VR Biofeedback Experience Shows Potential for Fibromyalgia Pain

Immersive virtual reality with multisensor biofeedback (IVR-BF) has demonstrated potential in reducing pain and improving quality of life in patients with fibromyalgia (FM).1

“IVR has recently transitioned from a futuristic concept to a practical technology with significant therapeutic potential in pain management, offering immersive experiences that enhance cognitive distraction and reduce pain perception. If clinical trials consistently highlight IVR efficacy in alleviating acute pain, applying IVR for chronic pain, such as FM pain, is more complex due to the multifaceted nature of this condition2,” lead investigator Luca Chittaro, MSc, Human-Computer Interaction Lab, Department of Mathematics, Computer Science, and Physics, University of Udine, Italy, and colleagues wrote.1

Chittaro and colleagues conducted a single-center, pilot, open-label, randomized controlled trial with adult patients with FM randomly assigned 1:1 to either the treatment (TR) group to receive IVR-BF immediately, or a waitlist control (WL) group to receive IVR-BF after the TR group completed treatment. The study primarily assessed reduction in visual analog scale (VAS) pain scores in the TR group, after 5 IVR-BF sessions, compared to the WL group, after the waiting period. Secondary outcomes included improvements in FM Impact Questionnaire (FIQ) score and Short-form McGill Pain Questionnaire (SF-MPQ) score. The investigators also longitudinally analyzed trends in outcomes during the trial.

Out of 50 screened patients, 20 female patients (TR, 10; WL, 10) completed the trial and analysis. Chittaro and colleagues found that the TR group had significantly lower VAS pain scores compared to those in the WL group (mean ΔVAS −26.00 [95% CI, −45.17 to −6.83]; P = .011) as well as significant improvements in the FIQ score (mean ΔFIQ, −17.90 [95% CI, −32.37 to −3.43]; P = .018).1

Longitudinally, participants experienced progressive improvements in VAS pain, SF-MPQ, and FIQ score, as well as physiologic improvements including heart rate variability, respiratory rate, and skin conductance. Significant improvements in VAS pain (mean ΔVAS −21.50 [95% CI, −32.18 to −10.82]; P < .001) and FIQ scores (mean ΔFIQ −20.25 [95% CI, −27.65 to −12.85]; P < .001) were observed after 5 sessions, though VAS scores returned to baseline by day 15. FIQ improvement was partially sustained (mean ΔFIQ −13.75 [95% CI, −23.09 to −4.41]; P = .003), and significant reductions were seen across all SF-MPQ domains, including sensory, affective, total, and PPI scores.1

Participants in the study expressed a high level of satisfaction with IVR-BF and experienced no significant safety concerns. Out of 21 patients that completed the satisfaction questionnaire, 15 (71.43%) reported being satisfied, 3 (14.28%) rated the intervention as neutral, and 3 (14.28%) expressed dissatisfaction. Rating the experience itself, 6 appreciated the sense of relaxation, 5 valued its novelty, and 5 appreciated its high engagement. On the other hand, 5 deemed the IVR experience to be too repetitive, 2 deemed it to be too demanding for the time required, and 1 deemed it to be too simple. Overall, 17 patients (80.95%) would recommend the experience to other people with FM.1

“In conclusion, the multisensor IVR-BF system appears to provide promising preliminary clinical advantages in pain relief and quality of life for patients with FM in tertiary care settings. Given the favorable feasibility data and high patient satisfaction with minimal adverse events, these encouraging results support the need for larger-scale studies to further evaluate the efficacy of IVR-BF across diverse populations and to optimize treatment protocols," Chittaro and colleagues concluded.1

REFERENCES

1. Chittaro L, Longhino S, Serafini M, Cacciopo S, Quartuccio L. Efficacy of Immersive Virtual Reality Combined With Multisensor Biofeedback on Chronic Pain in Fibromyalgia: A Pilot Randomized Controlled Trial. ACR Open Rheumatol. 2025; 7(5): e70048

2. Pretat T, Koller C, Hügle T. Virtual reality as a treatment for chronic musculoskeletal pain syndromes. Joint Bone Spine 2025; 92(1):105769.