Background: The increasing use of virtual reality (VR) has extended into medical applications, including pain management through immersive mechanisms. This study aimed to evaluate the effectiveness of the Clone Hero for reducing pain intensity, threshold and tolerance. Methods: A randomized crossover trial compared three conditions during a cold pressor test in 25 healthy volunteers over 35 years: playing Clone Hero (interactive), watching Clone Hero (control), or no intervention (placebo). Outcome measures included usability and acceptability (qualitative questionnaire), pain intensity (VAS), pain threshold, pain tolerance, physical activity (IPAQ), and adverse effects. Results: Twenty-five participants completed the study. Overall satisfaction was high, with 92% reporting a positive experience. The Clone Hero group showed significantly lower pain intensity scores (4.9 ± 0.49) than the placebo (5.6 ± 0.48; p = 0.037) and control groups (6.1 ± 0.42; p = 0.004). Pain threshold was higher in the Clone Hero group (74.45 ± 20.7 s) compared to the placebo (62.91 ± 18.58; p < 0.001) and control (43 ± 14.77; p = 0.001). Pain tolerance was also greater (127.6 ± 9.46 s) versus the placebo (p = 0.021) and control (p = 0.001). No serious adverse effects were reported. Conclusions: Interactive pain management interventions demonstrated high levels of acceptability and user satisfaction, and may enhance pain modulation more effectively than passive or control.
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