Fluoroscopic image of the lumbar spine during a guided sympathetic chain injection at Padda Institute, St. Louis

Cancer pain management · St. Louis

Cancer Pain Management in St. Louis

Cancer pain management here uses procedures that interrupt the pain signal directly, so you need less medicine.

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Call (314) 481-5000Text (314) 886-5902

Same-day and emergency appointments are available.

What can you do when cancer pain medication is not enough?

Pain from cancer and its treatment often does not yield to pills at doses a person can stand. The dose needed for relief brings drowsiness, confusion, constipation and nausea. Patients are left choosing between pain and being present.

That trade-off is not always needed. When the pain travels along a nerve path we can find, that path can often be interrupted directly. The result is less medicine. It does not replace cancer doctors or palliative (comfort) care. We work alongside both, not instead of them.

Interventional pain care is under-used in cancer. That is mostly because patients are not sent, not because it does not work.

Fluoroscopy-guided injection being performed by Dr. Padda at Padda Institute, St. Louis

Why does cancer pain need more than one treatment?

Cancer pain is rarely one problem. Organ, bone, nerve and mechanical pain often show up in the same patient. Each responds to something different. So the exam decides the treatment, not a standard menu. And more than one approach is usually needed.

Celiac plexus block interrupts the visceral (organ) pain path that carries signals from the pancreas and upper belly organs. Its main use is deep belly pain from the organs, most often chronic pancreatitis. In pancreatic cancer it has a well-proven role. It can sharply cut the need for opioids.

Other sympathetic blocks target pain from the pelvis and lower belly the same way. They interrupt the visceral (organ) pain path instead of dulling the brain.

Vertebral augmentation — vertebroplasty and kyphoplasty — treats painful vertebral compression fractures (crushed bones in the spine). Most of these fractures come from osteoporosis (thin bones). Fractures from cancer that has spread, or from bone weakened during treatment, are less common. The reason to treat is the same either way: an active fracture where the pain comes with movement and weight.

Peripheral nerve blocks treat pain that stays in one nerve’s area. That includes some pain after surgery and after radiation.

Ketamine can help when central sensitization has set in (the nervous system has become oversensitive) and higher opioid doses no longer help.

Can pain from chemotherapy, surgery or radiation be treated?

Not all cancer pain comes from the tumor. Nerve damage from chemotherapy (chemotherapy-induced peripheral neuropathy) is common. It often lasts after treatment ends. It is often accepted as permanent when no one has ever checked it.

We check it like any nerve damage. We use electrodiagnostic testing to find what is affected and how badly. Then we treat the nerve and the tissue around it. That includes photobiomodulation when poor blood flow and inflammation are holding back healing.

Pain after surgery and after radiation can be treated too. It is also rarely sent our way.

How does pain management work with your oncologist?

We do not take over cancer care. Your cancer doctor runs treatment of the disease. We treat the pain. We talk with your team instead of working in a silo.

Timing matters. Procedures are often thought of only at the very end. By then the patient is least able to handle a procedure, and the window for real benefit has shrunk. A celiac plexus block done early in pancreatic cancer does far more good than the same block done in the final weeks.

If you or your doctor are not sure a procedure applies, ask sooner rather than later.

Reduce The Medication Burden

Procedures can interrupt the pain signal directly. Call to talk about whether one fits you.

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What Our Patients Say

Individual results vary. These are unpaid patient testimonials shared with permission and are not a guarantee of outcome. See all patient stories.

Cancer Pain FAQs

No. We treat the pain and keep them in the loop. Your cancer doctor still runs treatment of the disease itself.

Rarely, but earlier is far better. Procedures work best while a patient is well enough to handle one and there is time for the benefit to matter.

Often, and that is usually the aim. When a block interrupts most of the pain path, medicine can often be lowered. That helps alertness, bowel function and quality of life.

It should be tested, not assumed permanent. We test to find what is affected and how badly. Then we treat the nerve and the tissue around it. Some of it can change.

Most are done under local anesthetic (numbing medicine) with no sedation; you stay awake. Kyphoplasty and vertebroplasty use mild sedation. They take well under an hour. How well you can handle it is part of the decision. We weigh your current condition instead of using a set protocol.

Ask about a procedure sooner rather than later. Sometimes pills at doses you can stand do not control the pain. Then a pain path that follows a known nerve can often be interrupted directly. We use a celiac plexus block, another sympathetic block or a peripheral nerve block. The goal is less pain on less medicine, so you can stay alert and present. We work alongside your cancer and palliative care teams.

There is no single best one, because cancer pain is rarely one problem. Organ, bone, nerve and mechanical pain often occur together. Each responds to something different. So the exam decides the treatment, not a standard menu. Most patients need a mix. A procedure can often lower the medicine dose, and with it the drowsiness, confusion and constipation.

Yes. A celiac plexus block interrupts the visceral (organ) pain path that carries signals from the pancreas and upper belly organs. In pancreatic cancer it has a well-proven role. It can sharply cut the need for opioids. Timing matters. The same block does far more good early in pancreatic cancer than in the final weeks. So raise the question with your doctor soon.

Often, yes. Vertebroplasty and kyphoplasty treat painful vertebral compression fractures. The bone may have been weakened by osteoporosis, by cancer that has spread, or during cancer treatment. The reason to treat is the same in every case: an active fracture where the pain comes with movement and weight.

Send A Message

For questions, fill out the form below.

Prefer not to fill in a form?

Call (314) 481-5000Text (314) 886-5902

Same-day and emergency appointments are available.

Pain Conditions We Treat

At Padda Institute, our pain management specialists provide the guidance and treatments tailored to your needs. We diagnose and evaluate to determine your best treatment plan, so that you can experience chronic pain relief like never before.

Radiofrequency generator ramping up at the start of a treatment cycle

Celiac Plexus Block

A celiac plexus block puts local anesthetic (numbing medicine) around the celiac plexus, a nerve bundle in the upper belly, using live imaging. Sometimes we add a neurolytic…

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Fluoroscopic image of the lumbar spine during a guided sympathetic chain injection

Pancreatitis Pain Treatment

Pancreatitis is the inflammation of the pancreas. The pancreas is a large gland behind the stomach and near the first part of the small..

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Exterior of the Padda Institute clinic at 4477 Woodson Rd, St. Louis, Missouri, at night

Ketamine for RSD, CRPS and Refractory Nerve Pain

Ketamine blocks the NMDA receptor. That is why we consider it for RSD, CRPS and stubborn nerve pain once standard care falls short. We offer it by vein…

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Part of our complete guide to Interventional Pain Management in St. Louis.