Pain is the most common reason for medical consultation and use of health care resources. The high socio-economic burden of pain justifies seeking an appropriate therapeutic strategy. Immersive virtual reality (VR) has emerged as a first-line non-pharmacological option for pain management. However, the growing literature has not been accompanied by substantial progress in understanding how VR could reduce the pain experience, with some user experience factors being associated with the hypoalgesic effects of immersive VR. The aim of this review is (i) to summarize the state of the art on the effects of VR on adults and children suffering from pain conditions; (ii) to identify and summarize how mechanisms across immersive VR user experience influence hypoalgesic effects in patients with acute and chronic pain among adults and children. A critical narrative review based on PICOT criteria (P = Patient or Population and Problem; I = Intervention or Indicator; C = O = Outcome; T = Type) was conducted that includes experimental studies or systematic reviews involving studies in experimentally induced pain, acute pain, or chronic pain in adults and children. The results suggest an association between immersive VR-induced hypoalgesia and user experience such as distraction, presence, interactivity, gamification, and virtual embodiment. These findings suggest that hierarchical relationships might exist between user experience-related factors and greater hypoalgesic effects following an immersive VR intervention. This relationship needs to be considered in the design and development of VR-based strategies for pain management.

Background/Objectives: Pediatric chronic pain requires individualized care. The Pediatric Pain Screening Tool (PPST) allows for stratification of psychosocial and physical risk factors and may guide targeted interventions. However, its integration into multimodal physiotherapy programs remains unexplored. This exploratory feasibility case series study evaluated a PPST-guided, risk-stratified multimodal physiotherapy intervention in children aged 8–17 years with chronic pain. Methods: Participants were classified as low, medium, or high risk. Interventions were tailored accordingly. Outcomes were assessed pre- and post-intervention and included pain intensity, pain interference, psychological distress, and quality of life. Results: Ten participants (mean age = 13.5 years; 60% girls) were included. Six were classified as high, three as medium, and one as low risk based on the PPST. After an 8-week physiotherapist intervention program, pain interference significantly decreased (MD = −7.5; p = 0.040; d = 1.69), as did pain intensity at rest (MD = −3.1; p = 0.002; d = 2.60) and during movement (MD = −3.0; p = 0.004; d = 2.55), exceeding the MCID of 1.92. In the high-risk group, reductions were observed in anxiety (p = 0.006; d = 2.36), pain-related worries (p = 0.001; d = 3.79), fear of movement (p = 0.015; d = 1.62), and fear of pain (p = 0.002; d = 3.37). Eighty percent reported feeling “a great deal better” in the PGIC including all high-risk participants. Conclusions: These results supports the feasibility of integrating PPST risk stratification into multimodal management, providing a structured and effective framework for addressing pediatric chronic pain.

Space flights can produce physiological changes in the spine, leading to the development of acute and chronic pain in passengers. However, there is a lack of comprehensive literature exploring physiological spine changes and acute and chronic pain in space passengers (astronauts and animals). The first aim of this study was to identify the physiological changes experienced by passengers (humans and animals) after space flight. The second aim was to identify the incidence of low back pain during and after space flight. This systematic review was conducted following PRISMA guidelines and was pre-registered in PROSPERO (ID 451144). We included Randomized Controlled Trials or longitudinal studies in humans and animals, and the variables must be assessed either in-flight or post-flight. We conducted a literature search in major databases combining the keywords: Pain; Space; Low Back Pain; Astronauts; Spine Changes; Microgravity; Physiological Changes; Humans; Animals. Risk of bias and quality of studies were analyzed, and the level of evidence was assessed using the GRADE system. After duplicates were removed, 115 abstracts were screened by two reviewers, and finally, 11 articles were included in this review. The evidence indicates that astronauts experience muscle atrophy in the lumbar multifidus with a moderate to large effect, especially in the L4-L5 and L5-S1 segments. Space flights also decrease the range of motion with a moderate effect, along with disc herniations and disc dehydration. 77% of astronauts experience pain during spaceflight, and 47% develop acute pain after spaceflight. Chronic pain was reported by 33% of the astronauts. After space flights, astronauts suffer from lumbar muscle atrophy, reduced range of motion, disc herniations, and disc dehydration, with a high incidence of both acute and chronic pain. Plain Language Summary: Space travel affects the spine and can cause both immediate and long-term pain. Our study aimed to understand what changes happen in the spine during and after space travel and how often these changes lead to low back pain. Why was the study done? We wanted to investigate the specific spinal changes and the frequency of low back pain in both astronauts and animals exposed to space travel. This is important because understanding these effects can help improve health interventions for space travelers. What did the researchers do? We reviewed studies that examined spine changes and pain in humans and animals during and after space flights. We used a systematic approach to find relevant research, following strict guidelines and assessing the quality of each study. What did the researchers find?Astronauts often experience muscle loss in the lower back, particularly in the lumbar spine.Space travel reduces the spine’s range of motion.There is a significant occurrence of disc herniations and disc dehydration.77% of astronauts report pain during space flights.47% experience acute pain after returning to Earth.33% suffer from chronic pain post-mission. What do these results mean? Our findings show that space travel can lead to serious spinal issues and a high risk of pain. These results highlight the need for better health strategies to protect astronauts during and after their missions. Understanding these effects is crucial for developing effective interventions and ensuring the well-being of space travelers.

Introduction: Pain in lower back is a common condition reported by astronauts, both during and after space missions. Investigating the alterations in the spine and the mechanisms driving these changes is essential for a deeper understanding of how microgravity impacts the human spine. This knowledge could also open pathways for therapeutic or preventive interventions. Nevertheless, there is a limited evidence regarding changes in intervertebral discs (IVDs) due to space travel. Materials and Methods: In this study, 2 astronauts were enrolled in a space travel. Before the space flight, a lower back magnetic resonance imaging (MRI) scan was performed. We repeated an MRI instantly after 17-days space travel, and again 3 months after landing. The water content and glycosaminoglycan (GAGs) levels in the lumbar IVDs were evaluated using DIXON water-only phase imaging and T1rho MRI sequences. Additionally, alterations in the size and quality of the paraspinal muscles (PSMs), including fatty infiltration, were examined. Results: Varied alterations were observed in the IVDs and PSMs of both astronauts. One astronaut experienced a reduction in water and GAGs content, while the other showed an increase. These changes in the IVDs following spaceflight appeared to be linked to the degree of baseline degeneration. Regarding the PSMs, differences in size and fatty infiltration also varied between the two astronauts. Notably, these changes had not stabilized by the final follow-up at 3 months. Conclusion: Our findings offer initial evidence indicating that even brief exposures to microgravity might be linked to biochemical alterations in IVDs and changes in the quality of PSMs, which could continue evolving for more than 3 months after returning from space.

Placebo effect has been widely studied in musculoskeletal neck pain treatment. This effect derives from the therapeutic context and is common to all of them. Latest research suggests Kinesio Taping could be a kind of placebo effect. This clinical trial analizes if Kinesio Taping could be a kind of placebo effect in subjects with musculoskeletal neck pain. Kinesio Taping was compared with a placebo. After analyzing 30 subjects, the results show that Kinesio Taping clinical effects are similar to placebo. Expectations, conditioning, or suggestion could be very closely related to clinical effect in patients. Se ha estudiado el efecto placebo en el dolor musculoesquelético cervical ampliamente. Se deriva del contexto de la intervención y es común a todas ellas. Las últimas investigaciones apuntan a que ,Kinesio Taping, podría ser una forma de efecto placebo. A través del presente estudio se prende analizar si el ,Kinesio Taping, es una forma de efecto placebo en sujetos con dolor musculoesquelético cervical. Se comparó el efecto del ,Kinesio Taping, con el de un placebo. Tras analizar 30 sujetos, los resultados muestran que el efecto clínico del ,Kinesio Taping, es similar al de un placebo. Las expectativas, el condicionamiento o la sugestión pueden estar muy relacionadas con el efecto clínico en los pacientes.