Cognitive strategies have received considerable attention in the field of pain management, together with more traditional approaches based on physical interventions and behavior modification. Distraction is a technique that lately has been often studied.

Distraction is based on an individual's limited attention capacity; it diminishes attention aimed to a painful stimulus with a subsequent pain reduction (Wismeijer & Vingerhoets, 2005).

To study the effect of VR as a distraction technique in an experimental pain task.

37 healthy participants were induced pain through two consecutive immersions using the cold-pressor test. All participants went through two experimental conditions: VR and black screen. The order of conditions was counterbalanced and a design of repetitive measures was used.

A virtual environment “Surreal World” was developed based on distraction techniques designed to surprise participants. The effect of VR as a distraction technique was evaluated using objective measures of pain (threshold, tolerance, pain intensity and time estimation) and other cognitive measures (self-efficacy and catastrophic thinking in vivo).

VR significantly decreased tolerance and pain intensity, influenced participants to underestimate the length of immersion. A higher self-efficacy in VR and a lower rumination and helplessness were registered in the pain experience. Thus, VR may help improve the efficacy of cognitive strategies.

The study shows the relevance of VR as an adjunctive method in the treatment of acute pain and allows studying its efficacy in patients with chronic pain.