Effects of Virtual Reality-Based Interventions on Neuropathic Pain in Individuals with Spinal Cord Injury: A Meta-Analysis of Randomized Controlled Trials

Why clinicians should know about it

• Picked for Pharmacology (medical) (top studies of the week, 27 September 2026): VR for neuropathic pain, no PK/PD analysis

Abstract

BACKGROUND: Neuropathic pain is a common and difficult-to-treat complication of spinal cord injury (SCI). Virtual reality (VR)-based interventions have emerged as a non-pharmacological approach to pain modulation, but their efficacy remains uncertain. This meta-analysis evaluated the effect of VR-based interventions on neuropathic pain intensity in individuals with SCI. METHODS: PubMed, Cochrane Library, Embase, Web of Science, Wanfang, and CNKI were searched through June 19, 2026. Randomized controlled trials (RCTs) comparing VR-based interventions with control conditions in adults with SCI-related neuropathic pain were included. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using a random-effects model accounting for the influence of potential heterogeneity. RESULTS: Ten RCTs involving 317 participants contributed 12 comparisons. VR-based interventions significantly reduced neuropathic pain intensity compared with controls (SMD = -0.50, 95% CI -0.76 to -0.25; p < 0.001; I2 = 27%). Leave-one-out sensitivity analyses confirmed the robustness of the finding (SMD range, -0.42 to -0.60; all p < 0.05). No significant subgroup differences were observed according to study design, mean age, time since SCI, VR intervention type, intervention session pattern, comparator type, pain assessment scale, or risk-of-bias judgment (all p for subgroup differences > 0.05). Meta-regression analyses identified no significant effect modifiers. The certainty of evidence was moderate according to the GRADE system. CONCLUSION: VR-based interventions probably reduce neuropathic pain intensity in individuals with SCI. Further well-designed, adequately powered RCTs are warranted to confirm the magnitude and durability of this effect.

Abstract as published, via PubMed.