Virtual Reality for Pain in Acute Orthopedic Injuries

Inclusion Criteria: 1. Outpatient adults in the Level 1 Trauma Center 2. Age 18 or older 3. Able to meaningfully participate meaningfully (English fluency and literacy) and stable living situation 4. Acute musculoskeletal injury (e.g., fracture, dislocation, rupture) 1-2 months earlier (acute phase). 5. Pain Catastrophizing Scale ≥20 or Pain Anxiety Symptom Scale-20 ≥40 6. Has access to internet (Wi-Fi or wireless) 7. Willing to participate and comply with the requirements of the study protocol, including virtual reality program and questionnaire completion No psychotropics or stable for \>6 weeks 8. Free of concurrent psychotropic medication for at least 2 weeks prior to initiation of treatment, OR stable on current psychotropic medication for a minimum of 6 weeks and willing to maintain a stable dose (i.e., no psychotropics or stable for \>6 weeks) 9. Cleared by orthopedic surgeon for study participation Exclusion Criteria: 1. Current or prior diagnosis of epilepsy, seizure disorder, dementia, migraines, or other neurological diseases that are contraindicated for VR 2. Medical condition predisposing to nausea or dizziness. 3. Hypersensitivity to flashing light or motion. 4. Vision or severe hearing impairment. 5. Injury to eyes, face, or neck that impedes comfortable use of virtual reality 6. Diagnosed with a medical illness expected to worsen in the next 3 months (e.g., malignancy) 7. Other serious injuries that occurred with the orthopedic injury or surgical complications (e.g., infection, need for repeat surgery) 8. Current or prior untreated mental illness, substance use disorder, or suicidal ideation 9. Self-reported pregnancy 10. Currently in litigation or under Workman's Comp 11. Practice of cognitive-behavioral therapy, yoga/meditation, or other mind body techniques once per week for 45 minutes or more within the last 3 months