone the same way. Games that I may find engaging and analgesic, you may find tedious and frustrating. How do we figure out which ones work for which people when the field of games is so humongous? … I think, and I hope, that the more that media scholars and social scientists start working together with medical professionals and researchers, the better the understanding we will have,” Khalili-Mahani said.

She continued to say that amplifying individual testimonies from people who experience chronic pain is key to future research and implementation of games as a component of health care. “I think the effective push is going to come from the bottom-up, from personal narratives of patients who are explaining what works for them, what works for thousands of them. To the point that it can’t be ignored anymore.”



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