Virtual reality (VR) is an emerging technology increasingly used to ameliorate acute and chronic pain although controlled, quantifiable data are limited. The purpose of this study is to evaluate VR's effect on heat pain threshold (HPT), pressure pain threshold (PPT), immediate pain and anxiety, and recalled pain and anxiety.

Prospective, randomized, crossover clinical trial.

The Stanford Chariot Program conducted this study at the Stanford School of Medicine Health System.

Healthy participants meeting inclusion criteria were recruited by solicitation from the Stanford School of Medicine Health System.

Participants were randomized by hand dominance and condition sequence and underwent standardized pain threshold tests with a thermode or an algometer during VR and control conditions.

Pain threshold, numeric pain scores, and anxiety scores were immediately recorded. Recalled pain and anxiety scores were recorded 24 h later.

A total of 80 participants were included, 40 who underwent HPT testing and 40 who underwent PPT testing. VR increased pain thresholds for both HPT (P = 0.002) and PPT (P = 0.044). The use of VR resulted in no difference in initial pain scores for HPT (P = 0.432) or PPT (P = 0.24). There was no difference in recalled pain when using VR for HPT (P = 0.851) although there was for PPT (P = 0.003). Initial and recalled anxiety scores for HPT (P = 0.006, P = 0.018, respectively) and PPT (P = 0.014, P = 0.002, respectively) were all reduced when using VR.

This study demonstrates that VR increased pain thresholds while modulating initial and recalled experiences with anxiety, which has implications for enhancing patient experiences during medical interventions and long-term health outcomes by optimizing memories during stressful events.

Clinical trial registration: NCT05836649, 4/19/23.

IRB registration: Stanford IRB #69330.