Sufferers of chronic pain often experience long waits to see a specialist and can become reliant on heavy, sometimes addictive, drugs - but what if there is another way?
Researchers at Auckland University of Technology (AUT) and Waitematā District Health Board (DHB) are testing just that.
New Zealand-based health tech company Exsurgo has created a medical device, called Axon, which is being tested on 116 chronic pain patients across Auckland.
If successful, it could be rolled out to hospitals and medical clinics across the globe by mid-next year.
The helmet-like device looked like part of a video game, and in a way it was.
Over the past five years, mechanical engineers have developed the helmet combining traditional neuroscience with hi-tech computer science. It allowed patients to see their own brainwaves on a tablet.
Patients then engaged in neurological exercises in the form of animated games to encourage them to concentrate on brain movement.
Each session took about 35 minutes and sessions were repeated four times a week in the first eight weeks.
Exsurgo chief executive Richard Little said initial research showed Axon could change lives and he wanted the device to be made affordable and accessible to all New Zealanders battling chronic pain.
"We know many people struggle to get help. Chronic pain could cause massive issues with stress, anxiety, sleep and often patients could slip into major depression because they couldn't do the things they loved."
One in five people lived in chronic pain worldwide, and some of those were left unable to enjoy the activities they loved or even continuing working.
The crippling condition was understood to be costing New Zealand's health system up to $14.9 billion a year, according to a 2018 report.
The device had already been tested on a dozen patients in the UK. Every single person in that trial received some benefit and three-quarters found a greater than 30 per cent improvement which was better than most drugs, Little said.
"We had a lady with a muscular spinal injury who started horse riding again, it had always been her passion and she hadn't ridden in 20 years," he said.
"Another woman who hadn't be able to write because she had psoriatic arthritis which causes swelling in the fingers, was finally able to."
Little said not only did those patients have less pain but they had less stress and were able to sleep better.
UK-based spinal specialist Nick Birch, who had worked in the field for 30 years, said
chronic pain placed a huge toll on patients and their families, and was difficult to manage.
"The results from this trial showed that brain training may provide an easy-to-use, very-low-risk home-based solution for managing chronic pain."
However, Canterbury DHB pain medicine physician John Alchin said it was really important not to "count your chickens before they hatch".
"It's like expecting to win lotto when you've just paid for your ticket, results aren't in yet and it will take years."
He said while he was quick to throw cold water on this research, changing neuropathways through learning and biofeedback was a good idea.
"This is really exciting research ... my suspicion is in 20 to 50 years' time, not five years away but decades away, you may well get non-invasive external brain stimulation through magnets like this, it's very promising research but it's a long slow process."
Alchin said including a placebo controlled group was a crucial part of the research because pain was subjective.
Half of the participants in the trial would receive a "sham treatment" and the
consulting clinicians wouldn't know who was and who wasn't receiving the active treatment, Little said.
"The design of the chronic pain trial at Waitematā DHB is a 'double-blind clinical trial' which is the gold standard for clinical trials."
Kayla Norah, 28, shouldn't have waited nearly a decade to find out the cause of her crippling pain.
She could have avoided two surgeries and spending $40,000 on tests, countless specialist appointments and emergency hospital trips had she known she had autoimmune arthritis.
But even with a diagnosis, life is difficult.
"Some days even getting out of bed is a struggle, even my eating and talking can be affected," Norah said.
"I don't think there has been a day in the last six years I haven't had pain medication."
The Wellingtonian was in her late teens when she first started experiencing symptoms.
"I started getting throbbing pains in my joints that couldn't really be explained. I was constantly tiered and had joints that would just swell up and I was getting hurt a lot because my joints couldn't hold in place," Norah said.
It wasn't until October last year she was formally diagnosed with autoimmune arthritis. It's a chronic inflammatory disorder affecting many joints, including those in the hands and feet. When the immune system attacks itself, the result is inflammation in a joint that can cause pain, stiffness, and mobility problems.
She said people often thought her condition was a "get out of jail free card" because people didn't understand chronic pain.
"We would love to come to events and have normal lives and not have our partners be told they are saints for tolerating us."
After getting her diagnosis, she has had to change her whole lifestyle. No longer can she do high impact exercise like running and instead to aqua jogging.
"If something happens like a joint rolling it's just so dangerous so I had to take everything down a notch."
Norah said she wished people wouldn't judge from the outside because you don't know the pain some people were going through.
"I often get dirty looks taking a disability seat on the bus during a flare-up or when I got my Covid jab before older people, I just wish people took the time to listen instead of judge."
New research was often talked about within chronic pain communities, she said.
"Any research into chronic pain is good research. Will I give it a crack? Offer it to me, I would try anything.
"At the end of the day chronic pain is too widespread to be tackled by one magical fix. We need to get hammering away so we have options."
To people who were experiencing chronic pain, she urged them to seek help, get a second opinion if they didn't feel listened to and don't be afraid to sing out of Facebook support pages.
Text by Emma Russell, NZ Herald