Cluster-Randomised Controlled Trial of At-Home Virtual Reality for People With Chronic Musculoskeletal Pain on the Waiting List

Background: Virtual reality (VR) has been introduced as a novel intervention in chronic musculoskeletal pain (CMP) rehabilitation. However, much remains unknown about the effectiveness of VR for CMP. The aim of this study was to examine the effectiveness of VR in daily life versus no treatment for people with CMP who were on a waiting list to receive secondary pain treatment.

Methods: This study employed a cluster-randomised, controlled design. The intervention group received a novel VR application that offers pain education and pain management techniques. This home-based, stand-alone, immersive VR intervention was advised to be used daily for four weeks. The control group received no treatment. Primary outcome measure was health-related quality of life at four weeks; secondary outcome measures included various pain-related variables (e.g., pain self-efficacy). Intervention effectiveness was analysed using linear mixed models.

Results: Fifty-three participants were included in this trial (mean age: 55.5 (SD: 15)) of which 70% were women. No significant between-group differences were found at four weeks on physical (mean difference (95% CI): 0.039 (−2.810 to 2.889), p = 0.978) or mental (3.590 (−1.640 to 8.819), p = 0.172) health-related quality of life or any of the secondary outcome measures.

Discussion: The pain education VR intervention showed no effect in improving outcomes for people with CMP who were on a waiting list, compared to a no-intervention control group. Future research should investigate for which patients, settings, and timing this VR intervention could be beneficial.

Significance Statement: Prior research showed that VR could be beneficial for people with CMP. However, the results of this study showed that VR is ineffective as stand-alone therapy for people with CMP who were on a waiting list to receive secondary pain treatment.