A breakthrough in neurotechnology developed by researchers at UNSW Sydney is offering a glimpse into a future where chronic nerve pain is managed not with powerful pharmaceuticals, but through the power of the mind and interactive gaming. The technology, known as PainWaive, utilizes an innovative "brain-training" system that teaches individuals how to consciously alter their own brain waves, providing a potential drug-free alternative for those suffering from debilitating neuropathic pain.
The PainWaive project is the culmination of years of interdisciplinary collaboration at UNSW Science and Neuroscience Research Australia (NeuRA). Led by Professor Sylvia Gustin and Dr. Negin Hesam-Shariati from UNSW Sydney’s NeuroRecovery Research Hub, the team has successfully developed a non-invasive, in-home treatment designed to regulate the abnormal brain activity that characterizes chronic nerve pain. Recent findings from a pilot trial, published in the Journal of Pain, suggest that this interactive approach could provide relief comparable to, or even exceeding, the efficacy of traditional opioid medications.
Neuropathic pain, often described as a burning, stabbing, or electric shock-like sensation, is notoriously difficult to treat. It arises from damage or disease affecting the somatosensory nervous system, and for many patients, the condition is chronic and resistant to standard painkillers. The current reliance on opioids to manage such pain has long been a concern for healthcare providers due to the risks of dependency, side effects, and the escalating global opioid crisis. The development of PainWaive represents a significant shift toward a neuromodulation-based approach that targets the root neurological causes of pain rather than merely masking the symptoms.
The scientific foundation of PainWaive is rooted in the seminal research of Professor Sylvia Gustin, who has spent years investigating the structural and functional changes in the brain associated with neuropathic pain. Her work has specifically highlighted the role of the thalamus—a critical structure deep within the brain that acts as a central relay hub for sensory information. In individuals with chronic nerve pain, the thalamus often fails to communicate effectively with other regions, creating a feedback loop of persistent pain signals.
According to Professor Gustin, the brainwaves of those living with neuropathic pain exhibit a distinct and measurable signature. "The brainwaves of people with neuropathic pain show a distinct pattern: more slow theta waves, fewer alpha waves, and more fast, high beta waves," she explains. This imbalance is believed to disrupt the dialogue between the thalamus and the sensory-motor cortex, the area of the brain responsible for registering and processing physical sensations. "I wondered, can we develop a treatment that directly targets and normalises these abnormal waves?" Gustin says.
PainWaive was designed to do exactly that. The system consists of a custom-engineered EEG (electroencephalogram) headset and a tablet preloaded with a specialized gaming application. As users play the game, the headset monitors their brain activity in real time. The game is programmed to respond dynamically to the user’s brainwave patterns; it provides positive feedback and progresses only when the user successfully shifts their brain activity toward a more "normal" or balanced state—specifically by increasing alpha waves and reducing the problematic theta and beta waves.
In the initial trial of the technology, four participants were provided with a home-use kit and given instructions on how to navigate the system. The trial lasted four weeks, during which participants engaged with the interactive game daily. To assist them in achieving the desired brainwave shifts, the researchers provided various mental strategies. These included techniques such as deep relaxation, focused breathing, and the visualization of happy memories. These strategies served as the "controls" for the game, allowing participants to learn which mental states successfully modulated their neural activity.
The results of the trial were striking. Across hundreds of measures tracking pain intensity and "pain interference"—the degree to which pain disrupts daily activities—three out of the four participants reported significant reductions in their symptoms. The researchers noted that these improvements became particularly pronounced toward the end of the four-week period, suggesting a cumulative learning effect as the brain became more adept at self-regulation. For these three participants, the level of pain relief achieved was on par with or superior to what is typically expected from opioid therapy.
However, the research team remains cautious and emphasizes the preliminary nature of these results. "Restrictions in the study’s size, design and duration limit our ability to generalise the findings or rule out placebo effects," says Dr. Hesam-Shariati. Despite these limitations, the pilot study has provided the necessary "proof of concept" to move forward. "The results we’ve seen are exciting and give us confidence to move to the next stage and our larger trial," she adds.
One of the most significant aspects of the PainWaive project is its focus on accessibility and patient empowerment. Traditional EEG and neurofeedback treatments often require expensive equipment and frequent visits to specialized clinics, making them inaccessible for many patients, particularly those living in rural or underserved areas. The UNSW team sought to eliminate these barriers by creating a system that is both affordable and easy to use at home.
The development of the hardware was a challenge in itself. Initially, the researchers looked into using commercially available EEG systems, but they found that existing options were either prohibitively expensive or lacked the signal quality necessary for clinical-grade neurofeedback. In response, the team decided to build their own hardware from the ground up.
By leveraging 3D printing technology and in-house engineering, the researchers were able to drastically reduce the cost of the EEG headset. While traditional clinical EEG systems can cost anywhere from $1,000 to $20,000, the PainWaive headset can be produced for approximately $300. "Everything except the open-source EEG board was built in-house," Dr. Hesam-Shariati notes, adding that the team is currently working on a custom-designed board to replace the open-source component, further refining the proprietary technology.
The design of the headset also prioritizes user comfort and data integrity. It utilizes a saline-based wet electrode system, which provides superior signal quality compared to dry electrodes without the mess and inconvenience of the conductive gels typically used in hospital settings. The headset is specifically calibrated to target the sensorimotor cortex, ensuring that the neurofeedback is focused on the areas most relevant to pain processing. Professor Gustin emphasizes that the design process was highly collaborative: "We’ve worked closely with patients to ensure the headset is lightweight, comfortable, and user-friendly."
The ease of use was further demonstrated during the trial, as participants were able to master the system with minimal professional intervention. After only a few introductory sessions conducted via Zoom, the participants managed the treatment entirely on their own. Their data was automatically uploaded to a secure cloud, allowing the UNSW research team to monitor their progress remotely. This "telehealth" model of neurofeedback not only reduces the burden on patients but also opens up new possibilities for long-term, self-managed care.
"Participants felt empowered to manage their pain in their own environment," says Dr. Hesam-Shariati. "That’s a huge part of what makes this special." This sense of agency is often missing in traditional pain management, where patients can feel like passive recipients of medication. With PainWaive, the patient becomes an active participant in their own recovery, learning a skill that can be applied whenever symptoms flare up.
Looking ahead, the researchers are preparing to scale up their investigations with two major upcoming trials. The first, the Spinal Pain Trial, will investigate whether the PainWaive technology can effectively reduce chronic pain originating from the spine. The second, known as the StoPain Trial, will focus on a particularly challenging population: individuals living with chronic neuropathic pain resulting from a spinal cord injury.
The potential for this technology to provide a truly affordable and accessible solution for at-home pain management is a driving force for the team. For the millions of people worldwide who live with chronic nerve pain, the prospect of a low-cost, non-invasive, and drug-free treatment could be life-changing. By bridging the gap between advanced neuroscience and consumer-friendly technology, the PainWaive project is paving the way for a new era in pain medicine—one where the brain’s own plasticity is harnessed to heal itself.
The researchers are currently calling for individuals who suffer from chronic nerve pain or spinal pain to register their interest in the upcoming clinical trials. As the project moves into these larger, more robust phases of testing, the team at UNSW Sydney hopes to gather the definitive evidence needed to bring PainWaive to the broader public, offering a new sense of hope to those for whom traditional medicine has fallen short.
