A first interventional pain appointment is a diagnostic visit. The goal is to find what is causing your pain. Then we agree on what would confirm it with more certainty. The goal is not to hand you a prescription and a follow-up date. Knowing that ahead of time changes what you bring and what you ask.
What to bring
The most useful things to bring are the ones nobody asks for until later.
- Your actual imaging, not just the report. Reports sum things up. The images let us match the findings to your symptoms.
- A list of what you have already tried, including what helped a little, what did nothing, and what made things worse. Failures are clues.
- Your current medication list, with doses, plus anything you stopped and why.
- A clear account of what you can no longer do. Walking distance, standing time, sleep, stairs. These tell us more than a number out of ten.
- Previous procedure records, if you have had injections before. Whether a block worked, and for how long, is one of the strongest clues we have.
What the visit involves
A history, a physical exam, and a review of past imaging and past treatment. The exam looks for a pattern that matches one structure. That is why it may focus on positions and movements, not on the spot that hurts most.
From there, we talk about what would confirm the source. Sometimes that is a diagnostic block. We numb one structure and watch whether the pain it should be making goes away. Sometimes it is electrodiagnostic testing to measure how well nerves really carry signals. Both give a result, not an interpretation. That is the point.
Questions worth asking
A good first visit should leave you able to answer these. If it does not, ask straight out.
- What do you think is causing this pain, and what else is still on the list?
- How would we confirm that, rather than assume it?
- If the test is negative, what does that rule out, and what comes next?
- What are we measuring to decide if this is working?
Practical details
There are two offices: 4477 Woodson Road, Suite 100, St. Louis, MO 63134, next to St. Louis Lambert International Airport, and 12174 Natural Bridge Rd, St. Louis, MO 63044. Both are listed with directions on the locations page. Hours are Monday to Friday, 8:00 AM to 5:00 PM.
You do not need a referral from another doctor. You do not need to be an existing patient. That holds for urgent cases too, which are covered on the same-day and emergency visits page.
On insurance: we accept commercial plans. But copays, deductibles and each plan’s rules on certain treatments vary. So check your own coverage for a planned procedure rather than assume. Office policies are laid out in the office policy FAQs.
Frequently asked questions
Do I need a referral to be seen?
No. You do not need a referral from another doctor, and you do not need to be an existing patient. Urgent cases are covered on the same-day and emergency visits page.
Will I get an injection at the first visit?
Not by default. The first visit finds what is causing the pain and what would confirm it. If a same-day procedure makes sense, we can discuss it. See same-day and emergency visits.
What should I bring with me?
Your imaging, not just the reports. A list of treatments you have tried and how each one went. Your current medicines. A clear account of what you can no longer do. Prior injection records are especially useful. See the range of pain treatments for context.
I am already taking opioids. What happens?
The aim is to treat the real source of the pain, so you need less medicine over time. We also avoid withdrawal during any cut-back. That approach is described under opioid stewardship.
How do I know which kind of specialist I need?
That question is worked through in choosing a pain specialist after treatment has not helped.
What does it mean when a doctor sends you to pain management?
Usually that the first plan has stalled and your doctor wants the source found. A referral to interventional pain management is a referral for diagnosis and targeted treatment: testing which structure produces the pain and treating it directly. It does not mean anyone thinks the pain is imagined, or that you are after medication. Learn more: do you need a referral for pain management?
To arrange a first visit, request an appointment, call (314) 481-5000, or text (314) 886-5902.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
