Why an Illinois patient crosses the river for this

Most pain care in the Metro East happens inside a hospital system. A hospital system is built to move people through departments. The scan is read in one building and the shot is given in another. The doctor who ordered it is rarely the one holding the needle. That is not malice. It is an assembly line. Assembly lines are very good at treating where a symptom is. They are very bad at asking what caused it.

This is an independent practice with one physician. He takes the history, does the exam, reads your imaging with you, orders the bloodwork and does the procedure. Dr. Padda is the medical director. There are no drug company reps in the building. The first visit is long on purpose. The reason is that people who drive here from Belleville or Edwardsville have usually been examined for two minutes and imaged for two years. That ratio needs to be flipped.

Why does pain keep going after the injury settles?

A disc, a facet joint or a sacroiliac joint is where the pain signal starts. Whether that signal becomes a life-altering pain depends on the terrain it travels through. Insulin resistance and metabolic inflammation lower the point at which a nerve fires. They thin the tiny blood vessels the nerve needs for repair. They keep the immune cells around a hurt nerve root switched on long after the injury has settled. Broken sleep takes away the overnight window when the spinal cord turns down its own alarm. So the same input hurts more the next day. Add a rotating shift at the refinery, a forklift at a Gateway Commerce Center warehouse, or a commute that eats the hour you would have walked. Now the mechanics of the spine are the smallest part of the problem.

None of that is an excuse to skip the procedure. It is the reason the procedure is paired with the metabolic work. It is also paired with Acceptance and Commitment Therapy, done in-house by a licensed, pain-trained behavioral clinician. Roughly 40 to 50 percent of the plan is lifestyle and behavior. Each piece has a body-based reason behind it. That is because a nerve root that has been decompressed and de-inflamed still has to be retrained to stop sending alarms. Read the full mechanism at metabolic health and pain.

What does an interventional pain management doctor do?

• Diagnostic blocks before anything lasting. A medial branch block or a level-specific epidural tells us which part is making the pain. We learn that before we commit to radiofrequency ablation or a device.
• Image-guided injections for the spine, the sacroiliac joint, the knee and the hip. Every one is done under fluoroscopy or ultrasound, with contrast dye to confirm the target.
• Orthobiologics: PRP injections, bone marrow concentrate and microfragmented fat for a worn knee, hip or shoulder and for tendons that keep flaring. They are made from your own tissue and placed under ultrasound, with no sedation.
• Neuromodulation: spinal cord stimulation and peripheral nerve stimulation. Each is trialed before it is implanted. There is also an intrathecal pump for when pills by mouth have become the problem.
• Vertebral augmentation (kyphoplasty) for a painful compression fracture, and ketamine by the sublingual (under the tongue), intranasal (in the nose) or topical (on the skin) route for complex regional pain syndrome.
• The taper for patients who arrive dependent on an opioid. We do it by replacing what the drug was doing, not by just taking it away. See opioid stewardship.

Some cases need implants, nerve decompressions or other operating-room procedures. These come after conservative and interventional options run out. They can be done under Dr. Padda’s privileges at Anderson Hospital in Maryville, on the Illinois side, or at SSM Health St. Clare Hospital in Fenton. The blocks and the image-guided procedures happen at Woodson. You can also book a consult at the Illinois office in Troy, 505 Buckeye Dr, Suite 200.

How far is the clinic from the Metro East?

Every time below assumes no traffic on the bridges. You know your bridge better than a map app does. From East St. Louis it is about 20 minutes, from Granite City about 25, and from Alton or Wood River about 30. Glen Carbon and Fairview Heights sit at roughly 35 minutes; Collinsville and Maryville just under 40. Edwardsville, Belleville, Swansea, O’Fallon, Shiloh, Troy and Godfrey are all about 40. Bethalto and Columbia run about 45, and Highland about 55.

From Madison County take I-270 west over the Chain of Rocks, then I-170 or Lindbergh down to I-70 and the Woodson exit beside the airport. From St. Clair County, I-64 west over the Poplar Street Bridge to I-170 north does the same job. The procedure clinic is off I-70 at Woodson Road, next to St. Louis Lambert International Airport, with parking at the door. The Illinois office is at 505 Buckeye Dr, Suite 200, in Troy. You are driving that far, so the visits are planned to save trips. Diagnosis comes on the first trip and the block on the second. Results come by phone or video when that is clinically appropriate. The details are in for Illinois patients and in every town page from the Metro East hub.

Can I choose my own doctor after a crash or work injury in Illinois?

Illinois is an at-fault state, and the general limitations period for a personal-injury claim is two years under 735 ILCS 5/13-202. An injured Illinois worker may choose their own physician, subject to the two-choice rule in 820 ILCS 305/8(a) unless the employer has an approved preferred provider program; the Illinois Workers’ Compensation Commission administers the claim. None of that is legal advice, and a case-specific question belongs with an attorney or the IWCC. Here is what it means for you. The doctor who examines you after a crash on I-55 or a lift injury at the steel works can be one you chose. And the record we build is written to hold up to a hostile reading. Start with after a car accident, injured at work, and, if you represent the patient, for attorneys.

Will pain management take me off opioids?

Arriving patients in this practice average more than 90 morphine milligram equivalents a day after two and a half years or more in pain. Under interventional treatment, 21% are fully weaned within 90 days and 34% within one year, and across the established population fewer than 1% remain above 90 MME. Practice-reported figures from our own population, not trial outcomes, and individual results vary. Nobody is cut off on day one and nobody is lectured; the taper follows the procedures, not the calendar.

Common questions

Related reading

• For Illinois patients: records, insurance, the bridge and the drive home
• About Dr. Padda
• Pain management across the Metro East
• Your first visit, from Illinois
• When injections stop working