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Pain Management in St. Louis

Pain management is a diagnosis before it is a procedure. The work here is to identify which structure is actually generating your pain, confirm it, and treat that \u2014 rather than manage you indefinitely and hope the pain settles.

What pain management means here

Most people arrive having already been 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 describes anatomy; it does not tell you which structure is producing the signal. That is what a diagnostic block is for \u2014 numb one specific structure under image guidance and see whether the pain goes with it.

Every procedure at this practice is image-guided, which means placement is confirmed rather than assumed. Care is physician-led by Dr. Gurpreet Singh Padda, MD, MBA, MHP, who is board certified in interventional pain and practices at this location. If a procedure is not the right answer, we will say so \u2014 physical therapy, medication management and metabolic care often do more for durability than another injection would.

Conditions we treat

The most common reasons people are referred here. The full list is on conditions we treat.

Low Back Pain

The most common presentation, and the one most often treated without a working diagnosis.

Sciatica

Leg-dominant pain from a compressed or irritated nerve root.

Neck Pain

Including cervical radiculopathy and headache arising from the neck.

Spinal Stenosis

Narrowing that limits how far you can walk before you have to stop.

Herniated Disc

Most improve without surgery when the right structure is targeted.

Knee Pain

Osteoarthritis and post-surgical pain, including genicular nerve options.

Diabetic Neuropathy

Burning, numbness and night pain \u2014 treated alongside the metabolic driver.

Fibromyalgia

Widespread pain that needs a different framework than a structural one.

How we treat it

Diagnostic first, therapeutic second, and only what the diagnosis supports. Every procedure is detailed on treatments and procedures.

Diagnostic Nerve Block

Confirms which structure is generating 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 appropriate.

Radiofrequency Ablation

Longer-lasting relief for facet-mediated pain that blocks confirmed.

Facet Joint Injection

Targets the small stabilising joints at the back of the spine.

Spinal Cord Stimulator Trial

A trial first \u2014 you find out whether it works before anything is implanted.

Joint Injection

Shoulder, hip, knee and sacroiliac joints under guidance.

Physical Therapy

Matched to the actual diagnosis rather than issued generically.

Medication, and what this practice will not do

This is not a practice for continuing or escalating an opioid prescription. The direction of travel here is the opposite one: reduce opioid burden where it is not helping, and treat the pain generator directly so that less medication is needed. That is stated plainly on opioid stewardship, and it is worth reading 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 distinction is that it is one tool among several rather than the plan itself.

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 \u2014 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 \u2014 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 appointment is a conversation and an examination, not a procedure. Bring your imaging discs or reports, a list of what you are taking, and what has already been tried. If you have an MRI report and cannot make sense of it, understanding your MRI report translates the language 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 \u2014 the documentation requirements 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 (314) 310-5577.

Patients come from across St. Louis County and St. Charles County, and south through Jefferson County. There are dedicated pages 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. In practice that means a history and examination, reading the imaging against your symptoms rather than in isolation, and often a diagnostic nerve block to confirm which structure is responsible before any therapeutic 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 \u2014 insurance and billing covers how that works.

Will I be put on opioids?

That is not the model here. This practice works to reduce opioid burden rather than continue or escalate it, and treats the pain generator 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 medication list, and a short history of what has already been 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 carry more of the durable result than any single procedure does.

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.