The stars in the sky shine brightly as they bring life to this pitch-black galaxy. Within the darkness rests Omega, a space station filled with the scum of the universe. My goal is simple: find the Archangel, master assassin. I am Commander Shepard, and for this brief moment, I am immersed in this other world — the agonizing, burning aches that ripple through my legs aren’t quite so apparent. In this alternate universe, I’m not shackled to a bed on the brink of tears, struggling just to keep my head straight. I feel stronger as Shepard: I am saving the world as the embodiment of the person I’d be, were I not living with a chronic illness every day.

According to the Institute of Medicine of the National Academies, approximately 116 million Americans suffer from chronic pain. To put that in perspective, the American Academy of Pain Medicine found more people suffer from chronic pain than cancer, diabetes, and heart disease combined. What makes chronic pain such a formidable foe is that it lingers: pain signals continue to fire for long periods of time, overwhelming the body.

Think of the most menacing boss you’ve ever faced — then imagine having to battle them 24/7. That’s chronic pain. Just when you think you’ve won, they replenish their health and unleash a renewed attack, obliterating your hope of victory. But while chronic pain might be an invincible opponent, a vitality potion exists for many sufferers: videogames.

Something magical happens when we load up a game — the places they take us, the renewed mindset that they provide, and the immersion we feel when we step into a new gaming world are extraordinary. For the past five years, I’ve suffered from fibromyalgia, a disorder with a primary symptom of widespread chronic pain. I’ve often used gaming as part of my pain management; where many medications have failed, games have succeeded, and I’ve often wondered why no other medium measures up. The answer is deceptively simple: while games provide an engaging distraction, they also affect our brains in positive ways, and researchers and medical professionals are starting to take notice.

Surrender to the Flow
Gaming hasn’t always been associated with pain management, but many pain sufferers find it to be their savior. Mark Donahue, 37, of Joliet, Ill., who has polymyalgia rheumatica — a syndrome of regular pain and stiffness primarily in the shoulders, hips, and neck — finds a nightly session of gaming essential for keeping the misery at bay. When Donahue boots up a game, it transports him to a different place. “It’s mostly a mental distraction, but we all know how much our state of mind can affect our daily lives,” he says. “Playing games means there’s less time for me to ponder my situation.”

Donahue has found something in games that other media, like movies or television, just don’t quite fulfill. “[It’s] sensory overload,” he says. “Unlike other forms of entertainment, gaming forces you to pay attention. To interact. To be involved. This is what I love about it. I get something pretty to look at, music to listen to, and a character under my control.”

But what’s truly going on in games that helps to diminish the impact of pain? It all comes down to one word: flow. According to Maribeth Gandy, Senior Research Scientist at Georgia Tech’s Interactive Media Technology Center, much of what happens to us when we game involves Hungarian psychologist Mihály Csíkszentmihályi’s theory of “flow,” or the mental state where someone becomes so alertly focused on one activity that they’re completely absorbed in it. When we’re experiencing flow, we’re essentially “in the zone” — nothing can distract us from completing the task at hand. This is how we find ourselves up until four in the morning exploring the misty mountaintops of Skyrim — we’re deep within a sense of flow.

Gandy is currently collaborating with the Gains Through Gaming Lab in North Carolina on a cognitive gaming project. “Games can help transport you mentally to another place and time, distracting you from your actual surroundings or physical state,” she says.

Studies have shown that when flow is experienced, pain is more tolerable. In a 2009 study, for instance, Bryan Raudenbush, Department Chair of Psychology and Director of Undergraduate Research at Wheeling Jesuit University in West Virginia, and his colleagues confirmed that videogames could distract from the mere sensation of pain. In their research, people put their hand in a device called a cold pressor, which contains water chilled to three degrees Celsius (37-degrees Fahrenheit). People either played a retail videogame or did nothing with their free hand. The results? Those who gamed during the pain sensation were able to keep their hand in the intensely cold water longer. Even more interesting was that those who played action games — the type requiring the greatest focus — kept their hands in the water the longest.

“What’s interesting is that data suggests that [games] are more than a distraction — that the patient experiences physiological changes as a result of using the system,” Gandy says. “The games may have an analgesic influence and may impact how the brain responds to painful stimuli.”

According to licensed psychologist Sarah Dunn, who does research for Emory University’s Department of Psychiatry at Grady Memorial Hospital in Georgia, the more active your brain during gameplay, the more likely it is to block the sensation of pain. As games entertain us, our brains react by producing endorphins, which improve our state of mind and act as a pain reliever.