Analgesic and Anxiolytic Effects of Virtual Reality and Classical Music Therapy on Tension-Type Headache: A Randomized Controlled Trial.

Abstract

Tension-type headache is the most common primary headache worldwide, significantly reducing individuals' quality of life. Although nonsteroidal anti-inflammatory drugs are commonly used for the pharmacologic treatment of tension-type headache, complementary and alternative treatment methods are gaining increasing importance. In this context, virtual reality technology stands out as a noninvasive option, particularly in pain management. This study investigates the analgesic effects and acute mood changes associated with virtual reality and classical music therapy in tension-type headache patients. This randomized controlled trial involved 140 patients diagnosed with tension-type headache, divided into 2 groups. The control group received intravenous 25-mg dexketoprofen trometamol, whereas the intervention group was provided with virtual reality goggles to listen to classical music in a simulated forest environment in addition to this treatment. Pain intensity was assessed using the visual analog scale (VAS), whereas mood changes were measured using a 5-choice ordinal rating scale. The mean (SD) values for VAS-0, VAS-30, VAS-60, and VAS-120 in the control group were found to be 80.5 (11.2), 60.1 (17.0), 51.0 (18.0), and 45.9 (19.9), respectively, whereas the mean (SD) values for VAS-0, VAS-30, VAS-60, and VAS-120 in the intervention group were calculated as 79.8 (11.3), 40.35 (26.6), 21.9 (22.2), and 12.1 (15.7), respectively. Pain intensity was observed lower in the intervention group throughout the treatment than the control group. When ΔVAS-30, ΔVAS-60, and ΔVAS-120 values were examined, the values in the control group were 20.3 (13.4), 29.4 (15.9), and 34.5 (17.9), respectively, whereas in the intervention group, these values were 39.5 (22.5), 57.9 (20.1), and 67.7 (15.5), respectively. Regarding the ΔVAS%-30, ΔVAS%-60, and ΔVAS%-120 values, the control group had values of 25.5 (16.2), 36.8 (19.4), and 43.2 (21.9), respectively, whereas the intervention group had values of 50.9 (30.5), 73.6 (25.7), and 85.4 (18.4), respectively. At 120 minutes, the proportion of patients reporting a 5-choice ordinal rating scale score of 4 or 5 (indicating a positive mood) was significantly higher in the intervention group: 81.4% versus 31.4%, with a difference of 50% (95% confidence interval 35.8% to 64.2%). The findings suggest that the combination of virtual reality and classical music effectively manages pain and improves mood in tension-type headache patients. This approach may reduce medication use and offers an innovative alternative for tension-type headache management, consistent with similar studies in the literature.