A Dose of Nature to Reduce Pain?

A new systematic review and meta-analysis suggests that exposure to nature, in real life or virtually, shows a small to moderate benefit for acute pain. Whether the results would apply to chronic pain or migraine remains uncertain.

Over the past decade, numerous studies have reported that spending time in nature offers many health benefits, ranging from a decreased risk of anxiety, stress, and depression to bolstered immune function. Because nature exposure has such far-reaching effects, researchers have wondered if it might influence the experience of pain, too.

Now, researchers at the University of Vienna, Austria, have conducted a systematic review and meta-analysis of 62 studies, which included more than 4,000 participants across 21 countries, to assess the impact of nature-based interventions on self-reported acute pain. Led by senior author Claus Lamm, the researchers found that nature exposure consistently had a small to moderate beneficial effect on pain, including experimentally induced pain and pain induced in medical settings.

They also identified factors that influenced these effects, pointing to the types of control interventions used in studies of nature exposure, as well as the type of nature exposure, as particularly important. The authors did urge, though, that their results be interpreted with caution, considering that the studies showed high heterogeneity and risk of bias.

Mohab Ibrahim, University of Arizona, Tucson, US, who was not involved with the research, told Migraine Science Collaborative that the analysis was a “comprehensive, challenging undertaking” that was “nicely done.”

“They showed, whether people were exposed to nature outside or a virtual reality depiction of nature, that there was a positive effect – an actual biological effect that improved people’s reports of their pain. This effect happened regardless of what kind of pain [subjects had] or how it was measured,” Ibrahim said. “There’s no question that nature exposure is doing something here. And we need to look into that, taking a rigorous approach so we can understand it and then optimize it.”

“The study has many strengths, including a pre-registered, rigorous and well-conceptualized analysis plan that addresses a clinically important question related to improving interventions for chronic pain,” wrote Andrew Rogers and Jeffrey Lackner, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York, in an accompanying News & Views.

Whether the findings might also apply to chronic pain or migraine, however, remains unclear.

The systematic review and meta-analysis appeared online on January 6, 2026, in Nature Mental Health, with the related News & Views appearing on January 26, 2026.

Looking for the big picture
First author Maximilian Steininger said he and his colleagues were inspired to undertake the new research while working on a brain imaging study examining the effects of nature exposure on acute pain; that study included healthy participants subjected to experimental pain.

“We saw evidence that nature exposure in the form of a nature video might help not only in terms of reductions in self-reported pain but also in reducing activity in different parts of the brain associated with pain,” he said. “While we were preparing this study for publication, we wanted to get a good picture of what was happening in the field…. We had an impression that there were a lot of studies out there that pointed in a specific direction, but we wanted to do an analysis in a systematic way to really understand what was there.”

So the researchers scoured the literature for studies that looked at the effects of different types of nature exposure on acute pain. Steininger said they initially thought they would find maybe 20 studies, but as they delved deeper, they found more studies than expected, with nature exposures ranging from nature videos to virtual reality interventions.

“The default option for virtual reality systems, interestingly enough, is a nature stimulus,” he said. “We ended up with more than 60 studies in the analysis, with a high level of heterogeneity. Different studies used different forms of nature exposure, they looked at different forms of acute pain, and they also used different ways of reporting pain.”

Studies included in the analysis took place both in medical (75.8%) and experimental settings (24.2%). Some studies measured pain using a visual analog scale (51.6%), and others a numerical rating scale (32.3%) or graphical rating scale (6.4%). Six studies (9.7%) relied on pain threshold and/or tolerance measures. And there was just as much variation in the types of acute pain measured: Some studies in medical settings had participants rate their pain after a blood draw or colonoscopy, while in experimental settings, pain might be induced through cold or pressure stimuli.

Despite the high level of heterogeneity across the 60-odd studies, Steininger said the group observed a consistent and significant trend: Exposure to nature, whether it was a walk in the garden or a prolonged look at a nature mural, resulted in lower self-reported pain.

“It was a small to moderate effect, meaning, if you think about a pain scale that ranges from zero to 10, it’s approximately the change of one scale point,” said Steininger. “It’s not a massive effect, but it’s not nothing. It’s similar to the effects seen in other non-pharmacological approaches, like music intervention.”

Ibrahim agreed that seeing a reduction was important. He added that the results suggest nature exposure could work in tandem with other treatments to help prevent or reduce pain in a wide variety of pain conditions.

“A reduction is a reduction,” he said. “If someone tells me that watching a nature video or walking in the park for 15 minutes will decrease my ibuprofen intake from three times a day to twice a day, that’s still less pain, less medication, less side effects, less potential complications for something fairly easy to do. To me, that’s a win-win situation.”

The investigators reported additional findings that filled out the picture of what the literature says about nature exposure and pain.

For instance, the group looked at what the studies of nature exposure interventions used as comparators (controls) – a non-matched comparator, such as treatment as usual, or a comparator that was to some degree matched to the nature exposure, such as comparing nature scenes to images of urban scenes. It turned out that the effects of nature exposure on pain were half as much when the studies used matched comparators.

In addition, nature exposures that involved multisensory stimuli had stronger effects than those that engaged only a single sense.

Finally, with regard to study quality, the researchers found that a little more than half of the studies had a high overall risk of bias, while the others had at least some issues, especially related to outcome measurement and randomization.

Applications to chronic pain and migraine?
While the results are promising for acute pain, Steininger said there are still many open questions about the efficacy of nature exposure for chronic pain conditions and migraine.

“The research really is in its infancy stage, and we don’t know how much it might translate to chronic conditions like migraine. We also don’t know if all people are impacted by [nature exposure], if there are differences in how people respond to it, if there are specific aspects of nature that are especially important, or whether those mechanisms will be the same for different conditions,” said Steininger.

To date, he added, there is little evidence to suggest that nature exposure can help with migraine or headache. There is some evidence, he said, that green light therapy exposure, which is related to nature, may help. Yet given prevalent light and sound sensitivities in those living with migraine, it might be difficult to convince people to try other types of nature-related interventions.

Ibrahim, who led the research study on green light therapy for migraine (see MSC related interview with Ibrahim), concurred. But he believes green light, as well as other aspects of nature, could work in a preventative fashion, helping to decrease the frequency or intensity of headache.

“I would like to see a randomized clinical trial to test these different aspects of nature so we can really assess their effects,” he said. “As a pain physician, I’d like to see what aspects of green light therapy or nature might help my patients. As a scientist, I want to know how nature might be causing these pain reduction effects that we see. I want to know how it works. Because if we can understand the mechanism, we can make the treatment better. We can add it to a multimodal approach to treatment in order to not only decrease pain in patients but improve their overall quality of life.”

Rogers and Lackner, the News & Views authors, agreed that a better understanding of mechanisms is needed. Here, they suggested some interesting possibilities.

“[I]t is possible that nature-based interventions relieve pain by increasing positive mood, decreasing negative mood, relieving stress, decreasing cortisol levels, and/or promoting mental acuity.”

Kayt Sukel is a freelance writer based in Kansas.

Image credit: 123RF Stock Photo.

References
Nature exposure reduces self-reported pain: a systematic review and meta-analysis.
Steininger et al.
Nat Ment Health. 2026;4:165-80.

Toward an understanding of how and why nature exposure is associated with reduced self-reported pain.
Rogers AH, Lackner JM.
Nat Ment Health. 2026;4:193-4.