Periprocedural anxiety is a common problem for patients who undergo interventional pain procedures. Virtual Reality (VR) is an immersive experience that has gained acceptance in the medical field as a tool for reducing anxiety and pain for patients.Research Aim:
To evaluate the effect of immersive virtual reality (VR) on periprocedural anxiety related to therapeutic cervical epidural steroid injections (ESI).
The investigators hypothesize that immersive virtual reality will result in a clinically meaningful anxiety reduction, defined as the proportion of participants with \> 50% reduction in Numeric Rating Scale (NRS) anxiety scores when compared to participants in the non-treatment group who will have standard preprocedural waiting time conditions in clinic, but no VR experience. Similarly, the investigators hypothesize a significant reduction in objective sympathetic tone as measured by skin sympathetic nerve activity (SKNA).
Inclusion Criteria
- Age 18-80 years old at day of enrollment
- Neck pain patient deemed to be a candidate for pain control treatment with interventional fluoroscopically guided cervical epidural steroid injection as determined by their pain medicine provider based on history, physical exam, and radiographic findings
- Willingness to undergo pre-procedural intervention of VR viewing experience or equivalent pre-procedural wait time
- No history of prior epidural steroid injections
- Did not receive sedatives prior to or during procedure
Exclusion Criteria
- Refusal / inability to participate or provide consent
- Contraindications to injection (anticoagulated states, allergy to components of injection, local infection at injection site, current infectious process or treatment of antibiotics for current infection)
- Uncontrolled anxiety disorder or untreated/inadequately treated psychiatric disorder
- History of Alzheimer's, dementia, or cognitive dysfunction
- Patient currently taking benzodiazepines
- Severe motion sickness
- Seizure disorder
- Vision loss
- Non-English speaking patients