The DOI matches its Crossref record; 57 of the 59 references it cites were found in a registry or an index.
The effectiveness of virtual reality distraction for pain reduction: A systematic review
Abstract
Virtual reality technology enables people to become immersed in a computer-simulated, three-dimensional environment. This article provides a comprehensive review of controlled research on the effectiveness of virtual reality (VR) distraction for reducing pain. To be included in the review, studies were required to use a between-subjects or mixed model design in which VR distraction was compared with a control condition or an alternative intervention in relieving pain. An exhaustive search identified 11 studies satisfying these criteria. VR distraction was shown to be effective for reducing experimental pain, as well as the discomfort associated with burn injury care. Studies of needle-related pain provided less consistent findings. Use of more sophisticated virtual reality technology capable of fully immersing the individual in a virtual environment was associated with greater relief. Overall, controlled research suggests that VR distraction may be a useful tool for clinicians who work with a variety of pain problems.
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“It is known that VW in this perspective is an established tool for acute affect modulation and acute pain relief [22, 23].”
From Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study (2024) · cites this paper as [23]
In the citing paper
“In VR relaxation [21] and VR pain management [36], presence is likely a mediator of intervention effects due to the inherent correlation with distraction from the outside and inside world”
From Experiences of gamified and automated virtual reality exposure therapy for spider phobia: qualitative study (2020) · cites this paper as [36]
Citations
Cites
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.51.6.1173 · Cited by 91,532
Statistical Power Analysis for the Behavioral Sciences (2nd ed.).
Lachenbruch, P. A., & Cohen, J. (1989) · Journal of the American Statistical Association · doi:10.2307/2290095 · Cited by 37,421
Wasserman, S. S., Hedges, L. V., & Olkin, I. (1988) · Journal of Educational Statistics · doi:10.2307/1164953 · Cited by 10,377
The empirical status of cognitive-behavioral therapy: A review of meta-analyses
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006) · Clinical Psychology Review · doi:10.1016/j.cpr.2005.07.003 · Cited by 3,215
Statistical Methods for Meta-Analysis
(1985) · Elsevier eBooks · doi:10.1016/c2009-0-03396-0 · Cited by 2,564
Psychometric properties of the credibility/expectancy questionnaire
Devilly, G. J., & Borkovec, T. D. (2000) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(00)00012-4 · Cited by 2,295 · cited 1×
“To our knowledge, there has been no empirical research on possible biological (Gold, Belmont, & Thomas, 2007) and psychological mechanisms such as expectancy (Kirsch, 1985) and credibility (Devilly & Borkovec, 2000) that might explain how VR distraction works to relieve pain.”
BackgroundMorley, S., Eccleston, C., & Williams, A. (1999) · Pain · doi:10.1016/s0304-3959(98)00255-3 · Cited by 1,597
Lost productive time and cost due to common pain conditions in the US workforce
Stewart, W. F. (2003) · JAMA · doi:10.1001/jama.290.18.2443 · Cited by 1,570
Response expectancy as a determinant of experience and behavior.
Kirsch, I. (1985) · American Psychologist · doi:10.1037/0003-066x.40.11.1189 · Cited by 1,009
Handbook of pediatric psychology
(1988) · Choice Reviews Online · doi:10.5860/choice.26-2400 · Cited by 799
Flagged first, then by citations
2 of the 59 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- McGrath, 1985, CHEOPS: A behavioral scale for rating postoperative pain in children, Advances in Pain Research and Therapy, 9, 395
- Riva, 2008, Editorial, Annual Review of CyberTherapy and Telemedicine, 6, 10
Cited by
Sorted by citations
Items 601–650 of 650
Çetin, H., Yağız, M., & Hamidi, K. (2025) · Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Dergisi · doi:10.21020/husbfd.1549690
Stan, D., Voicu, D. C., Zainea, P., Alexandra Monica, T. O. M. A., & Ciubară, A. (2025) · Diseases · doi:10.3390/diseases13090308
“This enduring effect supports earlier research suggesting that virtual reality enhances cognitive-behavioral exposure therapy by creating immersive, controlled environments in which patients can confront anxiety triggers safely and progressively [10,13,14].”
Esteban-Sopeña, J., Bravo-Aparicio, J., Trillo-Charlín, I., Roldán‐Ruiz, A., Beltrán-Alacreu, H., & García‐Magro, N. (2025) · Healthcare · doi:10.3390/healthcare13192439
“Virtual reality (VR) has rapidly emerged in recent years as an effective strategy for modulating pain perception [1].”
Beebe, K., Alvarez, A., Nguyen, L., Petros, J., Trujillo, M. S., & Aygün, O. (2025) · Journal of Medical Extended Reality · doi:10.1177/29941520251381338
Garay, J., Phillips, S., Purdam, J., Duczynski, J., Azizi, M., Dickson, M., Carter, M., Hespanhol, L., Negin, J., & Mooney‐Somers, J. (2025) · doi:10.2196/preprints.88001
Stencel, M., Pilarski, B., Kuca, J., Kapuśniak, N. E., Turska-Czyż, D., Florek, S., Piegza, M. J., Gorczyca, P. W., & Pudło, R. (2025) · Reports — Medical Cases Images and Videos · doi:10.3390/reports8040247
“This effect has been repeatedly observed in studies on pain [50] and stress [58], providing a coherent explanation for the changes in anxiety and sleep observed in our study.”
Baek, S., Qu, Z., & Gorlatova, M. A. (2025) · ACM Symposium on Virtual Reality Software and Technology (VRST) · doi:10.1145/3756884.3765987 · Cited by 1
“Studies have examined the effect of background distractions on task performance and visual fatigue [2], and the use of distraction to reduce pain [23, 46].”
Matheve, T., Bogaerts, K., & Timmermans, A. A. A. (2020) · Figshare · doi:10.6084/m9.figshare.12177747
Matheve, T., Bogaerts, K., & Timmermans, A. A. A. (2020) · Figshare · doi:10.6084/m9.figshare.12177741
Armstrong, M., Lun, J., Groner, J. I., Thakkar, R. K., Fabia, R. B., Noffsinger, D. L., Ni, A., Keesari, R., & Xiang, H. (2022) · Figshare · doi:10.6084/m9.figshare.20517123
Matheve, T., Bogaerts, K., & Timmermans, A. A. A. (2020) · Figshare · doi:10.6084/m9.figshare.12177735
Wolf, S., Zanker, J., Sommer, F., Vlasenko, D., Pinto, D. R. M., Hoffmann, M., Anthuber, M., & Schrempf, M. C. (2023) · Figshare · doi:10.6084/m9.figshare.22603132
Matheve, T., Bogaerts, K., & Timmermans, A. A. A. (2020) · Figshare · doi:10.6084/m9.figshare.12177753
Traitements des syndromes douloureux musculosquelettiques chroniques par la réalité virtuelle
Pretat, T., Koller, C., & Hügle, T. (2025) · Revue du Rhumatisme · doi:10.1016/j.rhum.2025.12.003
Advancing Clinical Care Through Virtual Reality: Lessons Learned and Future Directions
Burrows, B. T., Leo, G. D., Kwon, S., & Hernández, R. (2026) · Lecture notes in computer science · doi:10.1007/978-3-032-12808-9_16
Keny, C., Shafiq, U., Lorenz, K., Russell, M., Leutwyler, H. C., Wagner, L. M., Tang, V., & Park, L. (2025) · doi:10.2196/preprints.81791
Hassan, A. A., Algabbani, M. F., Farrag, A., Elsayed, W. H., Rezk, M. Z. A., Bindawas, S. M., Alhusaini, A. A., & Shaheen, A. A. M. (2026) · Disability and Rehabilitation · doi:10.1080/09638288.2026.2625551
“…also improved significantly. scD-related bone and joint complications, particularly from VOcs, can restrict movement and cause avascular necrosis [52]. though direct research on VR and functional mobility in scD is sparse, VR has shown positive effects in children with cP, though with smaller…”
Behavioral and neural mechanisms underlying odor modulation of pain perception
Chen, Y., Guo, J., Zhou, W., Zhou, B., & Kong, Y. (2026) · Chinese Science Bulletin (Chinese Version) · doi:10.1360/csb-2025-5720
Keny, C., Shafiq, U., Lorenz, K., Russell, M., Leutwyler, H. C., Wagner, L. M., Tang, V., & Park, L. (2026) · JMIR Perioperative Medicine · doi:10.2196/81791
Zhao, J., Liu, Y., Jiang, C., & Yu, J. (2026) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2026.2619033
“These solutions typically incorporate VR headsets or EEG wearables and are structured around three core functions: pain intervention, physiological monitoring, and data management (Malloy & Milling, 2010).”
GAO, F., Yu, T., Song, J., Chen, Z., & Hu, D. (2026) · Journal of Spinal Cord Medicine · doi:10.1080/10790268.2026.2626118
Maneuvrier, A. (2020) · theses.fr (ABES) · doi:10.70675/3fbb4dbfzc553z459dzba8fz7ee7a2f5ec28 · Cited by 1
Michaux, R., Wagener, A., Durieux, N., & Stassart, C. (2026) · European Journal of Pain · doi:10.1002/ejp.70282 · Cited by 1
“VR has primarily been studied for acute pain (AP) management (Malloy and Milling 2010; Tas et al. 2022), with analgesic effects attributed to attentional distraction through immersive environments (Bentsen et al. 2001; Boerner et al. 2014; Dumoulin et al. 2007).”
Verasingam, P. K., Dvorkin, L., & Kavanagh, M. (2026) · doi:10.2196/preprints.99969
Paygozar, R., Tahery, N., & Mousaei, F. M. (2026) · Pain Management Nursing · doi:10.1016/j.pmn.2026.02.003
Virtual reality for pain and anxiety reduction during venous puncture procedures
Rosenecker, A., Amato, M., Geiger, I., Winkler, S., Willeit, P., Schennach, H., & Siller, A. (2026) · Wiener klinische Wochenschrift · doi:10.1007/s00508-026-02763-3
Sebastien, J., Zhu, J., Chirico, A., Mancuso, V., MARKS, A., Soffer, G., & Won, A. S. (2026) · Augmented Humans International Conference (AHs) · doi:10.1145/3795011.3795032
“Studies testing VR and pain perception identify presence, immersion, embodiment, interactivity, and, more broadly, distraction as key mechanisms for pain reduction by drawing users’ cognitive and attentional resources away from processing acute pain [39, 40, 54, 91].”
Hu, Q., Chen, L., Zhu, Y., Xiang, T., Liang, X., Wu, G., Ding, M., & Long, T. (2026) · JMIR Formative Research · doi:10.2196/92442
Zheng, L., Wang, T., & Shen, T. (2026) · ANZ Journal of Surgery · doi:10.1111/ans.70775
Virtual Reality and Augmented Reality Applications in Pediatric Neurorehabilitation
Lorentz, L. (2026) · Springer eBooks · doi:10.1007/978-3-032-26192-2_14
Effects of Virtual Reality Interventions on Pain and Anxiety in Burn Care
Zielina, M., Dostál, D., Raudenská, J., Šmahaj, J., Zajíček, R., Doležal, D., & Javůrková, A. (2026) · Pain Management Nursing · doi:10.1016/j.pmn.2026.05.029
Chakmak, Y., Jicol, C., & Petrini, K. (2026) · Computers in Human Behavior · doi:10.1016/j.chb.2026.109106
Hadjiat, Y. (2025) · Dunod eBooks · doi:10.3917/dunod.poisb.2025.01.0292
Virtual Reality for the Assessment of Visual Capacities: A Systematic Review
Dolcini, J., Olivetti, P., Capriotti, A., Lucertini, F., Ferretti, A., & Franciotti, R. (2026) · Applied Sciences · doi:10.3390/app16157788
Khalilipicha, S., Gromala, D., Froozanfar, A., Shaw, C., May-Derbyshire, P., & Erhan, E. (2026) · Lecture notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering · doi:10.1007/978-3-032-27585-1_2
Baoai, W., Qingke, L., Zhiqiang, X., Xiaohong, D., & Zhongyuan, H. (2026) · Research Square · doi:10.21203/rs.3.rs-10048704/v1
Guarise, V., Amador, F. L. D., Alves, G. C. G., de Brito, C. M., de Oliveira, É. G., dos Santos, V. R., Coutinho, G. M. D. M., & Moreira, R. S. L. (2025) · Acta Paulista de Enfermagem · doi:10.37689/acta-ape/2025spe31f
The use of virtual reality for teaching undergraduate nursing in the surgical center: scoping review
Guarise, V., Amador, F. L. D., Alves, G. C. G., de Brito, C. M., de Oliveira, É. G., dos Santos, V. R., Coutinho, G. M. D. M., & Moreira, R. S. L. (2025) · Acta Paulista de Enfermagem · doi:10.37689/acta-ape/2025spe31i
“(30,31) For the future development of new learning experiences with VR, it is recommended to use consolidated guidelines and methods, (27) such as the standards of the International Nursing Association of Clinical Simulation and Learning (INACSL), standards of Best Practices for Healthcare…”
Guarise, V., Amador, F. L. D., Alves, G. C. G., de Brito, C. M., de Oliveira, É. G., dos Santos, V. R., Coutinho, G. M. D. M., & Moreira, R. S. L. (2025) · Acta Paulista de Enfermagem · doi:10.37689/acta-ape/2025spe31e
Kasim, A. M., & Hassan, A. F. (2026) · Nigerian Postgraduate Medical Journal · doi:10.4103/npmj.npmj_630_25
Cheminet, G., Corbasson, A., Alkoudsi, K. T., Charmettan, M., Barthélémy, C., Namaoui, W., Khimoud, D., & Arlet, J. (2026) · British Journal of Haematology · doi:10.1111/bjh.70766
Verasingam, P. K., Dvorkin, L. S., & Kavanagh, M. (2026) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2026.115382
O'Malley, C., Harris, D., Hughes, S., Cottrell, J., Lloyd, D., Vine, S. J., & Arthur, T. (2026) · European Journal of Applied Physiology · doi:10.1007/s00421-026-06399-z
Yong, Z., Paasche‐Orlow, M. K., Perkins, R. B., & Bickmore, T. (2026) · ACM International Conference on Intelligent Virtual Agents (IVA) · doi:10.1145/3806774.3827987
Zhang, L., Zhang, X., Zhang, R., Yu, Y., Yang, Z., & Yang, L. (2026) · Frontiers in Neurology · doi:10.3389/fneur.2026.1922187
Peralta‐Álvarez, J., Nieto-Escámez, F. A., López‐Liria, R., González-Gerez, J. J., Benzo‐Iglesias, M. J., & Pérez, P. R. (2026) · Physiotherapy Research International · doi:10.1002/pri.70354
Boronczyk, B., Avşar, P., Nugent, L., Renjith, V., Byrne, S., & Wilson, H. J. E. (2026) · International Journal of Orthopaedic and Trauma Nursing · doi:10.1016/j.ijotn.2026.101331
Aljenfawi, K., Hasan, M., Albazee, E., & Yaiesh, S. M. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15208145
“VR has shown potential benefits for pain and anxiety reduction in several medical and minor procedural settings, although the magnitude and consistency of these effects vary across populations and procedures [11–13].”
Sanmugananthan, V. V., El‐Sayed, R., Inman, R. D., & Davis, K. D. (2026) · Frontiers in Pain Research · doi:10.3389/fpain.2026.1945745
Metadata
- Authors
- Malloy, K. M., & Milling, L. S.
- Affiliations
- University of Hartford (US)
- Corresponding author
- Milling, Leonard S.
- ORCID
- Milling, Leonard S.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2010-12
- Volume
- 30
- Issue
- 8
- Pages
- 1011-1018
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2164662311
- Cited by
- 653
- References
- 59
- Citations by year
- 2026: 44 · 2025: 72 · 2024: 52 · 2023: 67 · 2022: 59 · 2021: 75 · 2020: 66 · 2019: 53 · 2018: 51 · 2017: 31 · 2016: 18 · 2015: 18 · 2014: 23 · 2013: 9 · 2012: 7
- FWCI
- 2.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- virtual reality, distraction therapy, analgesia, experimental pain, immersion, pain management
- MeSH terms
- Attention, Burns, Humans, Injections, Pain, Research, User-Computer Interface, Treatment Outcome, Controlled Clinical Trials as Topic, Pain Management
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