Nature immersion in virtual reality does not reduce naturally occurring muscle pain or improve motor outputs during prescribed or self-regulated tasks

Virtual reality (VR) can reduce experimental and clinical pain, yet it remains unclear whether these effects translate to naturally occurring muscle pain (NOMP) experienced during physical tasks. This study examined whether nature immersion presented through immersive VR attenuates NOMP and enhances motor performance during prescribed and self-regulated exercise. Two within-participant crossover studies were conducted. In Study 1, twelve healthy participants completed a stepped incremental cycling task to exhaustion under three conditions: immersive VR (nature scene), a two-dimensional sham display, and a no-intervention control. Pain onset, NOMP intensity, perceived effort, and time to exhaustion were measured. In Study 2, twenty-four participants performed intermittent isometric handgrip contractions at fixed light (13/100) or strong (50/100) perceived effort under the same conditions, with self-regulated force output and NOMP intensity measured. Immersive VR did not significantly delay pain onset, prolong time to exhaustion, reduce NOMP intensity, or lower perceived effort compared with sham or control conditions. A small reduction in NOMP intensity occurred early in the cycling task, but effects were trivial and not sustained. In Study 2, NOMP intensity, force production, and fatigue-related declines were similar across conditions. Exploratory analyses showed no moderating effects of sex, environmental presence, or fatigue. Overall, these findings demonstrate that nature-based VR immersion has limited effects on NOMP or motor performance. This likely reflects a mismatch between central mechanisms targeted by VR and strong peripheral drivers of NOMP. Consequently, VR hypoalgesia appears pain-type dependent and potentially pain-intensity dependent, with effects limited to lower pain intensities.