Could Virtual Reality Benefit People With Fibromyalgia?

In this blogpost, I will introduce you to the emerging field of virtual reality-assisted rehabilitation and explore whether this approach may be helpful for people with fibromyalgia and other types of chronic pain. There is an explosion of devices already on the market for people to try and an increasing amount of research.

This is a long blog, so in case you want to skip to a section of particular interest, the following is what I cover:

• What Is Fibromyalgia (FM)?
• What Causes Fibromyalgia?
• What Does Fibromyalgia Feel Like?
• What Are Effective Treatments for Fibromyalgia and Other Chronic Pain Syndromes?
• How to Enhance Neuroplasticity
• What is Virtual Reality?
• 4 Key Features of Virtual Reality
• How Does Virtual Reality Work?
• Potential Benefits of VR Compared with Usual Treatment
• How Virtual Reality Benefits Chronic Pain
• Is Virtual Reality Rehabilitation Effective for Fibromyalgia?
• What Is VR Like According to Chat GPT?
• Is Virtual Reality Safe?
• What to Look for in a Virtual Reality System

What Is Fibromyalgia (FM)?

FM is a chronic syndrome consisting of musculoskeletal pain, fatigue, cognitive problems and unrefreshing sleep. At the biological level, FM is characterized by nociplastic pain and central sensitization.

These features are associated with altered processing of pain signals in the brain without evidence of tissue damage, inflammation or nerve injury. The key is that the pain is generated by the overactivity of pain processing in the brain. Even though it feels as if the pain is caused by tissue damage in the body, this is often not the case. Research shows evidence of changes in brain function, such as neurotransmitter function (e.g., increased glutamate levels) and electric function in the brain and spinal cord.

What Causes Fibromyalgia?

The risk factors for developing chronic musculoskeletal pain such as fibromyalgia include

• chronic pain from things like autoimmune diseases (e.g., rheumatoid arthritis or lupus),
• trauma in childhood or adolescence,
• depression,
• operations,
• sleep impairment and
• use of opioid medication.

What Does Fibromyalgia Feel Like?

• chronic widespread pain,
• pain that moves around to different parts of the body,
• increased sensitivity to light touch and/or pain without any touch or pressure at all,
• sensitivity to temperature, especially cold,
• problems with concentration and thinking,
• unrefreshing sleep,
• depression and anxiety,
• loss of precision of fine movements and more.

Fibromyalgia is caused by overactive pain processing in the brain. Once active, this can cause pain and other symptoms anywhere in the body, including

• chronic musculoskeletal pain anywhere in the body, including low back pain,
• chronic tension-type headaches,
• irritable bowel syndrome (IBS),
• painful bladder syndrome,
• temporomandibular joint disorders (TMJ) and
• complex regional pain syndrome (CRPS).

What Are Effective Treatments for Fibromyalgia and Other Chronic Pain Syndromes?

Conventional pain treatment with medication and physiotherapy is notoriously ineffective for pain syndromes generated by the brain. This may be because conventional pain treatments are directed at the body, and these syndromes are generated by the brain. If you don’t direct treatment to the correct body system, it won’t work.

In previous blog posts, I discussed how neuroplasticity is perfectly positioned to reverse nociplastic pain. If you rewire the overactive brain pathways generating pain, it is possible to reverse nociplastic pain. The strategies I have described rely heavily on the use of imagination to shift the focus of attention away from the pain and other symptoms to imagined experiences that are pleasant, engaging and meaningful. Consistently redirecting attention will create new neural pathways and allow the old pathways to be broken down and recycled.

How to Enhance Neuroplasticity?

To grow new brain pathways, one needs the right neurochemical environment and repeated practice of new skills and behavior (Voss, Thomas, Cisneros-Franco, & de Villers-Sidani, 2017).

• Anything that increases alertness or arousal level will increase the possibility of rewiring the brain. If you are dozing off, your learning will not be effective.
• Sustained attention enhances neuroplasticity by increasing the activity of a neurotransmitter called acetylcholine. Meditation is one example of something that will increase the ability to pay attention, and research shows that it acts through neuroplasticity, resulting in measurable changes in brain imaging (Calderone et al., 2024). If you are not paying attention to your learning, it will not hardwire.
• Exercise increases brain-derived neurotrophic factor (BDNF). BDNF enhances neuroplasticity if paired with new learning.
• Enriched environments of any kind, such as dance, music, language and art, are beneficial for learning.

What is Virtual Reality?

The Encyclopedia Britannica defines VR as “The use of computer modeling and simulation that enables a person to interact with an artificial three-dimensional (3-D) visual or other sensory environment.”

Most virtual reality systems use a headset with visual and auditory input. You can look anywhere in the virtual space—up, down, left, right, or behind—and hear sounds from speakers in the headset or headphones. For rehabilitation, you may be asked to respond to the stimuli with movements, e.g., moving your arm to touch, hit or lift something in the VR environment. There are also VR systems that train cognitive functions like attention, memory, visual and visuospatial skills.

4 Key Features of Virtual Reality
 • Immersion: the capacity to emerge the user in the experience by cutting him or her from the real world,
•  Interaction: the possibility for the user to interact with said environment and get feedback in real time,
•  Presence: the capacity to create the perception of one’s presence inside the virtual environment,
•  Imagination: the ability to learn and develop new skills.

How Does Virtual Reality Work?

In essence, virtual reality works by enhancing neuroplasticity.

• VR can trick the brain into thinking it’s experiencing something real, and research has repeatedly shown that imagining something activates many of the same neuronal pathways as doing it for real. For example, the same neural pathways that light up when you’re playing the piano light up when you are imagining yourself playing the piano (Meister et al., 2004).
• The VR experience is thought to decrease pain and other symptoms in real time as the external stimuli from the VR experience compete and suppress the internal signals generating symptoms.
• Positive mood: Pain is worsened by the emotions associated with it. By elevating mood, pain decreases.
• Hypnosis: Some systems include elements of hypnosis by creating a pleasant space with suggestions to reinforce feelings of wellness and relaxation.

Neuroplasticity is key for any kind of rehabilitation. After a brain injury like a stroke, certain parts of the brain may be damaged, leading to impairments in movement, speech, or other everyday functions. Healing occurs through repeated practice to relearn and rewire the functions that have been lost.

VR stimulates measurable positive changes in brain imaging like functional MRI, QEEG and transcranial magnetic stimulation. Furthermore, these changes correlate with functional improvement, suggesting that neuroplasticity is the driver of functional improvement and not just a coincidence (Hao, Xie, Harp, Chen, & Siu, 2022).

Potential Benefits of VR Compared with Usual Treatment

Rehabilitation can be tedious and boring. This makes it hard for all but the most disciplined and determined people to achieve maximal improvement. VR may be a way to make the practice more fun and engaging so that people stick with it. The most effective practice is the one that people can commit to consistently over weeks to months, even as they make progress.

• VR is multisensory, including visual, auditory and movement components. It activates many areas of the brain at the same time.
• The immersive experience is more engaging than repetitive practice. If practice is more fun, people will do it more often.
• VR holds people’s attention longer (attention is key to neuroplasticity).
• VR can be gamified to offer incentives to push a bit harder or longer.
• VR can increase engagement for people who struggle with imagination.
• Home systems make practice easier and less expensive than driving to repeated appointments.
• VR systems can adjust to user’s individual preferences and needs.

How Virtual Reality Benefits Chronic Pain

There is a wide range of available systems and approaches. A VR experience for chronic pain may include being immersed in a calm, pleasing environment like a forest or lake. You might hear birds chirping or water moving. You may be guided through meditations, coached on paced breathing, and taught cognitive strategies or other skills while in this relaxed state.

You may view images of people doing the activities you are being coached in. Viewing others is a good first step to training the brain that the activity is safe. After you are comfortable with viewing others and have become proficient at attaining a state of calm, you may be coached to perform some of the activities that currently trigger your pain. Taking action to do the things you want to achieve is important.

The VR immersion may make some of the strategies you already use more enjoyable and engaging. This may encourage you to practice more consistently, increasing your chances of success.

A review of several studies on people with chronic pain suggests that VR practice effectively decreases pain and increases function compared with other approaches (Goudman et al., 2022). Not all reviews have found evidence of benefit (Pretat, Koller, & Hügle, 2025).

Is Virtual Reality Rehabilitation Effective for Fibromyalgia?

Several studies have focused specifically on people with fibromyalgia (Cortés-Pérez et al., 2021). Of these, the interventions lasted between 3 - 24 weeks, 2 - 3 times/week, and for 35 - 80 minutes. Taken together, the studies show improvement in a wide range of symptoms and on the Fibromyalgia Impact Questionnaire—the most commonly used survey in FM research. Virtual reality-assisted rehabilitation leads to improvements in

• pain scores,
• balance,
• aerobic fitness,
• fatigue,
• quality of life,
• depression and
•  anxiety.

One study compared using a VR system with audio instructions in people with chronic low back pain and fibromyalgia. The participants experienced pain education, cognitive behavioral strategies, relaxation and mindfulness for 21 days. Those in the VR group reported more improvement in pain intensity and less pain interference (Darnall, Krishnamurthy, Tsuei, & Minor, 2020).

What Is VR Like According to Chat GPT?

Just for fun, I asked chatGPT what a VR experience for chronic pain might consist of. Here is what I got back. I’ve bolded some key points—the aspects of any practice that can successfully rewire the brain and decrease focus on pain.

Putting on the VR headset, you feel a mix of curiosity and skepticism. Chronic pain has been your constant companion for months or years, coloring every action and thought. The idea of relief through technology feels surreal yet hopeful.

You’re transported into a serene world—a quiet beach, a forest alive with rustling leaves, or a meditative space of soothing lights. The beauty feels jarring compared to your usual surroundings. For the first time in ages, you take a deep, calming breath.

At first, the pain is all you notice. But as guided exercises begin—breathing in sync with glowing orbs or a mindfulness session with a calming voice—your attention shifts. The immersive environment is so engaging that the pain fades into the background. It doesn’t disappear but feels detached, as if the experience buffers your mind from your body. Relief isn’t just physical; it’s emotional—a rare moment of control over what usually feels overpowering.

You engage in tasks like throwing virtual objects, painting with light, or exploring fantastical landscapes. The novelty distracts your brain, helping it focus on something other than pain. You realize the technology doesn’t cure pain but retrains your brain to process it differently.

When the session ends, the pain remains but feels more manageable. Your mood has shifted—less frustration, more patience. The ache feels less dominant, as if the VR experience provided mental tools to navigate it.

Chronic pain often isolates, but this therapy fosters connection—to your body, to new possibilities, and to hope. Relief feels attainable, and you leave empowered, knowing you can actively shape how you experience pain.

This narrative explains that the changes come from a shift in your attention from the pain to things that are more enjoyable and calming. Pain is a physical, emotional and mental experience, and VR addresses all these aspects. The slight shifts you may feel during a VR session give you a sense of hope and agency. You begin to realize there are things you can do to shift your experience. And the interactive tasks encourage you to reengage in functions you may have been avoiding due to pain. I couldn’t have described the experience of how neuroplasticity shapes our experience any better. ChatGPT paints a rosy picture.

The studies show that VR is equally or more effective than other modalities. But in my opinion, not everyone will take to VR. I am not a fan of tech and might find the intensity overwhelming. But for people who like computer games, this might be a great option. Like every other treatment modality, it will appeal to some more than others.

Is Virtual Reality Safe?

In most studies, very few adverse effects are reported (Pretat et al., 2025). The most common is a reaction referred to as cyber-sickness. This includes feeling disorientated, followed by nausea, blurry vision, dizziness, sweating and loss of balance. This is more common with a 3D immersive experience than a 2D screen. It is thought to be due to a mismatch between what the brain expects and is used to and the VR stimuli. Typically, 1 or 2 people out of twenty or more drop out of research studies due to this reaction. In a case where someone is working with a therapist, it is usually possible to adjust the dose/intensity of the immersion to allow the brain to adjust with fewer symptoms.

Not mentioned but likely relevant to the complex chronic disease community are the effects of the electromagnetic frequency (EMF) associated with the technology—the electricity and Wi-Fi if involved. Having something on the head is particularly problematic for people who are sensitive to EMF.

When VR is used for psychiatric conditions such as anxiety or PTSD, some people’s symptoms may be triggered by the realistic images and sounds associated with the immersive experience. This can be mitigated by increasing the relaxation training and backing off on the intensity and duration of exposures to allow the brain to recognize that it is safe.

What to Look for in a Virtual Reality System

As I investigated VR systems, the following is what I discovered:

• Many are expensive and seem to be marketed to professionals.
• Some don’t list the price at all, which is concerning for people on a budget.
• Some that have been studied in research are no longer on or never were on the market.
• This is a rapidly changing field.

Below is what I suggest:

• Identify the skills you want to improve, including pain, cognitive skills, movements, activities of daily living, calm and improved mood.
• See whether one of the commercially available VR systems, like Meta’s Quest series or Nintendo Wii, has some games that address what you want to work on.
• For brain health, I recommend Brain HQ. It is the most researched program. Many studies show Brain HQ produces meaningful gains in as little as 40 hours of practice over 8 weeks. Improved processing speed, memory and attention in older adults generalizes to everyday life skills like driving safety. Brain HQ is used worldwide in studies to improve cognitive function in diseases including dementia and long COVID.

Conclusions

Leveraging neuroplasticity, our brain’s natural ability to change in response to lived experience is increasingly included in mainstream treatments for a wide range of conditions, including fibromyalgia and chronic pain.

For tech lovers, virtual reality can make rehabilitation more engaging so patients enjoy and stick with the treatment. In addition, the multisensory and immersive experience can increase the intensity of neuroplastic change.

There is no clear leader in the field for the common problems experienced by people with Fibromyalgia and other chronic pain conditions. Some research will be required to find a VR system that is right for you.

References

Calderone, A., Latella, D., Impellizzeri, F., de Pasquale, P., Fama, F., Quartarone, A., & Calabro, R. S. (2024). Neurobiological Changes Induced by Mindfulness and Meditation: A Systematic Review. Biomedicines, 12(11), 15. doi:https://dx.doi.org/10.3390/biomedicines12112613

Cortés-Pérez, I., Zagalaz-Anula, N., Ibancos-Losada, M. d. R., Nieto-Escámez, F. A., Obrero-Gaitán, E., & Osuna-Pérez, M. C. (2021). Virtual Reality-Based Therapy Reduces the Disabling Impact of Fibromyalgia Syndrome in Women: Systematic Review with Meta-Analysis of Randomized Controlled Trials. Journal of Personalized Medicine, 11(11), 1167. Retrieved from https://www.mdpi.com/2075-4426/11/11/1167

Darnall, B. D., Krishnamurthy, P., Tsuei, J., & Minor, J. D. (2020). Self-Administered Skills-Based Virtual Reality Intervention for Chronic Pain: Randomized Controlled Pilot Study. JMIR Form Res, 4(7), e17293. doi:10.2196/17293

Goudman, L., Jansen, J., Billot, M., Vets, N., De Smedt, A., Roulaud, M., . . . Moens, M. (2022). Virtual Reality Applications in Chronic Pain Management: Systematic Review and Meta-analysis. JMIR Serious Games, 10(2), e34402. doi:10.2196/34402

Hao, J., Xie, H., Harp, K., Chen, Z., & Siu, K. C. (2022). Effects of Virtual Reality Intervention on Neural Plasticity in Stroke Rehabilitation: A Systematic Review. Arch Phys Med Rehabil, 103(3), 523-541. doi:10.1016/j.apmr.2021.06.024

Meister, I. G., Krings, T., Foltys, H., Boroojerdi, B., Müller, M., Töpper, R., & Thron, A. (2004). Playing piano in the mind—an fMRI study on music imagery and performance in pianists. Cognitive Brain Research, 19(3), 219-228. doi:https://doi.org/10.1016/j.cogbrainres.2003.12.005

Pretat, T., Koller, C., & Hügle, T. (2025). Virtual reality as a treatment for chronic musculoskeletal pain syndromes. Joint Bone Spine, 92(1), 105769. Retrieved from https://doi.org/10.1016/j.jbspin.2024.105769

Voss, P., Thomas, M. E., Cisneros-Franco, J. M., & de Villers-Sidani, É. (2017). Dynamic Brains and the Changing Rules of Neuroplasticity: Implications for Learning and Recovery. Frontiers in Psychology, 8. doi:10.3389/fpsyg.2017.01657