Mind over pain: VR-based hypnotherapy for chronic non-specific low back pain - a randomised controlled trial

BackgroundChronic non-specific low back pain (CNSLBP) is a prevalent musculoskeletal disorder associated with pain, functional limitations, reduced quality of life, and increased healthcare costs. Virtual reality (VR)-mediated hypnotherapy combines immersive VR with hypnosis, offering a potential non-pharmacological intervention for CNSLBP.AimTo evaluate the effects of VR-mediated hypnotherapy (VRH) on pain, functional status, sleep quality, quality of life, psychological outcomes, and healthcare expenditures in individuals with CNSLBP.MethodsIn this prospective, parallel group, randomized controlled trial, 60 participants with CNSLBP were randomly assigned to receive either standard physiotherapy alone (control group, n = 30) or physiotherapy plus 15 sessions of VRH (VR group, n = 30). Outcomes-including pain intensity, functional disability, sleep quality, quality of life, anxiety and depression, healthcare expenditures, and software usability-were assessed at baseline, post-intervention, and six-week follow-up.ResultsVRH significantly reduced pain and functional disability and improved sleep quality and overall quality of life immediately post-intervention compared with control. At six weeks, only sleep improvements remained significant. Anxiety and depression scores did not differ between groups. Healthcare expenditures were significantly lower in the VR group at one month, but not at six months. The intervention was well tolerated, with transient side effects, and received a good usability rating (SUS: 72.4 +/- 8.1).ConclusionsVRH is a feasible and well-tolerated adjunct to physiotherapy for CNSLBP, producing short-term improvements in pain, function, sleep, and quality of life, with early reductions in healthcare expenditures. Further, larger-scale trials are needed to confirm the long-term benefits and evaluate the potential for home-based implementation.ClinicalTrials.gov registration number: NCT06698354, Date: 21.11.2024.ConclusionsVRH is a feasible and well-tolerated adjunct to physiotherapy for CNSLBP, producing short-term improvements in pain, function, sleep, and quality of life, with early reductions in healthcare expenditures. Further, larger-scale trials are needed to confirm the long-term benefits and evaluate the potential for home-based implementation.ClinicalTrials.gov registration number: NCT06698354, Date: 21.11.2024.