321: Virtual Reality Hypnosis for Chronic Arthritis Pain: From User Experience to Randomized Trial

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Psychology, Non-pharmacological treatments, Digital Health Technologies

Background and Aims: Chronic pain affects approximately one in five adults worldwide, representing a major public health challenge and a leading cause of disability and reduced quality of life (1,2). Arthritis and osteoarthritis are among the most frequent causes of chronic musculoskeletal pain and functional limitation (3). Non-pharmacological interventions such as hypnosis and virtual reality (VR) have demonstrated clinically meaningful analgesic effects in experimental and clinical settings (4–8), yet their combined use remains insufficiently studied in patients with chronic pain. This study aimed to evaluate feasibility, user experience, and clinical effects of a virtual reality–hypnosis (VRH) intervention in adults with arthritis-related chronic pain.

Methods: First, a user-experience study assessed acceptability, immersion, benefit, and usability of VRH in adults with chronic pain, complemented by interviews exploring participants’ experiences and mechanisms of action. Second, a RCT compares two conditions: four sessions of VR alone, or two sessions of VR followed by two sessions of RVH. Patients are recruited from two academic pain clinics (9). Outcomes include pain intensity/interference, patient-reported engagement, treatment adherence, and physiological responses. Assessments are conducted at baseline, during sessions, after the fourth session, and at one-month follow-up. Analyses are conducted using intention-to-treat mixed-effects models adjusted for baseline covariates and site effects.

Results: The user experience study (n=24) showed high acceptability, with 92% of participants willingness to reuse the intervention, with average immersion scores of 7/10. Participants reported an average pain reduction of 1.8 points on a 0-10 scale, and qualitative interviews indicated that most participants perceived relaxation, attentional absorption, and reduced pain-related distress as key mechanisms of benefit (10). Preliminary analyses from RCT (n=60) indicate greater reductions in pain intensity and interference in the VRH group compared with VR alone, along with higher session completion rates and good overall adherence. Physiological recordings showed patterns consistent with increased relaxation during VRH sessions.

Conclusions: Combining hypnosis with immersive VR appears feasible, acceptable, and safe for adults living with arthritis-related chronic pain. Findings from the user-experience study and preliminary trial data suggest that VRH may enhance engagement, relaxation, and perceived analgesia compared with virtual reality alone. This multimodal approach may help optimize non-pharmacological pain management by targeting attentional, cognitive, and emotional mechanisms simultaneously. A home-based version of the intervention is planned to improve accessibility and support self-management in real-world settings. Ongoing analyses will clarify clinical effects, physiological correlates, and patient characteristics associated with treatment response.

References: 1. Goldberg, D. S., & McGee, S. J. (2011). Pain as a global public health priority. BMC public health, 11, 770. https://doi.org/10.1186/1471-2458-11-770
2. Canadian Pain Task Force. (2021). Chronic Pain in Canada: Laying a Foundation for Action. Health Canada.
3. Hunter, D. J., & Bierma-Zeinstra, S. (2019). Osteoarthritis. Lancet, 393(10182), 1745–1759.
4. Langlois, P., Perrochon, A., David, R., Rainville, P., Wood, C., Vanhaudenhuyse, A., Pageaux, B., Ounajim, A., Lavallière, M., Debarnot, U., Luque-Moreno, C., Roulaud, M., Simoneau, M., Goudman, L., Moens, M., Rigoard, P., & Billot, M. (2022). Hypnosis to manage musculoskeletal and neuropathic chronic pain: A systematic review and meta-analysis. Neuroscience and biobehavioral reviews, 135, 104591.
5. Malloy, K. M., & Milling, L. S. (2010). The effectiveness of virtual reality distraction for pain reduction: a systematic review. Clinical psychology review, 30(8), 1011–1018.
6. Patterson, D. R., & Jensen, M. P. (2003). Hypnosis and clinical pain. Psychological bulletin, 129(4), 495–521.
7. Cardinal, É., Augier, P., Giguère, É., Landry, M., Lemay, S., Véronneau, J., Nyssen, A. S., Faymonville, M. E., Vanhaudenhuyse, A., Rainville, P., Rousseaux, F., & Ogez, D. (2025). Combining Hypnosis and Virtual Reality: A Qualitative Investigation of User Experience During an Experimental Pain Study. Journal of clinical psychology in medical settings, 32(2), 336–346.
8. Rousseaux, F., Giguère, É., Landry, M., Piché, M., Mostanadi, M., Augier, P., Simon, J., Bicego, A., Faymonville, M. E., Nyssen, A. S., Ogez, D., Rainville, P., & Vanhaudenhuyse, A. (2025). Comparison of Experimental Pain Modulation by Hypnosis, Virtual Reality and Virtual Reality Hypnosis in Healthy Individuals. European journal of pain, 29(10), e70166.
9. Fournier, V., Simard, M. F., Yuen, S. Y., Guiné, J., Rousseaux, F., Lebeau, J., Jerbi, K., Richebé, P., Landry, M., Rainville, P., & Ogez, D. (2025). Combining virtual reality and hypnosis to alleviate chronic pain in elderly with hand arthritis: protocol for a randomised phase II clinical trial. BMJ open, 15(10), e103841.
10. Chevestrier-Lefeuvre, A., Guiné, J., Véronneau, J., Lebeau, J., Rousseaux, F., Laurin, A., Simard, M.F., Godin, N., Jerbi, K., Richebé, Ph., Landry, M., Rainville, P., Fournier, V., Ogez, D. Effects of a Virtual Reality Hypnosis Intervention on Chronic Pain: A User Experience and Proof-of-concept Study. Virtual Reality (In review).

Presenting Author: David Ogez
Submitting Author: David Ogez

Senior Author: David Ogez

IASP 2026 Global Year theme of Neuropathic Pain: No

• Fournier Valentyn: PhD - University of Montreal
• Vien Françpis-Xavier: BSc - University of Montreal
• Yuen Sai Yan: MD - University of Montreal
• Landry Mathieu: PhD - Université Laval
• Rainville Pierre: PhD - University of Montreal