Abstract
Pain is a global health issue with substantial individual, societal and economic impacts. Given the risks of pharmacological treatments, complementary approaches to pain management are essential. Nature exposure has emerged as a promising nonpharmacological strategy, but evidence of its effectiveness is inconclusive. Here in this systematic review and meta-analysis we examined 62 studies (96 effects) across 21 countries, including 4,439 participants, to assess the impact of nature exposure on self-reported pain. The results indicate a significant small-to-moderate reduction in pain associated with nature exposure (standardized mean difference of 0.53), but studies exhibited moderate-to-high risk of bias and substantial heterogeneity. Studies evaluating nature against matched comparators reported effects roughly half the size of those using nonmatched controls and multisensory stimuli tended to show stronger effects. These findings support nature as a promising complementary pain management strategy. However, high heterogeneity and risk of bias warrant caution and highlight the need for more rigorous research.