Is neck pain management using virtual reality effective?

A systematic review and meta-analysis published in the "Journal of Medical Internet Research" revealed the potential efficacy of virtual reality in minimizing the intensity of neck pain (cervicalgia). Researchers sought to analyze original randomized controlled trials (RCTs) demonstrating virtual reality effectiveness for neck pain and to give evidence for the clinical use of a novel alternative pain treatment strategy. 

For a relevant literature search, nine electronic databases were explored. RCTs in Chinese or English that examined virtual reality treatment for patients with neck pain were incorporated. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guideline and the Cochrane Back and Neck Risk of Bias tool were used to evaluate the strength of the evidence and the methodological quality, respectively.

For the final analysis, 8 trials with 382 subjects were incorporated. In terms of pain intensity, virtual reality treatment outperformed controls with a standardized mean difference (SMD) of -0.51 (GRADE: moderate) and an overall pooled effect size of 0.51. Subgroup analyses showed substantial differences in pain severity in the multimodal intervention (virtual reality + other therapies) contrasted to other interventions (SMD -0.45; GRADE: moderate). Additionally, people with chronic neck pain receiving the virtual reality intervention (SMD -0.70; GRADE: moderate) and patients receiving treatment in the research unit or clinic (SMD -0.52; GRADE: moderate) showed better analgesic effects than controls. 

In terms of other health outcomes, the virtual reality group illustrated higher kinematic function (mean and peak velocity, cervical range of motion), less impairment, and less kinesiophobia. The follow-up effects of virtual reality on pain intensity and impairment were not discovered. Hence, this promising technology displays advantages for multimodal intervention, those suffering from chronic neck pain, and virtual reality therapy delivered in a clinic or research setting.