Troy sits at the I-55/70 junction, a short drive from Anderson Hospital in Maryville, where Dr. Gurpreet Singh Padda, MD, MBA, MHP is on staff with full privileges. We are licensed in Illinois as well as Missouri.
Troy has primary care and urgent care but no interventional pain practice. The realistic options are a hospital pain program or a private practice, and both mean a drive.
What you should get in exchange is a diagnosis rather than another prescription. If a specialist cannot tell you which structure is producing your pain and cannot demonstrate it, the distance was not worth covering.
This is the single most useful distinction for anyone trying to make sense of why one treatment helped a friend and did nothing for them. The two categories behave differently, feel different, and respond to entirely different things.
Mechanical pain comes from a structure under load — a joint, a disc, a tendon, a ligament. It is usually described as deep, aching or sharp on movement. It is reliably worse with particular positions and better with others, and it stays fairly local even when it refers into the buttock or thigh. It generally responds to treatment aimed at the structure: facet joint injection, sacroiliac joint treatment, radiofrequency ablation, or stabilizing a fracture.
Neuropathic pain comes from the nerve itself. It is described as burning, electrical, shooting or like pins and needles, often with numbness in the same area. It follows the nerve’s territory rather than staying local, is frequently worse at night with no obvious mechanical explanation, and can be provoked by things that should not hurt at all — a bedsheet on the feet, a waistband.
Anti-inflammatories do very little for it, which is why patients with neuropathic pain so often report that “nothing helps.” It needs treatment aimed at the nerve: selective nerve root blocks, electroanalgesia, hydrodissection where a nerve is tethered, or spinal cord stimulation in established cases.
And a third possibility. Pain that has persisted long enough can become self-sustaining, with the nervous system amplifying signals out of proportion to anything still wrong in the tissue. Treating the original structure at that point does not work, because the problem has moved upstream. That requires a different approach, sometimes including ketamine.
Most long-standing pain is a mixture. Working out the proportions is the point of the first visit.
I-55/70 west to I-270 west, then south toward Lambert Airport, brings you to 4477 Woodson Road. Our Bridgeton office at 12174 Natural Bridge Road is slightly closer. Around thirty-five minutes outside rush hour.
A diagnostic block settles it. A small volume of local anesthetic is placed at one candidate structure under image guidance. If numbing it reliably removes the pain, that structure is confirmed and a longer-lasting treatment aimed at it is justified. If not, we have ruled something out and have not committed you to a procedure that was never going to work.
Sciatica, neck and low back pain, diabetic neuropathy, vertebral compression fractures, headache, and pain that persisted after surgery.
Bring imaging on disc or through a patient portal rather than only the report, a current medication list with doses, and a short account of what has already been tried and what each attempt achieved.
Plan on about an hour for a first appointment. It is a consultation and examination, and it should end with you knowing what we believe is generating the pain, what would confirm it, and what the realistic range of outcomes looks like. You will not be asked to commit to a long course of anything on day one, and if a procedure is scheduled that involves sedation you will be told in advance that you need a driver.
Burning pain that is worse at night, especially with numbness or tingling, points toward a nerve rather than a joint. It is worth evaluating as neuropathic pain rather than treating as a strain.
Frequently, and that is why treatment sometimes has to address both. A disc can compress a nerve and irritate a joint simultaneously.
Electrodiagnostic testing can establish which nerves are affected and how severely. See electrodiagnostics.
Not necessarily. Nerves can recover, and the environment around them — circulation, inflammation, metabolic control — strongly affects whether they do. That is worth evaluating rather than assuming.
Call (314) 481-5000 or request an appointment. See also pain management for Illinois patients.
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Same-day and emergency appointments are available.