Virtual reality has been used for years as a tool to help manage pain for hospitalized patients, offering a solo escape from physical discomfort. A new study now suggests that making the virtual experience a social one can significantly increase a person’s tolerance for pain. The research, a first of its kind, combined the known distracting power of VR with the dynamics of human social interaction, yielding complex and sometimes surprising results that could shape the future of non-pharmacological pain management.
In a randomized controlled trial, researchers from Cornell University’s Virtual Embodiment Lab investigated how interacting with another person in a shared virtual environment affects pain thresholds. They found that participants generally withstood higher levels of induced pain while connecting with either a friend or a stranger in social virtual reality (SVR) compared to being alone or interacting over a standard video call. This work builds on previous studies of VR’s analgesic effects, which are thought to work by immersing a user so completely in a virtual world that it diverts attentional resources away from pain signals. By adding a social component, the researchers have uncovered a new dimension to this therapeutic tool, suggesting that shared experiences, even virtual ones, have a powerful influence on how we perceive and endure pain.
A Novel Experimental Framework
To test the effects of social connection on pain, the research team developed a method that involved 70 participants, who were primarily students at the university. Each individual experienced four distinct scenarios in a random order to ensure the results were not biased by the sequence of events. The core of the experiment involved a pain-induction device, a thermal unit that participants would place their hand on. The device would grow progressively warmer, and the trial for that condition would end when the individual could no longer tolerate the heat and removed their hand. The temperature never exceeded a safe threshold of 50 degrees Celsius.
The four experimental conditions were designed to isolate the impact of social interaction within a virtual setting:
- Social VR with a Companion: The participant entered a virtual environment and interacted with a friend or family member who joined them in the same virtual space.
- Social VR with a Stranger: The participant interacted with a lab assistant they did not know within the shared virtual environment.
- Video Call with a Companion: The participant connected with their friend or family member via Zoom, a standard video conferencing platform, representing a more conventional form of remote social interaction.
- Alone in VR: The participant was in the virtual reality environment by themselves, providing a baseline for the non-social VR experience.
This structure allowed the researchers to compare not only the presence versus the absence of a social partner but also the medium of that interaction—immersive VR versus a standard video call. According to Andrea Stevenson Won, the lab’s director and the study’s senior author, nobody had previously examined the specific effects of social interaction on pain within a VR context. The team hypothesized that the combination would be especially helpful, adding the engagement of another person to the already powerful distracting effect of virtual reality.
Measuring Pain Objectively and Subjectively
A key strength of the study was its dual approach to measuring pain. The researchers recorded the maximum temperature the thermal device reached before a participant withdrew their hand. This served as a behavioral measure of pain tolerance—a direct observation of how much pain a person could physically endure. In addition to this objective data, participants were also asked to characterize their pain on a scale from one to 10 after the experience.
Won noted that self-reported ratings can sometimes differ from actual pain behavior, as post-experience characterizations of pain can be unreliable. For clinical applications, the behavioral measure is considered more useful. The goal in a hospital setting is not just for patients to say their pain was lower, but for them to actually notice it less and be able to endure necessary treatments or therapies more comfortably. While the participant’s characterization of their pain generally matched the thermal readings, the emphasis on observable behavior provides a more robust foundation for the study’s conclusions.
The Power of Shared Virtual Space
The results indicated a strong preference among participants for the social virtual reality conditions. Whether interacting with a known companion or an unknown stranger, the experience within VR was generally reported as more effective for pain management than being on a Zoom call or being alone in the virtual environment. This highlights the unique power of immersive SVR to create a sense of shared presence that transcends the capabilities of traditional digital communication. The study suggests that the simple act of co-existing and interacting with another avatar in a virtual space provides a level of engagement and distraction that significantly raises the threshold for pain.
The study joins a growing body of research showing that VR is a potent non-pharmacologic tool for analgesia. The prevailing theory behind its effectiveness is that VR captures a person’s conscious attention. Because the brain has a limited capacity for attention, the more resources are devoted to processing the immersive sensory inputs of a virtual world—visuals, sounds, and interactions—the fewer are available to process pain signals. Introducing a social partner appears to deepen this immersion, making the distraction even more powerful.
A Surprising Paradox of Presence
When More Immersion Meant More Pain
Despite the overall positive effect of social VR, the researchers uncovered a counterintuitive finding. Some participants who reported feeling highly present and deeply involved in the virtual world with their companion actually tolerated less pain. This result was confusing because it directly contradicts the prevailing theory and previous findings, which hold that a stronger sense of presence should lead to greater distraction and therefore less pain.
Isabelle McLeod Daphnis, the study’s corresponding author, offered a possible explanation for this paradox. She suggested that participants who were more present and engaged with their VR companion might have been more motivated or focused on the social interaction, causing them to keep their hand on the thermal device for longer, even as the pain became more intense. This prolonged exposure could lead to a quicker escalation to their ultimate pain threshold. In essence, their deep social engagement may have made them push their limits, resulting in a lower final temperature reading compared to someone less engaged.
Individual Differences in Pain Coping
Another nuance in the findings was that some individuals were able to tolerate more pain when they were alone. This suggests that for certain people, the presence of another person—even in a virtual context—may act as a distraction from their internal pain management strategies rather than a welcome one. It underscores that pain perception and tolerance are highly individual, and that social interaction is not a universally superior solution for everyone. These exceptions highlight the need for personalized approaches in clinical settings, where a patient’s personality and preferred coping mechanisms should be considered when designing VR-based therapies.
Implications for Clinical Pain Management
The findings from this study open new avenues for the use of virtual reality in health care. For years, VR has been used as a solo experience to distract patients during painful procedures like wound care, physical therapy, and chemotherapy. This research demonstrates the potential to enhance these interventions by making them social. Patients could potentially connect with family members or friends in a shared virtual world, reducing the sense of isolation often felt during hospitalization and simultaneously boosting their pain tolerance.
The distinction between interacting with a companion versus a stranger also has practical implications. While the study found benefits from both, the ability to connect with a loved one could provide emotional support that complements the distracting effects of the technology. As SVR technology becomes more accessible and user-friendly, it could be integrated into hospital protocols as a low-cost, non-invasive tool to supplement traditional pain medications. This could be particularly valuable in reducing the reliance on opioids and managing the anxiety that often accompanies painful medical conditions and procedures. The Cornell study is a critical step in exploring how to optimize virtual environments not just as a distraction, but as a fundamentally human-centered tool for healing.