Villanueva Institute of Pain and Spine
Chronic Pain Management in Burbank, CA
Chronic pain can affect far more than the area of the body that hurts. It can change how you sleep, work, move, exercise, care for your family, and feel about the future. When pain has lasted for months, keeps returning, or continues despite treatment, you deserve a careful evaluation and a plan that looks beyond short-term relief.
I’m Dr. John Villanueva, and at Villanueva Institute of Pain and Spine (VIPS), I approach chronic pain management as a double board-certified physician in interventional pain management and PM&R. As a double-board-certified physician and Certified Life Care Planner, I bring additional specialized training in evaluating the long-term needs of individuals with complex injuries and disabilities. This includes assessing future medical care, rehabilitation, and other ongoing needs that may be relevant in a medical-legal setting. I want to understand what pain has taken from your life and help alleviate it, so you can work toward better movement, function, and quality of life. If you have felt dismissed, discouraged, or unsure where to turn next, my team and I are here to listen closely, explain your options clearly, and help you take the next step at a pace that feels comfortable.
If you are looking for chronic pain relief in Burbank, CA, call VIPS at (818) 669-8895 or conveniently 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 Chronic Pain Management?
Chronic pain management is the evaluation and treatment of pain that lasts longer than expected, returns repeatedly, or interferes with your ability to function over time. Chronic pain may involve the spine, joints, nerves, muscles, prior injuries, prior surgery, inflammation, arthritis, or several overlapping issues.
At VIPS, chronic pain care begins with understanding the source of your pain as clearly as possible. I review your history, prior treatments, imaging, physical exam, neurological findings, and personal goals before recommending a plan. The right treatment may be simple, advanced, or multidisciplinary, but it should always be chosen for the right reason.
When Should You See a Chronic Pain Management Doctor?
You may benefit from chronic pain management if pain has affected your daily life for several months or has not improved enough with rest, medication, physical therapy, injections, surgery, or other treatments. While some are exploring pain care for the first time, many patients come to VIPS after seeing multiple providers and still feel like they do not have a clear explanation. You do not need to know exactly what is wrong before you come in. Often, the purpose of the visit is to finally begin connecting the details.
Chronic pain management may be appropriate for many conditions, including:
- Complex regional pain syndrome, also called CRPS
- Fibromyalgia
- Headaches and migraines
- Shoulder pain
- Knee pain
- Muscle pain
- Cancer-related pain
- Pain after spine surgery
- Pain after injury or trauma
How I Evaluate Chronic Pain
A chronic pain evaluation should not feel rushed. I want to understand where your pain began, how it has changed, what makes it better or worse, and what it has prevented you from doing.
During your consultation, I may review your prior records, medications, imaging studies, procedure history, and surgical history. I also perform a physical and neurological examination and may recommend EMG/NCS testing when nerve or muscle function needs to be evaluated more closely.
Whenever possible, I prefer to review your actual X-rays, MRIs, or CT scans, rather than just the written report. Reports are helpful, but the images themselves can reveal important details. My goal is for you to leave with a clearer understanding of what may be causing your pain and what treatment options may make sense.
Treatments That May Help Chronic Pain
Chronic pain management is not one treatment. Depending on your diagnosis, your plan may include rehabilitation planning, diagnostic testing, image-guided procedures, regenerative medicine, advanced interventional treatments, or medication management.
Physical Therapy and Rehabilitation Planning
Physical therapy and rehabilitation can help improve strength, mobility, posture, mechanics, and movement confidence. As a PM&R physician, I assess how pain affects your ability to move and function, and I consider how rehabilitation can support your overall treatment plan.
EMG/NCS Testing
EMG and nerve conduction studies can help evaluate nerve and muscle function. This may be useful if you have numbness, tingling, weakness, burning pain, radiating pain, or other symptoms suggesting a nerve condition.
Epidural Steroid Injections
Epidural steroid injections may help certain types of neck, back, arm, or leg pain caused by inflamed or irritated spinal nerves. These injections are often considered for conditions such as herniated discs, spinal stenosis, sciatica, or radicular pain.
Medial Branch Blocks and Facet Joint Injections
Medial branch blocks and facet joint injections can help identify or treat pain coming from the small joints of the spine. These may be considered when arthritis, degeneration, whiplash, or mechanical spine pain appears to involve the facet joints.
Radiofrequency Ablation
Radiofrequency ablation may be recommended when diagnostic blocks confirm that specific nerves are carrying pain from the facet joints or other targeted areas. For properly selected patients, RFA may provide longer-lasting relief than a temporary injection.
Nerve Blocks
Nerve blocks may help diagnose or treat pain related to irritated, compressed, or overactive nerves. Depending on the condition, nerve blocks may be used for spine-related pain, CRPS, pelvic pain, abdominal pain, headaches, or other chronic pain patterns.
Joint, Bursa, and Trigger Point Injections
Joint injections may help pain from arthritis or inflammation in areas such as the shoulder, knee, hip, elbow, wrist, or sacroiliac joint. Bursa injections may help inflammation around joints, while trigger point injections may help painful muscle knots or myofascial pain.
PRP and Regenerative Medicine
PRP therapy uses a concentration of platelets from your own blood and may be considered for certain joint, tendon, ligament, muscle, or spine-related conditions. Regenerative medicine is not appropriate for every patient, but it may be part of a broader plan when tissue irritation or degeneration is contributing to pain.
Spinal Cord Stimulation
Spinal cord stimulation may be considered for select patients with chronic pain that has not responded well to other treatments. I use device-agnostic language because the right platform should be selected based on your anatomy, pain pattern, lifestyle, and clinical needs rather than brand preference.
Intracept®
Intracept® may be an option for certain patients with vertebrogenic low back pain, a condition associated with changes in the vertebral endplates of the spine. This treatment is not for every type of back pain, so careful diagnosis and imaging review are essential.
MILD Procedure
The MILD procedure may help certain patients with lumbar spinal stenosis when thickened ligament tissue contributes to nerve compression. It is a minimally invasive option for select patients with symptoms such as leg pain, heaviness, numbness, or difficulty standing or walking for extended periods.
Medication Management
Medication management may help 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. The goal is to make sure your medications are appropriate for your diagnosis, risk factors, daily function, and long-term care.
How VIPS Builds a Chronic Pain Treatment Plan
At VIPS, I do not choose treatment based on the pain label alone. Two patients may both have back pain, but the source of their pain may be completely different. One may need rehabilitation and medication adjustment, another may need an epidural steroid injection, another may benefit from radiofrequency ablation, and still another may need a surgical opinion.
That is why I look at your symptoms, exam, imaging, medical history, prior treatments, and goals together. If an image-guided procedure may help, I will explain why. If medication management or rehabilitation should come first, I will say so. If your imaging or neurological findings suggest that surgery should be considered, I will tell you directly.
Rather than pushing you toward a procedure, my goal is to help you understand your options and choose the plan that best supports your mobility, function, and quality of life.
Chronic Pain Care That Helps You Feel Heard
Many patients with chronic pain have felt dismissed, rushed, or misunderstood before. Some have been told their pain is psychological, exaggerated, or too complicated to explain. If that has happened to you, I understand why it may be difficult to trust another physician right away.
At VIPS, I want you to feel that your pain is being taken seriously. Chronic pain can have physical, neurological, emotional, and functional layers, but that does not make it any less real. My job is to listen, examine, review, explain, and help you move toward the next appropriate step.
You do not have to minimize your pain or prove that you deserve care. You can tell me what has been happening, and we can begin there.
Chronic 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 visit from Burbank, Glendale, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Pasadena, Van Nuys, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, 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, human, 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.
Burbank Chronic Pain Management FAQs
Chronic pain can be exhausting, especially when it feels like no one has taken the time to fully understand it. My team and I are here to listen, carefully evaluate your symptoms, and help you take the next step toward better function and quality of life. To schedule a chronic pain management consultation in Burbank, CA, call (818) 669-8895 or contact VIPS online today.
Is chronic pain management only for severe pain?
No. Chronic pain management may be appropriate when pain is persistent, recurring, difficult to explain, or affecting your ability to function. You do not have to wait until pain becomes unbearable to seek a more thorough evaluation.
What is the goal of chronic pain management?
The goal is to improve your function, mobility, comfort, and quality of life. Pain relief matters, but I also want to understand what you want to do again, such as working, exercising, sleeping better, walking farther, caring for family, or returning to activities you have stopped doing.
Will chronic pain management make my pain go away completely?
Some patients experience significant relief, while others make progress by reducing pain enough to move better and participate more fully in daily life. I will be honest with you about realistic expectations based on your diagnosis, imaging, exam, and response to treatment.
Will I need injections for chronic pain?
Not necessarily. Injections are one option, but they are not the whole plan. Depending on your condition, I may recommend medication review, rehabilitation planning, diagnostic testing, image-guided procedures, regenerative medicine, or another approach.
What if I have already tried physical therapy?
Many patients come to VIPS after physical therapy, medications, injections, or other treatments have not provided enough relief. I will review what has already been tried, look for what may have been missed, and help you understand what options may still be worth exploring.
Is chronic pain management the same as opioid medication?
No. Chronic pain management is much broader than opioid medication. My approach may include diagnostic evaluation, non-opioid medications when appropriate, image-guided procedures, rehabilitation planning, regenerative medicine, advanced spine procedures, and coordination with other specialists.
Can chronic pain management help after spine surgery?
Yes, in many cases. Pain after spine surgery may involve nerve irritation, scar tissue, adjacent segment changes, facet pain, sacroiliac pain, or other structural concerns. A careful evaluation can help determine what options may be appropriate.
What should I bring to my chronic pain consultation?
Bring prior medical records, imaging studies, medication lists, procedure notes, surgical history, and referral information if you have it. Actual X-ray, MRI, or CT images are especially helpful because I prefer to review the images myself whenever possible.
What is the best treatment for chronic pain?
The best treatment for chronic pain depends on the source of your pain, your imaging, your physical exam, your medical history, and what has or has not helped in the past. For some patients, the right plan may include medication management and rehabilitation. For others, image-guided injections, nerve blocks, radiofrequency ablation, PRP therapy, spinal cord stimulation, Intracept®, or the mild® procedure may be appropriate.
Can chronic pain management help with nerve pain?
Yes. Chronic pain management can help evaluate nerve pain symptoms such as burning, tingling, numbness, weakness, radiating pain, or electric shock sensations. I may recommend imaging, EMG/NCS testing, medication review, nerve blocks, epidural steroid injections, or other treatments depending on whether the pain is coming from a pinched nerve, peripheral neuropathy, CRPS, sciatica, or another nerve-related condition.
What non-surgical chronic pain treatments are available?
Non-surgical chronic pain treatments may include medication management, physical therapy guidance, lifestyle changes, EMG/NCS testing, image-guided injections, nerve blocks, radiofrequency ablation, regenerative medicine, spinal cord stimulation, Intracept®, or the mild® procedure. My goal is to help you understand which options make sense for your diagnosis before considering more invasive care.
Can chronic pain management help me avoid surgery?
In some cases, yes. Chronic pain management may help you avoid or delay surgery when a nonsurgical plan is medically appropriate. However, if your imaging, neurological exam, or symptoms suggest that surgery should be considered, I will tell you directly and explain why.
How do I know if my chronic pain is coming from my spine, joints, muscles, or nerves?
The source of chronic pain is not always obvious, which is why a detailed evaluation matters. I look at your symptoms, physical exam, neurological findings, imaging, prior treatment history, and pain patterns to determine whether your pain may be coming from the spine, joints, muscles, nerves, or several sources at once.
When should I see a chronic pain doctor in Burbank, CA?
You should consider seeing a chronic pain doctor if pain has lasted for months, keeps returning, limits your movement, affects sleep or work, or has not improved enough with physical therapy, medication, injections, or surgery. At VIPS in Burbank, we see patients from Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, and communities throughout the San Fernando Valley and greater Los Angeles area.