Villanueva Institute of Pain and Spine
What Is Pain Management?
Pain management can help you understand why you hurt, what your options are, and how to move toward a better quality of life. If pain has started to limit your work, sleep, movement, family life, mood, independence, or ability to do the things that make you feel like yourself, you deserve more than a rushed visit or a generic plan.
I’m Dr. John Villanueva, and at Villanueva Institute of Pain and Spine (VIPS), I approach pain management as a double board-certified physician in interventional pain management and physical medicine and rehabilitation (PM&R). That combination matters because I do not only look at pain as a symptom. I look at how pain affects your body, your function, your daily life, and your sense of hope.
Beyond being double board-certified, I am also a Certified Life Care Planner. This specialized training allows me to evaluate the long-term medical, rehabilitation, and future care needs of individuals with complex injuries and disabilities, further supporting my role as a medical-legal consultant and expert medical witness.
With the right evaluation and treatment plan, pain management may help you return to pieces of your life that have felt out of reach, whether that means getting through a workday, going back to school, walking with less fear, sleeping more comfortably, or feeling hopeful about your body again.
If you are looking for pain management in Burbank, CA, or you have been referred by your primary care doctor, surgeon, or another specialist, call VIPS at (818) 669-8895. You can also request an appointment online. We are located in Burbank and proudly serve patients visiting from Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.
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What Is Pain Management?
Pain management is a medical specialty focused on evaluating, diagnosing, and treating pain that affects your ability to function. This may include back pain, neck pain, joint pain, nerve pain, headaches, pain after surgery, pain after injury, cancer-related pain, or chronic pain that has not been fully explained.
Pain can be complicated because the place where you feel it is not always the place where it begins. Hip pain may be coming from the lumbar spine. Leg pain may be related to a pinched nerve. Headaches may involve muscles, joints, nerves, or more than one pain generator at the same time.
That is why I take time to listen, examine, review records, study imaging, and explain what I believe is happening in clear language. When I recommend treatments like epidural injections, radiofrequency ablation, nerve blocks, PRP injections, Intracept®, the mild® procedure, or another option, I want that recommendation to be based on your diagnosis, your goals, and the best path forward for your body.
Why Would You Go to a Pain Management Doctor?
Many patients feel uncertain when they are referred to pain management. You may wonder whether your doctor is passing you off to someone else. You may feel like your surgeon did not have an answer, or your primary care doctor did not have enough time to fully explore what is happening.
I do not want pain management to feel like that.
When you come to VIPS, I want you to feel that your pain is being taken seriously. My job is to listen to what has been happening, understand what you have already tried, identify what may have been missed, and help you make sense of the next step.
Pain management may be appropriate for many different conditions, including:
You may benefit from pain management if you have:
- Persistent neck pain, back pain, or joint pain
- Pain that travels into your arms, hands, legs, or feet
- Numbness, tingling, burning, weakness, or nerve symptoms
- Headaches or migraines that are not improving
- Pain after spine surgery or another operation
- Pain from arthritis, degenerative disc disease, or spinal stenosis
- Complex regional pain syndrome, also called CRPS
- Cancer-related pain
- Pain that has not improved with medication, physical therapy, rest, or prior procedures
- Pain that limits work, sleep, exercise, family life, or basic daily movement
You do not need to know exactly what is wrong before you come in. Often, the purpose of the visit is to finally begin getting a clearer answer.
Understanding Your Pain Management Options
Pain management is not one single type of care. Depending on what is causing your symptoms, your treatment plan may include one or more of the following approaches:
Interventional Pain Management
This may include targeted, image guided procedures like epidural steroid injections, nerve blocks, medial branch blocks, facet joint injections, radiofrequency ablation, joint injections, or other treatments designed to address a specific source of pain.
Chronic Pain Management
Chronic pain management is broader and may involve long-term planning, rehabilitation support, medication review, lifestyle adjustments, diagnostic testing, and ongoing care for pain that has affected your life for months or years.
Pain Management vs. Surgery
Sometimes pain management can help you avoid or delay surgery when that is medically appropriate. In other cases, your imaging, exam, or symptoms may suggest that a surgical opinion is the better next step. If I believe surgery should be considered, I will tell you directly and explain why.
Medication Management
Medication management may be appropriate when medications need to be adjusted, simplified, monitored, or used more safely as part of a larger treatment plan. The goal is not simply to prescribe medication, but to make sure every part of your care is thoughtful and medically appropriate.
How VIPS Can Help You Reclaim Function and Quality of Life
Choosing a pain management doctor is not only about lowering your pain score. It is about finding someone who will listen carefully, understand what pain has taken from your life, and help you work toward what you want to do again.
At VIPS, I begin with your story, your records, your imaging, your physical exam, and your goals. Maybe you want to lift your child, return to exercise, sit through a drive, sleep more comfortably, go back to school, or walk with less fear. Those details matter because pain management should be measured by function, mobility, and quality of life, not pain level alone.
My background in PM&R and interventional pain management allows me to look at the whole picture. Your pain may involve the spine, joints, nerves, muscles, prior injuries, prior surgeries, or several factors working together. I take time to connect those pieces before recommending a plan.
I will also be honest with you about what makes sense. If an image guided injection, nerve block, radiofrequency ablation, medication plan, regenerative treatment, or advanced procedure may help, I will explain why. If your imaging or exam suggests that surgery should be considered instead, I will tell you that too.
Many patients come to VIPS after feeling dismissed, rushed, or unheard. My goal is for you to feel that your pain is being taken seriously and that you have a clearer path toward better movement, better function, and a more hopeful quality of life.
Pain Management Should Help You Feel Heard
Many patients have had their pain dismissed before. Some have been told their pain is stress, some have been told it is psychological, and some have been told they are exaggerating. Others have been moved from office to office without anyone sitting down long enough to connect the details.
When I meet you, I do not want to jump to a solution before I understand the problem. I want to hear your story. I want to know where the pain is, when it started, what makes it better or worse, what you have already tried, and what this pain has taken away from you.
I believe that listening is not separate from good medicine. It is part of good medicine.
Why I Chose Pain Management and PM&R
My path into pain management is personal. My mother lived with severe congenital scoliosis and underwent multiple spinal fusion surgeries. Even after surgery, she continued to struggle with chronic pain, numbness, tingling, and weakness.
As a child, I remember feeling helpless because I did not understand why she was suffering. That experience stayed with me. It pushed me to study musculoskeletal medicine, nerve function, pain pathophysiology, rehabilitation, and interventional pain management in a serious and methodical way.
I never want you to feel like your suffering is a mystery that no one is willing to investigate. I may not be able to promise that pain will disappear completely, but I can promise that I will take your symptoms seriously and work with you to understand what can be done.
How PM&R Shapes the Way I Practice Pain Management
PM&R stands for Physical Medicine and Rehabilitation. It is the part of my training that keeps the focus on function.
Pain is not only about discomfort. Pain can affect your ability to walk, sit, drive, work, sleep, lift your child, exercise, perform, create, travel, cook, or spend time with people you love. When I ask about your pain, I also want to know what pain is preventing you from doing.
Maybe you want to work out again or sit through a car ride without constantly changing positions. Maybe you want to return to school or work, sleep through the night, walk with your spouse, or participate in family life without planning everything around pain.
Successful pain management is not always defined by making pain completely disappear. Sometimes the most meaningful improvement is getting enough relief to reclaim movement, confidence, independence, and quality of life.
What Makes VIPS Different from a Typical Pain Management Clinic?
The Right Care, Not the First Available Option
Sometimes an injection is appropriate. Sometimes physical therapy, medication management, diagnostic testing, lifestyle changes, regenerative medicine, or a multidisciplinary plan should come first. Sometimes your imaging shows that you should speak with a surgeon rather than spend time and money on a procedure that is unlikely to help.
Honesty Before Comfort
If I do not think a procedure is the right choice for you, I will tell you. I would rather be honest than offer treatment that does not match the problem.
Advocacy Rooted in Clinical Judgment
That honesty is part of advocacy. You may not always hear exactly what you expected to hear, but I want you to understand that my recommendation is coming from a place of clinical judgment, transparency, and respect for your long-term outcome.
A Research Minded Approach to Pain Care
Pain medicine is always moving forward, and I believe your care should be guided by more than routine or habit. As new treatments become available and clinical guidelines become more refined, I continue to study how those changes may apply to the patients I see in real life.
VIPS is also involved in clinical research, which is uncommon for a private pain management practice. Our work has been presented through respected organizations in pain medicine and physical medicine and rehabilitation, and our pre-medicine and pre-health interns help support that academic side of the practice. That research environment keeps us engaged with the direction of the field while still staying grounded in the needs of each patient sitting in front of us.
For you, that means I am looking at your care from several angles at once. I consider your story, your exam, your imaging, current evidence, clinical guidelines, and the way your body responds over time so that your treatment plan is thoughtful, current, and specific to you.
A Team That Takes Your Pain Seriously
Your experience at VIPS is shaped by more than one physician. Jessica Villanueva-Couette, FNP-BC, is an important part of our chronic pain care team. She sees patients for chronic pain consultations, medication management, and follow-up care.
Many patients appreciate her thoroughness, compassion, and ability to notice details that may have been missed before. That kind of attentiveness matters in chronic pain care because small details can change the direction of a treatment plan.
From the front office to the clinical team, we want you to feel respected from the first call through your follow-up visits. Pain care requires trust. We build that trust by being prepared, communicating clearly, and treating your time and concerns with respect.
Trusted by Patients and Healthcare Professionals
I am grateful for every patient who chooses VIPS, and I am especially grateful that many healthcare professionals trust me with their own care or the care of their family members. Physicians, surgeons, nurses, and other medical professionals often understand how important it is to choose a pain doctor who is thorough, evidence-based, and honest.
That trust means a great deal to me.
At the same time, I treat every patient with the same level of attention. Whether you work in healthcare, entertainment, education, a trade, the arts, or any other field, your pain deserves to be taken seriously.
Dr. Villanueva’s regimen and acumen are without question. When I started treatment he gave me my life back... He is a true Doctor concerned in every regard of my health. You’re a saint in my eyes.
What an amazing practice! Jessica really took her time and listened to my whole history... She noticed something no other medical professional did before.
What Happens During Your First Pain Management Consultation?
Your first visit is meant to be thorough. I want you to leave with more clarity than you came in with.
Before your visit, please bring any medical records, medication lists, prior procedure notes, and imaging studies you have. Actual X-ray, MRI, or CT images are especially helpful. Reports are useful, but I prefer to review the images myself whenever possible.
During your consultation, I may:
- Listen to your history and how pain affects your daily life
- Review your prior records and imaging
- Perform a physical and neurological examination
- Explain what I believe may be causing your symptoms
- Discuss whether additional testing may be needed
- Create a treatment plan based on your condition, goals, and medical history
When appropriate, I may recommend EMG/NCS testing to evaluate nerve and muscle function. I may also recommend image guided treatments using fluoroscopy or ultrasound when those options fit your diagnosis.
My goal is for you to understand what may be wrong, why it hurts, and what we can do next.
What Types of Treatments Can Pain Management Include?
Pain management is not one single treatment. Depending on your diagnosis, your treatment plan may include conservative care, diagnostic testing, image guided procedures, regenerative medicine, advanced spine procedures, or medication management.
At VIPS, I choose treatments based on your symptoms, physical exam, imaging, medical history, prior response to care, and personal goals. The purpose is not to offer every possible procedure. The purpose is to identify which option, or combination of options, gives you the best chance at improved function and quality of life.
Treatment options may include:
- Epidural steroid injections
- Medial branch blocks and facet joint injections
- Radiofrequency ablation
- Headache injections
- PRP and regenerative medicine
- Nerve blocks
- Joint, bursa, and trigger point injections
- Spinal cord stimulation
- Intracept®
- mild® procedure
Some patients need one targeted treatment. Others need a broader plan that includes rehabilitation, medication review, diagnostic testing, and ongoing follow-up. I will explain why I am recommending a particular option, so you can make informed decisions about your care.
Pain Management Is Not Just Medication
Medication can be part of pain care, but pain management is much broader than prescribing medication.
I look at your imaging, nerve function, movement, prior procedures or surgeries, daily activities, sleep, goals, and risk factors. When medication is appropriate, I want it to be used thoughtfully and safely. When a procedure is appropriate, I want it chosen for the right reason. When another specialist should be involved, I will say so.
My goal is not to push a medication, device, or procedure. My goal is to advocate for the plan that makes the most sense for you.
You Will Not Be Judged for Your Pain
Pain can make people feel frustrated, anxious, defensive, exhausted, or afraid they will not be believed. If you have had negative medical experiences before, I understand why it may take time to trust another physician.
My job is not to judge you. My job is to listen, examine, review, explain, and help you understand your next step.
You do not have to perform, minimize your pain, or prove that you deserve care. You can tell me what has been happening, and we can begin there.
Pain Management in Burbank, CA
VIPS is located in Burbank, CA, where my team and I care for patients from across the San Fernando Valley and greater Los Angeles area. Many of our patients come from Burbank, Glendale, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Pasadena, Van Nuys, and surrounding communities.
Although we practice in Los Angeles, I want VIPS to feel more like a trusted neighborhood medical home than a cold medical office. Burbank has that feeling for me. I live here, work here, and care deeply about this community.
Our Burbank office is designed to feel warm, compassionate, and welcoming. Patients often notice the comfortable setting, original artwork, Magnolia Park neighborhood, and the sense that they are not entering a rushed or impersonal clinic.
For patients who need a higher level of care, Providence St. Joseph Medical Center is nearby, where I also serve as a staff pain management specialist.
Pain Management FAQs
Pain can be exhausting, especially when you feel like no one has taken the time to truly understand it. At VIPS, Villanueva Institute of Pain and Spine, my team and I are here to listen, evaluate your symptoms carefully, and help you take the next step toward better function and quality of life. To schedule a pain management consultation in Burbank, CA, call (818) 669-8895 or contact VIPS through our online form.
Is pain management only for severe pain?
No. Pain management may be appropriate when pain is persistent, limiting, confusing, or not improving with standard care. You do not have to wait until pain becomes unbearable to seek a more thorough evaluation.
Will I need injections?
Not necessarily. Injections are one tool, not the whole plan. I may recommend imaging, EMG/NCS testing, physical therapy, medication changes, lifestyle adjustments, a procedure, or referral to another specialist depending on your situation.
Do pain management injections hurt?
Most patients tolerate image guided injections well. You may feel pressure, temporary soreness, or brief discomfort. I explain what to expect before the procedure, so you feel prepared.
What should I bring to my first visit?
Bring your imaging studies, including X-rays, MRIs, or CT scans, along with reports, prior procedure records, medication lists, and referral information if you have it. Actual images are preferred when available.
Can pain management help after back surgery?
Yes, in many cases. Pain after spine surgery can have several causes, including nerve irritation, scar tissue, adjacent segment problems, facet pain, sacroiliac pain, or other structural concerns. A careful evaluation can help determine what options may be appropriate.
Is pain management the same as taking opioids?
No. Pain management is much broader than opioid medication. My approach may include diagnostic testing, image guided procedures, non-opioid medications, rehabilitation planning, regenerative medicine, advanced spine procedures, and coordination with other specialists.
What if my MRI does not explain all of my pain?
That is common. Imaging is important, but it is only one part of the evaluation. Your symptoms, physical exam, neurological findings, movement patterns, and history also matter.
Will you tell me if I need surgery?
Yes. If I believe surgery should be considered, I will tell you directly and explain why. I do not believe in recommending procedures that are unlikely to help simply because they are available.
Can VIPS help if I have already seen several doctors?
Yes. Many patients come to VIPS after seeing multiple providers. I will review what has already been done, look for patterns, study your imaging, and help you understand what may still be worth exploring.
What makes a good pain management candidate?
A good candidate is someone with real pain who is ready to participate in the process. Pain management works best when you are open to a thoughtful, multidisciplinary plan and willing to work with your care team toward improved function and quality of life.
Which insurance options are available at VIPS?
At VIPS, we accept many types of insurance, including Medicare, Medi-Medi, and self-pay. We also accept personal injury and Workers’ Comp cases, and we work with VA (Veterans Affairs) clients.