The practice that examines your neck before it believes your scan.

ABOUT THIS PRACTICE

An interventional pain practice that examines the neck before it believes the scan, and refines the diagnosis before anybody is sent anywhere.

What we do

We are an interventional pain practice in St. Louis. The work is diagnostic first and procedural second: establishing which structure is generating a person’s pain, and then treating that structure with the least invasive thing that will reach it.

For the neck specifically, that means the facet joints, the nerve roots, the upper cervical segments, the muscles, and the peripheral nerves in the arm — each of which has a distinct presentation, a distinct test, and a distinct treatment. Most people arrive having been treated for a category rather than a structure.

The physician

Dr. Gurpreet Singh Padda, MD, MBA, MHP is an interventional pain physician, addiction medicine specialist and obesity medicine diplomate, licensed in Missouri and Illinois. The combination is not incidental — chronic pain, medication dependence and metabolic health interact constantly, and treating one while ignoring the others is why a lot of pain treatment stalls.

Every page on this website is reviewed by him, and the review date is printed at the foot of each one.

How we work, stated as commitments

• We evaluate and refine the diagnosis before referring. Nobody is routed straight to a surgeon on the strength of a scan report and a symptom description. The exception is a genuine emergency, which goes urgently and without delay.
• We examine the shoulder and the arm at a neck appointment. The overlap is well documented and separating the two from history alone is unreliable.
• We test before we treat. Where a diagnostic block will answer a question, we do the block rather than assuming the answer.
• We say what the evidence does and does not support. Including where it is thin, and including where a treatment we offer has limits.

What we do not do

We do not manage the dental or occlusal side of jaw problems, we do not perform spine surgery, and we do not present procedures as cures where the literature does not support that. Where somebody genuinely needs a service we are not, we say so and we say why.

We also do not price treatment on this website. Cost depends on what is actually indicated after an evaluation, and quoting a figure before that evaluation would be guessing.

Where we are

12174 Natural Bridge Rd, Suite 302, St. Louis, MO 63044. Parking is at the door. The building is the three-story one with the lit entrance canopy.

We see patients from across the St. Louis region and from Illinois, and the practice is licensed in both states.

Working with the rest of your care

Most people arriving here already have a primary care doctor, and many have seen physical therapy, a chiropractor, a neurologist or a surgeon. None of that is a problem and none of it is duplicated unnecessarily — what we add is the diagnostic step that is frequently missing between a symptom and a treatment.

Where physical therapy has stalled, the usual reason is that it was aimed at the wrong structure rather than that it was done badly. Identifying the actual generator often makes the same rehabilitation work.

Medication, and our position on it

Medication has a role and it is not the plan. Anti-inflammatory treatment matters where inflammation is the mechanism. Neuropathic agents matter where the pain is neuropathic. Both are more useful when they are aimed at an identified problem for a defined period than when they accumulate over years.

Long-term opioid therapy for chronic neck pain is not something we build a treatment plan around, and where somebody arrives on it, reducing the dependence while actually treating the pain generator is the work — not a condition of being seen.

What that position looks like in published figures

This is not only a stated preference. In August 2026, on International Overdose Awareness Day, Dr. Padda published the opioid outcomes from his interventional practice: patients typically arrive above 90 morphine milligram equivalents a day after more than two and a half years in pain; 21% are completely off opioid pain medication within 90 days of active treatment and 34% within one year; and most of those who cannot be fully weaned are brought under 30 MME a day.

Those are practice-reported figures from his own patient population, not trial outcomes, and individual results vary. Reported by AP News; the full release is here.

Illinois patients

The practice is licensed in Illinois as well as Missouri and we see patients from across the metro east regularly. Nothing about the evaluation differs; the administrative side does, and it is handled at booking rather than left for you to work out.

What people ask before booking

Do I need a referral?

Not to be seen. Bring any imaging and any prior nerve studies if you have them, and the list of what has already been tried. What happens at the first appointment.

Will I get an injection at the first visit?

Not usually. The first visit is an evaluation. Procedures follow a diagnosis rather than substituting for one. How candidacy is assessed.

What should I bring?

Imaging on a disc or portal access, prior test results, a list of medications with doses, and a note of what has and has not helped. Where the practice sits in St. Louis.

How long is the first appointment?

Long enough to examine the neck, the shoulder and the arm properly, and to go through the history in detail. That is the appointment that decides everything after it. Where the practice sits in St. Louis.

Related reading

• What to expect at your first visit
• Am I a candidate?
• Neck pain doctor in St. Louis
• When a neck problem is urgent
• Why your MRI does not explain it
• Connect with us

Why the diagnosis gets so much of the attention here

Neck pain is not one condition. The facet joints, the discs, the nerve roots, the upper cervical segments, the muscles and the peripheral nerves in the arm all produce overlapping pictures, and several of them can be true in the same person at the same time.

Treatment that is aimed at the wrong one of those does nothing, and it does nothing in a way that is easy to misread as the condition being untreatable. A great many people who describe themselves as having failed everything have in fact had one thing tried repeatedly at a structure that was never the source.

What “interventional” means and what it does not

It means we can put a needle precisely where a question needs answering or a treatment needs delivering, under image guidance, with contrast confirming position before anything is injected. That is a genuine advantage over treatment delivered by inference.

It does not mean every problem gets a needle. A substantial share of what walks through the door is muscular, postural or load-related and is treated without any procedure at all. Owning an intervention is not a reason to use it.

The standing policy on referral

We evaluate and refine the diagnosis before routing anybody onward. That applies to surgeons, and it applies to every other service too. The reason is simple: a referral made on a scan report and a symptom description sends the patient into a service that will treat the part it can see, and the part it can see is not always the part that hurts.

The exception is genuine emergency. Cord compression signs, a progressive neurological deficit, or suspected giant cell arteritis with visual symptoms go urgently and immediately. Those are on a separate page and they are the one situation where speed outranks refinement.

On evidence, and on saying where it runs out

Several things we do have strong support. Some have moderate support. A few are reasonable clinical practice in populations that trials have largely excluded — people with multiple problems at once, significant metabolic disease, or long-standing medication exposure, who tend to be screened out of the studies and are heavily represented in a real clinic.

Where that is the situation we say so, rather than borrowing certainty from a trial that did not include anybody like you. It is the more useful answer even though it is the less comfortable one.