The scan was normal. Nobody has examined your neck since.

NECK PAIN DOCTOR · ST. LOUIS

Most people in St. Louis with a neck that will not settle have already seen someone. The problem is rarely that nobody looked. It is that nobody established which structure is generating the pain before treating it.

What an interventional neck workup actually involves

“Interventional” means the diagnosis is made with a needle rather than inferred from a picture. For the neck that matters more than almost anywhere else in the body, because the structure that most often causes persistent neck pain — the facet joint — is invisible on every scan you have had.

The sequence is deliberately unglamorous. Examine, decide which structure is the likely generator, confirm it with a diagnostic block, and only then treat the thing that was confirmed. Skipping the middle step is why so many people have had injections that did nothing.

Where we are, and who comes here

The clinic is at 12174 Natural Bridge Rd, Suite 302, next to DePaul Hospital, just off the junction of 270 and 70 and west of the airport. That puts it inside twenty minutes of most of north and west county and straightforward from St. Charles.

• St. Charles — about 15 minutes
• Maryland Heights — about 11 minutes
• Creve Coeur — about 16 minutes
• Florissant — about 14 minutes
• St. Peters — about 22 minutes
• Chesterfield — about 27 minutes

What we treat, specifically

This is a neck practice. That narrowness is the point — it means the facet joints, the nerve roots and the occipital nerves get examined properly rather than as a subsection of a general spine appointment.

• Facet-mediated neck pain — the most common cause of persistent axial neck pain, and the one that needs a block to identify.
• Cervical radiculopathy — a nerve root, and the arm symptoms that come with it.
• Cervicogenic headache — headache generated by the upper cervical segments rather than by a primary headache disorder.
• Whiplash that never finished — and the specific reason it so often does not.
• Work-pattern neck pain — worse on Thursday, fine by Sunday.
• Persistent pain after neck surgery.

Why a second opinion here is not the same appointment again

Most people arriving have had an X-ray, an MRI, a course of physical therapy and possibly an injection into a level that nothing had identified. Repeating that sequence produces the same result.

What changes the outcome is establishing the pain generator. If the facets are responsible, a radiofrequency neurotomy is a durable answer and physical therapy alone was never going to reach it. If a nerve root is responsible, that is a different treatment and a different natural history. If neither is, we will tell you that too rather than inject something.

What this practice will not do

It will not inject a level that nothing has identified. It will not run a series of procedures with no stated endpoint. It will not tell you a normal MRI means there is nothing wrong, and it will not tell you an abnormal one means there is. And where the finding points to a surgeon — progressive weakness, cord signs, a deficit that is worsening — you will be told that on the day rather than after a course of something.

Why St. Louis produces a particular kind of neck

Two occupational patterns dominate what comes through this door. The first is the distribution and logistics work concentrated along the 270 corridor and around the airport — repetitive overhead reaching, sustained loaded postures, and a cadence set by a shift rather than by the tissue. The second is desk work, where the load is smaller and the duration is the whole problem.

They present differently and are treated differently, which is worth knowing before booking. The warehouse neck usually has a facet component and a mechanical history. The desk neck usually has a muscular and postural driver with facets that have been recruited over years. The weekly pattern separates them faster than imaging does.

What people in St. Louis ask before booking

Do I need a referral?

No. You can book directly. If you have imaging and prior records, bring them; if you do not, the examination determines what is worth ordering. What the first visit covers.

Is this the same as the Padda Institute?

Same physician and the same standards. This site exists because the neck deserves more depth than it gets as one section of a general pain practice, and the workup here is neck-specific. How facet pain is confirmed.

How long before I know what is wrong?

Usually the first visit produces a working diagnosis and a plan for confirming it. A diagnostic block, where indicated, is a separate short appointment and the answer from it is immediate. Whether you are a candidate.

What if the answer is that I do not need a procedure?

Then that is what you are told, and it happens regularly. An assessment that ends in a loading program and a discharge is a legitimate outcome. How treatment gets paid for.

What the first appointment costs you in time

About an hour, most of which is examination and conversation rather than paperwork. Nothing is injected on a first visit. You leave with a working diagnosis, a plan for confirming it, and a straight answer about whether there is anything worth doing.

A meaningful proportion of people are told the answer is a loading program, a different specialty, or time. That is a real outcome rather than a soft refusal, and it is why the assessment is worth having even if you end up somewhere else.

The bloodwork question

You will be asked about your metabolic health, which surprises people who came about their neck. Insulin resistance and metabolic inflammation change collagen quality, lower the load a structure tolerates, and slow what it rebuilds.

That is the difference between two people doing identical work and only one of them developing a problem. Bring recent bloodwork if you have it — A1C, fasting insulin, a lipid panel. Almost nobody does, and it is one of the more useful things you can put on the table.

Second opinions, and what makes one worth having

If your previous workup consisted of imaging and a course of therapy, a second opinion built on the same two things will reach the same place. What changes the answer is a test nobody has done: a diagnostic block that names the structure, nerve conduction studies that separate a root from an entrapment, or quantified gait testing where the balance has changed.

That is what to ask for — here or anywhere else.

Related reading

• Cervical facet syndrome
• Cervical radiculopathy
• Radiofrequency neurotomy
• What happens at the first visit
• When a neck problem is urgent
• Am I a candidate?