Gateway Midwest Healthcare provides physician-led, image-guided pain management in St. Louis. We accept Missouri Medicaid, Medicare and commercial insurance.
Pain management is a diagnosis before it is a procedure. The job here is to find which part is making your pain, confirm it, and treat that. We do not manage you forever and hope the pain settles.
What pain management means here
Most people come in already told their imaging looks “normal,” or that everything on it is abnormal and nothing explains the pain. Both are common, and neither is a diagnosis. An MRI shows the body’s parts. It does not tell you which part is sending the pain signal. That is what a diagnostic block is for. We numb one specific part under image guidance and see if the pain goes with it.
Every procedure at this practice is image-guided. That means we see where the needle goes instead of guessing. Care is physician-led by Dr. Gurpreet Singh Padda, MD, MBA, MHP, who is board certified in interventional pain and works at this location. If a procedure is not the right answer, we will say so. physical therapy, medication management and metabolic care often do more for durability than another injection would.
Conditions we treat
These are the most common reasons people are sent here. The full list is on conditions we treat.
Low Back Pain
The most common complaint, and the one most often treated without a real diagnosis.
Sciatica
Pain mostly in the leg, from a pinched or irritated nerve root.
Neck Pain
Including cervical radiculopathy (a pinched nerve in the neck) and headache that starts in the neck.
Spinal Stenosis
Narrowing that limits how far you can walk before you have to stop.
Herniated Disc
Most get better without surgery when the right part is treated.
Knee Pain
Osteoarthritis and pain after surgery, including genicular nerve options (the nerves around the knee).
Diabetic Neuropathy
Burning, numbness and night pain. We treat it along with the metabolic cause.
Fibromyalgia
Pain all over that needs a different approach than a structural one.
How we treat it
Diagnose first, treat second, and do only what the diagnosis supports. Every procedure is explained on treatments and procedures.
Diagnostic Nerve Block
Shows which part is making the pain before anything is treated.
Epidural Steroid Injection
For nerve-root pain, placed under image guidance.
Medial Branch Block
The diagnostic step that decides whether ablation is the right fit.
Radiofrequency Ablation
Longer relief for facet-mediated pain that blocks confirmed. That is pain from the facet joints.
Facet Joint Injection
Aims at the small joints at the back of the spine that keep it steady.
Spinal Cord Stimulator Trial
A trial first. You find out if it works before anything is put in your body.
Joint Injection
Shoulder, hip, knee and sacroiliac joints under guidance.
Physical Therapy
Matched to your real diagnosis, not handed out the same for everyone.
Medication, and what this practice will not do
This is not a practice for keeping or raising an opioid prescription. We go the other way. We lower opioid use where they are not helping. We treat the source of the pain directly so you need less medication. That is stated plainly on opioid stewardship. Read it before you book if medication is the reason you are calling.
Medication still has a role, and medication management is part of the practice. The difference is that it is one tool among several. It is not the whole plan.
Missouri Medicaid is accepted here
We accept Missouri Medicaid (MO HealthNet). If you have been turned away from pain practices before, that is often the reason — details are on Missouri Medicaid. Commercial insurance and Medicare are also accepted; see insurance and billing.
One thing worth knowing in advance: when a procedure needs prior authorization, we will obtain it — but an authorization is a coverage decision, not a guarantee of payment. Your plan makes the final determination after the claim is filed.
Your first visit
The first visit is a talk and an exam, not a procedure. Bring your imaging discs or reports, a list of what you take, and what you have already tried. If you have an MRI report and cannot make sense of it, understanding your MRI report explains the words before you arrive.
Appointments are required. See new patients for what to bring, or request an appointment. If your pain follows a crash or a work injury, start at accident and injury care instead. The paperwork rules are different.
Where we are, and who we see
12174 Natural Bridge Rd, Suite 110, St. Louis, MO 63044. Monday to Friday, 8:00 a.m. to 4:00 p.m. Call us.
Patients come from across St. Louis County and St. Charles County, and south through Jefferson County. There are pages just for St. Louis City, Clayton, Kirkwood, Webster Groves, Creve Coeur, Maryland Heights, Chesterfield, Ballwin, Sunset Hills and Fenton.
West through St. Charles County: St. Charles, St. Peters, O’Fallon, Lake St. Louis and Wentzville. South through Jefferson County: Arnold, Festus and Farmington. Every community we serve is listed on locations.
Common questions
What does a pain management doctor actually do?
Finds the source of the pain and treats that source. That means a history and an exam. It means reading your imaging against your symptoms, not on its own. It often means a diagnostic nerve block to confirm which part is to blame before any treatment procedure is offered.
Do I need a referral to be seen?
No. You can book directly. Some insurance plans require a referral for coverage, and we will tell you when you call — insurance and billing covers how that works.
Will I be put on opioids?
That is not how we work. This practice works to lower opioid use, not keep or raise it. We treat the source of the pain directly so less medication is needed. See opioid stewardship.
Do you take Missouri Medicaid?
Yes. MO HealthNet is accepted, which is a common reason patients are referred here after being turned away elsewhere. Details on Missouri Medicaid.
What should I bring to the first appointment?
Imaging discs or reports, a current list of your medications, and a short history of what you have already tried. New patients has the full list, and understanding your MRI report helps if the report itself is the confusing part.
Is an injection the only option?
No, and often it should not be the first one. Physical therapy matched to the diagnosis, medication management and metabolic and lifestyle care do more for a lasting result than any single procedure does.
Sources
- Cohen SP et al. Consensus practice guidelines on interventions for lumbar facet joint pain from a multispecialty, international working group. Regional Anesthesia and Pain Medicine, 2020. PubMed 32245841
- Jensen MC et al. Magnetic resonance imaging of the lumbar spine in people without back pain. The New England Journal of Medicine, 1994. PubMed 8208267
- Brinjikji W et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR American Journal of Neuroradiology, 2014. PubMed 25430861
Hurt in an accident? Start here.
You do not need a lawyer, a police report or a referral to be seen. Bring your symptoms and we will work out the rest.
Monday–Friday, 8:00 a.m. – 4:00 p.m. Same-day appointments are often available for new accident and injury patients.