Pain management for Bonne Terre patients happens at Gateway Midwest Healthcare in St. Louis, about 65 minutes by US 67 and I-55. We most often treat osteoarthritis, facet joint pain, spinal stenosis and low back pain, planned as few trips as the treatment allows.
Bonne Terre sits on the Highway 67 corridor, and the drive to us is long but direct.
Why does back pain around Bonne Terre go years without a clear diagnosis?
The town’s mining history left a population with a high burden of musculoskeletal wear, and a medical infrastructure oriented toward general practice rather than interventional treatment.
What we most often provide is a specific diagnosis for pain that has been described generically for years. ‘Arthritis in the back’ covers several distinct conditions with different treatments, and separating them is usually the first useful thing anyone has done.
The roads around Bonne Terre, and what they send us
US 67 runs past Bonne Terre, the northern end of the lead belt and the part of it closest to the metro.
Local geography also determines how late people present. Where the nearest alternative is close, patients try it first, and we tend to see the problems that did not settle rather than the ones that did.
Highway 67 is the route north. Long, fast, two-lane-plus road with limited services along parts of it.
What we treat most for Bonne Terre patients
Osteoarthritis
Joint wear that is describable, diagnosable and treatable.
Facet joint pain
Spinal arthritis that actually generates pain, confirmed by block.
Spinal stenosis
Narrowing whose symptom is walking distance rather than constant pain.
Low back pain
Described generically for years and never separated out.
Is arthritis in the back one condition or several?
‘Arthritis in the back’ covers at least three distinct conditions with different treatments. Facet joint arthritis produces one-sided pain worse on extension and rotation. Disc degeneration produces central pain worse on sitting and flexion. Spinal stenosis, which results from both plus ligament thickening, produces leg symptoms on walking and almost no pain at rest.
They are distinguished clinically rather than radiologically, because all three appear on the scan of nearly everyone past sixty. What separates them is the pattern of provocation and relief.
Getting that separation right determines whether the next step is a facet block, an epidural, or a flexion-based walking program — three treatments that are largely useless for each other’s conditions.
How are visits from Bonne Terre scheduled?
For Bonne Terre patients the work most often centers on osteoarthritis, facet joint pain, spinal stenosis and low back pain. Each of those has its own page setting out how it is diagnosed here and what treatment actually involves, and reading the relevant one before the appointment tends to make the visit more productive.
It is about an hour by US 67 and I-55 from here, so appointments are grouped deliberately. Blocks that must be separated in time are separated; everything else is combined.
Please bring imaging, medications and a short history of previous treatments with their outcomes. Where records exist elsewhere, telling us in advance lets us request them before you travel.
Sixty-five minutes each way, planned as few trips as the treatment genuinely allows.
We also see patients from Park Hills, Farmington and De Soto. The full list is on areas we serve.
To book, call or text us. Monday to Friday, 8:00 a.m. to 4:00 p.m. We are at 12174 Natural Bridge Rd, Suite 110, St. Louis, MO 63044 — about 65 minutes from Bonne Terre, St. Francois County. No referral is needed to book and no attorney is needed to be treated after an accident.
What helps arthritis pain short of a joint replacement?
Arthritis on an X-ray and pain from arthritis are not the same thing, and the gap between them is where most of the useful work sits. Radiographic severity correlates only loosely with symptoms, which is why two people with similar films can function entirely differently.
For knees specifically, a genicular nerve block tests whether the nerves carrying pain from the joint are responsible, and where they are, ablating them can give many months of relief without touching the joint itself. That is a reasonable option for patients who are not candidates for replacement or who want to defer one.
The metabolic contribution is real too. Inflammatory load and blood sugar control affect joint pain independently of the structural changes, and addressing them is not a consolation prize.
Questions we get from Bonne Terre
I was told I have arthritis in my back. Is that a diagnosis?
It is a description. Several distinct conditions sit under it and they are treated differently.
Facet Arthropathy — What It Means explains one of the conditions under that label.
How long before I know if this is working?
Diagnostic blocks answer within hours. Therapeutic injections build over three to seven days. Ablation takes two to three weeks.
Do you accept Medicare?
Yes, including most Medicare Advantage plans.
Insurance & Medicaid has the details.
I was told I am bone on bone. Is there anything short of replacement?
Often yes. Blocking or ablating the nerves that carry pain from the joint can provide months of relief and is worth discussing.
Genicular Radiofrequency Ablation covers the procedure itself.
Do injections into the joint help?
Sometimes, and for a limited period. We establish what is generating the pain rather than repeat an injection indefinitely.
Joint Injection covers the injection itself.
What is pain management?
Pain management is finding the specific cause of your pain and treating that cause. Many Bonne Terre patients have been told for years that they have arthritis in the back. That label covers facet joint arthritis, disc degeneration and spinal stenosis, and each one is treated differently. Separating them is usually the first useful step, and it decides everything that follows.
What does a pain management doctor do?
A pain doctor works out which structure is actually causing the pain. Scans are not enough, because facet arthritis, disc wear and spinal stenosis show up on the scans of nearly everyone past sixty. What separates them is the pattern: what makes the pain worse, what eases it, and whether walking brings on leg symptoms. That pattern points to the right treatment.
What are the different types of pain management?
For back and joint pain, the main options here are a facet block, an epidural, a flexion-based walking program, and for knees a genicular nerve block followed by ablation. They are not interchangeable. Each one treats a different condition and does little for the others, so the choice depends on an exact diagnosis. Lowering inflammation and improving blood sugar control also ease joint pain, alongside any procedure.
12174 Natural Bridge Rd, Suite 110
St. Louis, MO 63044
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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.