The short-term effects of virtual reality versus pain neuroscience education versus conventional physiotherapy on pain, kinesiophobia, catastrophizing, and disability in patients with non-specific chronic neck pain

This study is a randomized controlled trial investigates the short-term effects of three physiotherapy approaches Virtual Reality (VR), Pain Neuroscience Education (PNE), and conventional physiotherapy on individuals with non-specific chronic neck pain, focusing on outcomes like pain intensity, kinesiophobia, catastrophizing, and disability. Chronic neck pain is a growing health issue, especially in India, due to poor postural habits, prolonged digital device use, and sedentary lifestyles. Despite a surge in technological advancements like VR and increased interest in educational approaches such as PNE, most existing research is based in high-income nations and lacks contextual relevance to Indian populations. The study recognizes the importance of understanding psychological contributors to chronic pain, particularly fear of movement and catastrophic thinking, which are often neglected in conventional protocols. The trial includes 81 subjects aged 18–65 years, divided into three groups Group A (VR-based therapy + exercise), Group B (PNE + exercise), and Group C (conventional therapy). Pain will be measured using the Visual Analogue Scale (VAS) and Pain Pressure Threshold, kinesiophobia with the Tampa Scale (TSK-17), catastrophizing with the Pain Catastrophizing Scale (PCS), and disability with the Neck Disability Index (NDI). Each group follows a structured 4-week  treatment plan, with outcome measures assessed at baseline and after completion. VR therapy aims to reduce pain through distraction and multisensory engagement. PNE seeks to shift the patient’s understanding of pain from a tissue-damage focus to a central nervous system perspective using metaphors and cognitive tools. Conventional therapy emphasizes structured exercise progression with heat application. Previous literature supports the benefits of all three interventions, yet comparative studies remain sparse. This research aims to fill that gap by providing India-specific evidence on efficacy and feasibility. If proven effective, VR and PNE may offer cost-effective, scalable alternatives for physiotherapy delivery, especially in underserved rural settings. Ethical clearance and informed consent will be obtained prior to enrollment. The findings are expected to aid clinicians in choosing effective, personalized interventions for managing chronic neck pain and may significantly improve the quality of life in affected individuals while reducing healthcare burden through innovative, accessible care models.