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.