A Discussion on Gaming with Chronic Pain

One of the goals I’ve set for 2022, as far as Phenixx Gaming goes, is to cover more in-depth content regarding Accessibility and gaming alongside various physical and mental health obstacles. The way I see it, the more information we can provide about these things, the better off people will be. Developers might one day see these articles and use them as a resource. I would love to consult one day on Accessibility options, but for now, this is my way of contributing.

Today’s topic deals with something that many people face all over the world, in one form or another, Chronic Pain. By definition, Chronic Pain is long-standing pain that persists beyond the usual recovery period or occurs along with a chronic health condition. This could be pain in conjunction with Fibromyalgia, Arthritis, Carpal Tunnel, or any other chronic health condition. The pain can be a continuous thing or it could come and go at regular intervals, whether that is seasonally, weekly, monthly, etc.

With that definition in mind, Lisa and I (among others on staff) have suffered from Chronic Pain for most of our lives for various reasons. Anyone who has had a broken bone will tell you that after that bone heals, certain shifts in barometric pressure and weather patterns can sometimes cause that former injury to flare up. You might be wondering what this has to do with gaming, and it is rather simple.

Take my own experience, for example. I have a fair bit of back pain and joint pain, from the joints in my fingers, to various other joints. During the Winter, these issues tend to be exacerbated by weather patterns, cold, and other such seasonal things. As a result of this, my gaming habits actually change. On days where the pain is worse than my baseline, I may play games that require fewer reflexive actions.

So, instead of playing say, Bayonetta, I might play Octopath Traveler, which is more menu-based. Instead of playing shooters or action games, I might go for something like Animal Crossing: New Horizons. Believe it or not, this has implications for accessibility too because there are some games that even on my worst days, I can still play. Ratchet and Clank: Rift Apart is a good example of this.

Because of the Accessibility options that are provided in Ratchet and Clank: Rift Apart, I can play it when my hands are hurting, even if I have to play for shorter periods. I can turn off the adaptive triggers, lessen the vibration intensity, and even turn the radial wheel for switching guns into a toggling action instead of having to hold it down.

Now, I mentioned before that this is usually an issue when I have a pain level above my usual “baseline”. To clarify this a little, a lot of people who have fluctuating levels of chronic pain will find that over time you get a sort of “functional tolerance” to a certain level of pain. The pain is still there, but at certain levels of pain, you can function enough to get things done that have to get done.

During the Winter, I am much slower getting reviews ready for Phenixx Gaming, because the time it takes me to play the games, is extended to some degree. Sometimes I have good days and I can play for 8 hours. Other days my neck could be hurting and I may only get 2-3 hours in. That’s not even factoring in the time that it takes to write the article and get it ready for publishing.

Another factor of this is that pain is exhausting. Even when you are at your baseline, there is a certain amount of work and a certain amount of function you’ll have in a day. Once you’ve reached your limit, that’s it. The well has run dry, the batteries are toasted, and you’re done for the day. So, even on days when I’m at my baseline, I look at my options and I weigh them on every factor from my enjoyment, my energy levels, and even to the other things I have to get done that day.

Imagine that process, but subtract an hour on a day worse than normal or two hours on a worse day than that or maybe even four hours on a day that’s well above the baseline. Suddenly you start to weigh things differently because you know you have less time for leisure that day since commitments still have to be taken care of. This is why accessibility is important. It is also why I say that difficulty can sometimes be inaccessible.

Do I want to waste my time on a higher difficulty when my reflexes (which can be slow by default) are slower than normal on a bad pain day? Or, do I want to turn the difficulty down a bit, and enjoy an adventure through a world that I can immerse myself in for several hours and forget about the pain? It is the budgeting of time on an extreme basis.

This is why I don’t even bother with From Software titles. They are designed to be accessible only to a certain set of people. They are designed for people who have the time to pound away at a boss for a week. They are also specifically designed for people who can spend 10 hours on one boss and not feel like their time was wasted and not feel like their hands are going to crumble to nothing.

Would I like to engage in the fun of experiencing Elden Ring? Oh most definitely. The game looks gorgeous, and I love a high fantasy setting. Will I have to settle for watching a Let’s Play because From Software can’t be bothered to stop catering to the “get gud” squad for more than five seconds? Probably.

Inaccessibility is like looking at a kid on the playground and saying “no, you’re not allowed to play with those kids, you just get to watch.” Which, let me just say, as a kid who watched other kids do things I wasn’t able to do, it sucks. Sometimes your friends will take the opportunity to do things you can be included in, but other times they just want to run around and chase each other with rocks, sticks, or whatever else they can get their hands on.

I’m getting off-topic, but I think I’ve made my point. Chronic Pain is a problem for a lot of people, and it isn’t just the disabled. There will come a day when those of us who are in our 20’s, will be in our 40’s and 50’s and will have a hard time playing reflex-intensive games. There will be a time when you won’t have the stamina to play on Nightmare difficulty, and then you’ll be glad for people like me talking about this issue.

This is not a “let’s solve this tomorrow” problem. This is a conversation we should be having, and not just the press, writers, and reviewers either. This is a conversation consumers should have online, and developers should have behind closed doors. If people like Phil Spencer can go out on stage and say “Gaming is for everyone” then it should be for everyone. There will always be things I can’t play but making the effort to minimize as many barriers to play as possible is important.