Inclusion Criteria:  Age greater than or equal to 18 Female or male Patients undergoing standard of care lumbar spinal interventional procedures including: epidural steroid injections, facet injections, medial branch blocks  Exclusion Criteria:  Patients who cannot consent for themselves, including cognitively impaired patients. Non-English speaking patients Patients taking beta blocker medication Patients that have a pacer and have a set rate Patients with self-reported hearing problems or with hearing aids