Virtual reality as a transformative tool in pain management

Pain remains one of the most common and distressing issues in healthcare, frequently regarded as a distinct and separate sensory experience[1]. An increasing body of evidence supports the use of virtual reality (VR) as an effective non-pharmacological intervention for various acute and chronic pain conditions. Functional imaging and clinical studies have demonstrated that VR can significantly reduce pain intensity, decrease opioid requirements, and improve patient experience across multiple populations^[2,3]. This letter complies with the TITAN 2025 guidelines for the responsible reporting of AI-assisted work[4]. Integrating VR technology into pain management represents a paradigm shift in our approach to analgesia, especially given the ongoing opioid crisis.

The analgesic effects of VR appear to stem from its ability to modulate multiple pain-processing pathways simultaneously. VR reduces pain perception at the cortical brain level by successfully diverting attention from nociceptive stimuli by creating immersive, engaging environments[2]. Functional MRI studies have shown that VR therapies increase activity in brain regions linked to emotional and cognitive regulation while decreasing activity in parts of the brain involved in processing pain[3]. This neuroplastic effect is particularly valuable for chronic pain patients, where maladaptive central sensitization often contributes to symptom persistence.

Clinical trials have demonstrated VR’s effectiveness across diverse patient populations. VR has outperformed traditional burn wound care in acute pain situations, reducing pain ratings by more than 35–50% when changing dressings[5]. Clinical trials show VR decreases pain, with parallel reductions in opioid requirements[6]. For procedural pain, VR has shown particular promise in pediatric populations, where it reduces both self-reported pain and observed distress behaviors during venipuncture and other minor procedures[7]. Studies have shown that VR can spare kids from GA or sedation in minor procedures[8]. These applications not only improve patient experience but may also reduce reliance on pharmacological analgesics and their associated side effects.

The potential of VR in chronic pain management may be even more important. Studies in fibromyalgia, complex regional pain syndrome (CRPS), and neuropathic pain conditions have shown that repeated VR sessions can result in sustained reductions in pain intensity and improved functional outcomes[9]. CRPS type 1 patients show significant improvement in pain reduction[10]. Although, research shows that VR may be a useful method for reducing pain and anxiety during labor because it was associated with significant decreases in sensory pain (−1.5, 95% CI, −0.8 to −2.2), affective pain (−2.5, 95% CI, −1.6 to −3.3), cognitive pain (−3.1, 95% CI, −2.4 to −3.8), and anxiety (−1.5, 95% CI, −0.8 to −2.3)[11]. The technology particularly works well when paired with cognitive-behavioral concepts, enabling patients to imagine and alter their relationship with pain through biofeedback-enhanced environments. This comprehensive approach addresses both the sensory and affective components of chronic pain, which are often inadequately managed by pharmacological interventions alone.

Several mechanisms contribute to VR’s unique therapeutic advantages. Concerning pain-related anxiety and avoidance, the technology’s ability to produce a sensation of presence in a virtual environment offers significant potential for graded exposure therapy. Motor imagery techniques facilitated by VR can help restore damaged cortical representations in phantom limb pain and other neuropathic conditions. Furthermore, innovative techniques of body perception modification are made possible by VR’s capacity to deliver real-time visual feedback, which has demonstrated great promise in the treatment of CRPS and other body perception problems[12].

Despite these promising findings, several challenges must be addressed to optimize VR’s clinical implementation. Current limitations include the need for more robust head-mounted displays, the development of evidence-based content protocols, and the standardization of treatment parameters. Accessibility may also be restricted for some patient populations due to financial constraints and the need for technology literacy. However, the rapid advancement of VR technology and decreasing costs suggest these barriers will likely diminish in the coming years. The VR program decreased hospital length of stay, which is cost-effective[13].

The implications for healthcare systems are substantial. VR-based pain management could reduce opioid prescriptions, decrease emergency department utilization for pain crises, and improve the quality of life for chronic pain patients. As the technology evolves, we may see the development of personalized VR therapies tailored to individual pain profiles and treatment responses. VR therapies are revolutionizing pain management through diverse applications, including interactive game-based VR for pediatric procedural pain (40% reduction), immersive environments like SnowWorld for burn care (35–50% pain decrease during dressing changes), and motor imagery VR for chronic conditions like CRPS (60% improvement)^[14–16].

This letter contributes to the current literature by reviewing increasing information on VR’s usefulness in a variety of pain scenarios, particularly where traditional analgesia is limited. Key takeaways are:

• Virtual reality lowers pain by modifying sensory and emotional networks.

• It has demonstrated efficacy in burn care, pediatric procedures, and childbirth.

• VR may minimize opioid consumption while improving patient outcomes.

These findings support VR as a scalable, non-pharmacological technique for current pain management.

Increased support for VR pain research is something we strongly encourage, especially for extensive randomized controlled trials that compare VR to conventional treatments for different pain conditions. Additionally, the emergence of clinical guidelines for VR implementation in pain management would facilitate broader adoption. One promising area in pain management that has significantly changed our therapeutic setting is the use of VR in pain programs. To fully integrate VR into pain management, the following steps are critical:

• Conduct large-scale randomized controlled trials comparing VR to conventional treatments.

• Develop evidence-based content protocols and clinical guidelines.

• Address financial and technological barriers to broaden accessibility.

Ethical approval

This type of article does not need any ethical approval.

Consent

No patients were included. Informed consent was not required for this editorial.

Sources of funding

The authors have not received any funds.

Author contributions

All the authors have equally contributed to the manuscript and have approved the final manuscript to be published.

Conflicts of interest disclosure

The authors declare that they have no financial conflict of interest with regard to the content of this report.

Guarantor

Rahmah Zafar Masood.

Research registration unique identifying number (UIN)

None.

Provenance and peer review

Not commissioned, externally peer-reviewed.

Data availability statement

Not applicable.