Inclusion Criteria:  Males and females; ages 18-90 years Lumbosacral radicular pain with a baseline average of leg pain score of > 4/10, MRI findings (if available) consistent with symptoms, duration of pain > 6 weeks, and no previous lumbar spine surgery. Documented diagnosis of radicular pain caused by herniated disc, central stenosis, foraminal stenosis, degenerative disk disease Willingness to adhere to undergo ESI with either sedation (midazolam and or fentanyl) or with virtual reality Able to appear for a follow up visit between 24-40 days following the intervention  Exclusion Criteria:  MRI findings discordant with symptoms (absence of herniated disc, spinal stenosis or severe disc degeneration without nerve root impingement (e.g. annular tears) that could explain symptoms) Previous lumbosacral spine surgery at the area affected Prior ESI within the past 6 months Allergy to contrast dye Poorly controlled psychiatric conditions that could affect outcomes (e.g. active substance abuse) or impose a barrier to participation (e.g. anxiety disorder requiring procedural sedation) Morbid obesity (BMI >40)