Augmenting Rehabilitation with Virtual Reality–Mediated Hypnotherapy in Chronic Nonspecific Neck Pain

Objective: Chronic nonspecific neck pain (CNSNP) is a prevalent musculoskeletal disorder linked to disability, reduced quality of life, and high healthcare costs. Virtual reality–mediated hypnotherapy (VRH) may represent a cost-effective adjunct. This randomized controlled trial (RCT) evaluated the effectiveness of VRH combined with conventional physiotherapy. Methods: Sixty-eight patients with CNSNP were randomized (1:1) to physiotherapy alone or physiotherapy plus VRH. Physiotherapy consisted of transcutaneous electrical nerve stimulation, hot pack application, and cervical stabilization exercises, five times per week for 3 weeks. The VRH group additionally received 20 min HypnoVR ® sessions. Outcomes included pain (Visual Analog Scale), disability (Neck Disability Index), quality of life (Nottingham Health Profile), sleep (Pittsburgh Sleep Quality Index), and healthcare costs, assessed at baseline, posttreatment, and 6 weeks. Results: Sixty-three patients completed the study (31 VRH, 32 control). Both groups improved in pain, disability, sleep, and quality of life (all p < 0.001). The VRH group showed greater pain reduction posttreatment ( p = 0.007) and at 6 weeks ( p = 0.044). Disability was lower posttreatment ( p = 0.038). VRH also provided superior short-term gains in sleep, mobility, and emotional well-being, although some effects diminished by 6 weeks. Healthcare costs were significantly reduced at 1 month ( p = 0.013) but not at 6 months. Conclusion: Adding VRH to conventional physiotherapy improved pain, disability, sleep, and emotional outcomes in CNSNP, while lowering short-term costs. Although benefits decreased over time, VRH appears safe, feasible, and associated with lower short-term costs. Larger, long-term trials are needed to establish durability.