Immersive learning: The role of virtual reality in patient education for musculoskeletal conditions – A systematic review and meta-analysis

OBJECTIVES: The study aims to seek if virtual reality (VR) delivered patient education (PE) is a safe, feasible approach and can affect pain intensity, physical function, psychological stress or other outcomes related to chronic Musculoskeletal (MSK) disorders. DATA SOURCES AND STUDY SELECTION: Seven electronic databases and one registry were searched from inception to December 2024 and updated in March 2026. Studies that included VR-based PE programs delivered in-person or at-home for MSK pain disorders were eligible. We assessed risk of bias with Cochrane RoB1 and ROBINS-I tools. DATA EXTRACTION AND DATA SYNTHESIS: Data extraction followed predefined objectives. Studies were categorized by characteristics, intervention specificities, and outcomes. Pain scores (primary outcome) from randomized controlled trials (RCTs) on low back pain (LBP) were separately extracted for meta-analysis. RESULTS: Twenty-one studies, 18 RCTs and 3 non-RCTs met study criteria. Of the 18 RCTs, 14 included LBP, and 4 included mixed MSK conditions. Meta-analysis of seven RCTs with LBP showed a significant reduction in pain (p < 0.05) in favor of VR-based PE with low-to-medium effect size (SMD = -0.41; 95% 95% CI, - 0.69 to - 0.41; p < 0.01) and low heterogeneity (I² = 35%). VR-based interventions also showed improvement in function and psychological measures and were well tolerated with high patient satisfaction, but few studies reported mild dizziness. CONCLUSION: VR-based PE seems an effective PE modality for improving pain, function and psychological stress in individuals with MSK pain. The interactive and engaging nature of VR can facilitate patient learning and improve the success rate of patient education. REGISTRATION NUMBER PROSPERO: CRD42024610605. CONTRIBUTION OF THE PAPER.