Can Virtual Reality Help People Manage Pain?

Snowflakes fall around me as I float above a river, weaving through an icy wonderland. I toss a fish to an otter, and it shivers with glee. Then, as I exit a cave full of colorful rocks, I flow into a bright spring landscape, complete with cherry blossoms.

This trippy yet oddly relaxing simulation (officially titled COOL!) comes courtesy of DeepStream VR, a Seattle-based virtual-reality startup. But it’s no game: early research has shown that for people with chronic or acute pain, having the same experience I did can offer a much needed reprieve–not just during the treatment but for days after. “We can manipulate the experience to get the best outcome for people,” says Howard Rose, DeepStream’s co-founder and CEO.

He’s not alone in that excitement. As VR technology gets better, cheaper and more accessible–thanks in part to consumer-friendly headsets like the Oculus Rift, which debuted in March–a small but growing number of scientists and entrepreneurs are using it to treat medical conditions, including PTSD and chronic pain. The financial stakes are high: Goldman Sachs expects total revenue from the VR industry to hit $95 billion in 2025, of which over $5 billion could come from medical applications. Virtual reality could also reshape the nature of medicine itself, enabling doctors to abandon what Rose calls “a one-pill-fits-all approach” to treatment.

Right now, though, its proponents still have a lot to prove. Although individual studies of people with chronic pain have shown that VR can offer relief, a 2014 review of 17 studies of people with acute pain revealed that relief was mostly short-lived. And for psychological conditions like social-anxiety disorder, a 2015 study showed in-person therapy worked better than VR. “I am on the fence [about VR health care] right now,” says Bernie Garrett, an associate professor at the University of British Columbia School of Nursing who is studying how VR affects chronic pain. “There are definitely some benefits, but we don’t understand what they are.”

That’s starting to change. Until recently, it cost millions to build VR labs and to conduct tests, which was too steep a price tag for most researchers. Now that the technology is more readily available, it’s a lot easier to experiment–and to gather the data necessary to draw more informed conclusions.

DeepStream is one of several for-profit startups in this space, alongside AppliedVR and Pear Therapeutics. But academics like Garrett are working hard too. At the University of Southern California, for example, researchers are virtually re-creating battle scenarios for veterans in order to treat their PTSD. It’s a more immersive version of exposure therapy, a common psychological treatment in which people talk repeatedly about traumatic events in order to process them. For patients who can’t “emotionally engage with their imagination,” VR can offer an invaluable assist, says Skip Rizzo, who’s heading the initiative at USC. “We can put people in environments that resemble what they went through, and help them go back and confront [their traumas],” he explains. “It adds to the menu of treatment options.”

It’s less clear how or why VR relieves chronic pain, since it’s a very new type of treatment. The prevailing theory is that it offers a distraction. Since humans can pay attention to only one or two things at a time, creating an environment that blocks everything out and makes them focus on a task–like, say, feeding an otter–makes it harder to focus on pain. “I’m very optimistic” about its potential, says Walter Greenleaf, who’s researching VR health care at Stanford University. Of course, immersing oneself in a virtual reality can have its own side effects, like motion sickness. During one of Garrett’s trials, a woman became so nauseated, she had to lie down for three hours to recover.

But for Ted Jones, a clinical psychologist at Pain Consultants of East Tennessee, the prospect of a new way to manage pain without pills is worth the risk. His patients have already experimented with Cool! and logged encouraging results. Now, Jones says, he’s waiting for VR treatment to become more widely accepted, so insurance companies will cover it. “We are in the heart of opioid-abuse land down here in Southern Appalachia,” he explains. “A non-opioid alternative is just what we need.”

For more on these stories, visit time.com/ideas