Therapeutic effects of virtual reality technology on chronic low back pain

This study aimed to systematically evaluate the clinical efficacy of virtual reality (VR) technology in patients with chronic low back pain (CLBP), focusing on its effects on pain, disability, kinesiophobia, and inflammatory markers.

A systematic search was conducted in 6 Chinese and English databases (PubMed, Web of Science, Cochrane Central, Embase, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure) to identify randomized controlled trials (RCTs) published before January 2025 that compared VR interventions with conventional treatments for CLBP. Meta-analysis was performed using RevMan 5.4 and Stata software. Primary outcomes included Visual Analog Scale (VAS), Numeric Rating Scale, Oswestry Disability Index, Tampa Scale for Kinesiophobia, and biomarkers such as C-reactive protein, adrenocorticotropic hormone, and the cross-sectional area of the multifidus muscle. Heterogeneity analysis, subgroup analysis, sensitivity analysis, and publication bias assessment were also conducted.

A total of 15 RCTs involving 711 patients were included. Meta-analysis revealed that VR intervention significantly reduced VAS (MD = -1.69, 95% confidence intervals [CI]: -2.47 to -0.88, P < .0001), Numeric Rating Scale (MD = -0.91, 95% CI: -0.97 to -0.85, P < .00001), Oswestry Disability Index (MD = -5.92, 95% CI: -7.97 to -3.86, P < .00001), and Tampa Scale for Kinesiophobia scores (MD = -9.04, 95% CI: -14.08 to -4.00, P = .0004) compared with control groups. VR also significantly decreased C-reactive protein and adrenocorticotropic hormone levels and improved the cross-sectional area of the multifidus muscle. Subgroup analysis indicated that short-term, high-frequency, and immersive VR interventions were more effective. Moderate to high heterogeneity was observed in some outcomes, and potential publication bias was noted for VAS scores.

VR interventions demonstrate positive clinical value in the treatment of CLBP by effectively alleviating pain, improving function, and reducing fear of movement, with favorable safety and feasibility. Future high-quality RCTs with long-term follow-up are warranted to explore standardized and personalized intervention protocols to further enhance clinical application and dissemination.