How VR Can Take Away Pain

There’s nothing worse than when a new technology becomes swept up in a flood of hype that sees its buzzwords used in all sorts of inappropriate ways. Remember when everything from toothpaste to shoes somehow had the word “nanotechnology” shoehorned somewhere into their product descriptions? Simply because the greater public had become aware of the scientific excitement around nanotechnology, adding it to your product, despite tenuous links to the field, would make it sound futuristic.

Well, I hate to say it but VR is starting to pick up a little of that unwelcome tendency. It’s being applied to all sorts of areas where it really shouldn’t be. The same thing is happening to artificial intelligence, with all sorts of applications and devices claiming to be “AI-powered”. This is why you’d be right to take with a grain of salt the claim that VR is an effective treatment for pain. And yet, here we are with serious evidence that virtual reality can in fact treat pain. How is this even possible?

patient with vr

What is Pain?

To understand how it can even be possible, in principle, for pain to be affected by something like VR, it’s important to understand what pain actually is. Pain is a built-in, evolved warning system that lets you know something’s not right with your body. Whether you step on a tack or have something wrong internally, an aching or stabbing sensation let’s you know about it.

Pain is delivered as a signal from your sense organs, transported by nerves and reaching the pain center of your brain. There it is interpreted and you then get a subjective experience of that signal. Pain medication works by putting a block somewhere along that delivery line. When the doctor applies a numbing agent to your skin before removing a mole, he’s preventing the pain sensors in your skin from reporting the damage in the first place. When you drink certain pain killers, they reduce how well those nerves function, lessening the intensity of the feeling. Strong painkillers such as opioids bind to pain receptors in the brain for a powerful effect that stops you from experiencing the sensation of pain even if the signal makes it all the way to your brain.

That’s the (rather broad) mechanical description of pain. It’s not exactly inclusive, but you get the general idea. The thing is, despite all the physical mechanisms of pain, in the end it is still a subjective mental process that makes up the experience of pain. This is why some people can feel chronic pain, pain that doesn’t go away no matter what medications you take, as a psychological problem. It’s also why some people are more resilient to pain than others. They habituate to it; they can override it mentally and otherwise deal with levels of pain or discomfort that would reduce a crybaby like me to a blubbering mess.

Hypnotherapy too, can be used to reduce the amount of pain a person feels. So it should be clear that it’s not only by using chemical agents that we can reduce how much pain a person experiences. That’s where VR comes in.

VR at the Dentist

I first became aware of this innovative use of VR when I read an article about how dentists were using VR to reduce pain as part of a study. In total, 80 people who needed a cavity fixed or a tooth yanked out took part in the study. These two types of procedures were split into separate groups and given one of two VR experiences. They could explore the coast or explore a city. A very unlucky third group got nothing at all! Ouch. Those who experienced the coastal exploration reported the most reduction in pain compared to both of the other groups.

appliedVr fractured leg


So promising is the prospect of VR pain reduction, especially in this era of opioid addiction, that one Matthew Stoudt launched an entire company to produce VR experiences aimed at reducing pain. The are putting together a whole library of experiences for many different medical scenarios. There are ones meant to calm you down before going into the operating room. There are ones meant for use during surgery; presumably the type of surgery that does not involve being put under! Finally, they have VR experiences meant to help with the postoperative pain issue.

The people from AppliedVR are working with hospitals to refine and test these VR pain interventions and the results are quite amazing. Researchers have found that 20 minutes of calming VR can reduce pain by 24%, which is significant. It means that you can get to an acceptable level of pain without drugs, or become pain free without needing quite as much. It might even be the case that VR could provide relief to people confined to bed and undergoing palliative care, such as those who have terminal cancer. The possibilities for improvements in quality of life excite me most of all.

The Work Ahead

There’s still a lot of research and testing that has to be done before we can even think of making VR pain treatments a mainstream approach to pain control. There are still so many questions. Even if they establish a reliable link between VR and pain relief, we still need to figure out what sorts of experiences work best. Which ones work for what sorts of pain? Does it matter what culture the patient is from? What about their gender or age?

I hope this research is well-supported and that we’re graced with another way to make people experience just a little less suffering in life. That’s not too much to ask.

vr backpack

VR Backpack Computers Versus Wireless HMDs - A Strange Battle

There’s a silent war brewing over the short-term future of virtual reality. It centers around how VR users are going to free themselves from the tethers that are currently part and parcel of the AAA premium VR experience. Yes, there are mobile and self-contained VR headsets, but none of them can compare to the fidelity and experience of a tethered HMD hook-up on a cutting-edge computer with the latest graphics technology.

The hardware needed to meet the minimum standards have indeed already shrunk down a lot; so much so that VR-ready ultrabooks such as the Razer Blade are possible. However, it’s still simply impossible to stick that level of hardware into a self-contained unit. So how do you get rid of that long tether and still have access to those powerful computational resources you need for cutting-edge VR? This isn’t just for VR gamers who feel inconvenienced – there are plenty of training and industrial applications for truly high-end VR that isn’t literally tied to an anchor.

wireless vr headset

Two Ideas are Better than One

Right now there are two approaches to solving the tethering problem. The obvious one is to create an HMD that can transmit its data wirelessly. The problem with this is that devices like the Oculus send massive amounts of data in both directions. The main killer here is the double HD 90 Hz video signal. The motion-tracking data going the other way is pretty beefy too.

Bandwidth isn’t even the whole story. With aggressive compression you can get it through a thinner pipe, but going wireless and still keeping the entire latency loop under 20ms has so far proven essentially impossible. In fact, measures such as video compression actually add to the total latency, since it takes time to squeeze those frames down before sending them over to the airwaves.

Despite these technical challenges, VR pioneer Oculus seems to be on the verge of releasing in 2018 the first practical wireless HMD. It’s a product that’s gone under the name “Santa Cruz” so far; it seems the time for it to come to market is getting close.

The other potential solution towards untethered AAA VR isn’t quite as compact and elegant compared to the concept of wireless HMDs. It is, however, something you could buy today if you had deep enough pockets.

Enter the Backpack VR Computer

HP has taken the genius step of taking all those compact, laptop-friendly components and putting them into a battery-powered chassis that can be strapped to your back. This means that the tether is now anchoring you to something that will go wherever you go. You can turn around to your heart’s content without getting tangled up.

The specifications of the two backpack computers offered by HP are right up there. This is a workstation-class machine, so you get a Pascal-based Quadro P5200 GPU with 16GB of RAM and an i7 vPro CPU. When you are done with the VR portion of your task, you can unclip the machine from the backpack harness and then plonk it down into its docking station. Of course, this convenience has a price tag – it starts around three grand, and that’s before you buy your HMD.

The fact that the backpack form is currently expensive is beside the point, however. The big question to me is whether this is an overall better idea than a wireless VR headset.

Why is a Wireless HMD So Important?

That’s the question, isn’t it? There are so many complex technical questions that have to be solved in order to connect the HMD wirelessly to a computer that I seriously have to question if it's worth it. Although the backpack computer might look a little cumbersome now, by this time next year they’ll be squeezed into an even smaller box. Even now the whole HP Z computer backpack setup weighs about 4 kilograms. I doubt the typical adult would even notice that weight on their back, and that’s just a first-generation design.

Wireless tethering would be a technological marvel, but is it an over-engineered one? There are so many things that can go wrong with wireless transmission that the very idea of using it for anything other than the least mission-critical task is rather laughable. The only real place it makes sense is if someone already has an existing VR setup and now needs to get rid of the tether.

The thing is, how long before the backpack form factor just becomes another style of case you can buy. Slap your own components into it and there you go. Now the backpack solution becomes an upgrade or a minor conversion. Has Oculus thought this through?

MSI Vr Backpack

Playing with Wire

Keeping everything connected with a direct wire link ensures reliable performance. This is the age of power-efficient, desktop-grade components. They don’t make a lot of heat and noise anymore. Mechanical drives are optional. With computers now so small and light, there may be no reason at all to leave them on the floor.

The real problem, if you ask me, is the reliance on an external tracking camera. That’s what really ties the VR user down. There’s no indication that Santa Cruz will be any different at this point. That's a problem, because Microsoft and its hardware partners have essentially made external camera tracking obsolete with Windows Mixed Reality headsets. These new HMDs have outward-facing cameras that track the room, not you – which means if you combine them with a battery-powered VR backpack you can go wherever you want.

More Mixed

Yes, I have to admit that this is probably an application more suited to mixed reality applications. Still, even if complete free-roaming VR is not really practical, the freedom of movement and relatively large space afforded to us by having a backpack-based VR system are features not to be sniffed at.

Betting on a Winner

Here's the bottom line, from my point of view. They’re spending all this time and money developing wireless display technology. The main reason they are doing this is because there’s no way to build the processing power of a full computer into something as small as an HMD. That’s fair enough, but VR-ready hardware has already been reduced in size to the point where it goes in an ultrabook chassis. We can’t really be that far from AAA VR hardware fitting in an HMD or a small tethered box worn on the belt or elsewhere on the body.

Right now VR backpack computers might seem a little silly, but give it a few years and more size reduction and it could be a completely different story.


ARCore: The Core of the Issue

Before ARcore, when Apple announced and then released their augmented reality developer kit, known as ARKit, it really took the VR and AR world by storm. This was some truly next-generation stuff unleashed on an unsuspecting market. It was augmented reality that did not need special markers. It can map out the dimensions of the room you’re in, find surfaces, remember them, and then project solid and convincing digital objects into the camera feed. ARKit is a quantum leap compared to basic AR apps we’ve already seen on smartphones and tablets.

Of course, we’ve seen this level of augmented reality before. Various outfits have been working on advanced AR systems for years now. Almost all of these have relied on specialized hardware in order to achieve the sort of spatial mapping and processing you need to craft such convincing digital illusions.

google android arcore

Google Does the Tango

The most famous project in this regard has to be Google Tango – a hardware standard created by the tech giant using multiple specialized sensors to do accurate range-finding and quickly create a virtual map of the 3D space around you. It worked fantastically, and the idea was that future phones would ship with all the Tango hardware built right in. The big downside to this is that it limits the number of people who can use this special AR platform to only those who buy phones designed for that purpose. It’s not exactly a recipe for mainstream success.

ARKit will run on just about any new Apple device. That makes it attractive to developers who know that they have access to virtually the entire install base of iOS machines. It becomes a virtuous cycle where people already have the platform so more developers make AR apps, which make money and then attract more developers. It also means that the quality of AR apps keeps getting better because of competition, just as the standards for app innovation have skyrocketed since the idea of a smartphone app was first introduced. There are no fart apps on the Top 10 list anymore!

ARCore is Ready to Rumble

It’s in this context that Google’s development of ARCore has been happening. Long before Apple was ready to release ARKit (which it now has) Google has been playing catchup. As I write this, ARKit has been out for some time. You can find plenty of writing about it on this site, and even app reviews and recommendations. It’s a mature and shockingly reliable platform. This is why I expect that Google will come out swinging with ARCore, the Android equivalent of ARKit. Unfortunately, given the nature of Android, they have a much bigger job ahead of them.

Why Android Makes ARCore Tricky

The big difference between iOS and Android is that iOS is a closed platform. Just like Mac computers, Apple has full control of both the hardware and the software. This is an approach that comes with pros and cons. In my opinion it’s the main reason that Apple computers never became dominant. Microsoft was wise enough to open Windows up to any PC maker, which meant the install base became huge and developers were lured to make software for the larger market. Apple was relegated to catering for niche creative markets like photo manipulation, desktop publishing, and film editing.

In this analogy, Android is like Windows. While Google is the custodian of Android, any phone maker can put it on their product. It’s also driven down the price of smartphones since it runs on low spec and high spec machines. The phone maker can concentrate on making the hardware and if they feel it’s worth it, they can customize the look and feel of Android, which is why Samsung Android phones have TouchWiz and Mi phones have MIUI, as an example. Since Google has given up control of the hardware their OS runs on, it makes it incredibly difficult to put out standardized hardware APIs similar to ARKit.

arcore thumb

Apple knows every component in every one of its products. If you take two random Android phones there’s little chance they both will have GPUs, processors, or RAM that are anything alike in type or performance. You can’t count on a given Android phone having a specific quality of camera sensor or level of gyroscopic accuracy.

It’s also why gaming on iOS is a much better experience than on Android in general. How many times have you downloaded a new Android game only to find that it doesn’t play well with your phone model? It might be too slow, and crash or glitch out. There are simply too many hardware combinations to test for all of them. It’s for these reasons that Google has its work cut out in releasing a competitor to ARKit.

Before we go into the details of ARCore, let’s first explain exactly what it is.

Paint By Numbers

Like ARKit, ARCore is a software development kit. Developers who make applications use these as a way to standardize their software with various hardware and operating systems. It also means that they don’t have to reinvent the wheel every time they make new software.

In the case of ARCore, the idea is that a software developer who wants to use AR as a part of their application just needs to send the right inputs and outputs to the ARCore software and, presto, you have an AR application. Obviously it’s much more complicated than this, but it comes down to Google solving the hard problems of AR in Android on behalf of developers and then making that solution available so they can focus on creating cool stuff with AR rather than grappling with AR technology itself.

What Can It Do?

OK, now it’s time to talk about the actual features of ARCore. Whether you’re someone who wants to make AR apps or just use them, these are the abilities you can expect from the system.

First of all, ARCore is capable of motion tracking using the camera feed and motion sensor data. In other words, just like ARKit it can find “landmarks” and stay oriented, which in turn means 3D objects can “stick” to their location in the real world.

That wouldn’t be much help if it couldn’t tell whether something was a table or a wall. So ARCore also has something known as “environmental understanding”, a fancy way of saying that it can figure out from the camera picture whether something is flat, horizontal, or vertical – the basic building blocks of mapping a room.

Now that it knows where things are and what they are, it needs to actually draw 3D objects in the scene so that they look as if they’re really there. One of the main reasons that AR looks fake is because it doesn’t match the ambient lighting. If the 3D object is lit arbitrarily then it stands out like a sore thumb. It also needs to cast a believable shadow. It’s funny how you can tell immediately when these things are missing, but can’t always put your finger on why it looks so wrong.

arcore tab

Who Can Use It?

Just as with ARKit, there are minimum requirements for ARCore to work on a given phone.

First of all, the phone must run at least Android N or “Nougat”. For the preview version of ARCore the only phones that support it are the Google Pixel phones (obviously) and the top-class Samsung Galaxy S8.

ARCore is big, but still an underdog. With the release of ARCore, millions more people will have access to advanced AR experiences. Although Apple handily beat Google to this milestone, there are still far more Android phones out in the world than iOS ones. This means that ARCore is possibly more important for the AR industry overall than ARKit is. That’s not to say that ARKit means nothing. I’ve said myself that it’s an incredible achievement and a real game changer.

However, if only flagship-class phone owners need to apply when it comes to ARCore, the whole thing may be a moot point anyway. It may be that the average Android phone still doesn’t have the sort of hardware to make ARCore work as intended. One real risk is that ARCore gives AR a bad name thanks to all the inconsistency of the market.

In the end, I’m just ecstatic that AR is moving forward and that it’s not locked into elite, experimental hardware, because that means everyone wins.