Abdominal Pain

Chronic abdominal pain has a variety of potential causes from irritable bowel syndrome to reproductive health problems and cancer. John Villanueva, MD, Pain and Spine Management, in Burbank, California, serving the greater Los Angeles area, provides customized pain management solutions for abdominal pain to help you restore your quality of life. Call Dr. Villanueva or make an appointment online today.

What are the causes of abdominal pain?

The most common causes of abdominal are usually not serious: gas pains, indigestion, or an abdominal muscle strain. Other causes may require more urgent medical attention. In addition to knowing the location and pattern of abdominal pain, the timing of the pain is useful when determining the cause.

Acute abdominal pain usually develops and often resolves over a few hours or days. They can range from minor condition to serious medical emergencies, including:

  • Abdominal aortic aneurysm
  • Appendicitis
  • Cholangitis (bile duct inflammation)
  • Cholecystitis
  • Cystitis (bladder inflammation)
  • Diabetic ketoacidosis
  • Diverticulitis
  • Duodenitis (inflammation in the first part of the small intestine)
  • Ectopic pregnancy
  • Fecal impaction (hardened stool that can't be eliminated)
  • Heart attack
  • Injury
  • Intestinal obstruction
  • Intussusception (in children)
  • Kidney infection (pyelonephritis)
  • Kidney stones
  • Liver abscess (pus-filled pocket in the liver)
  • Mesenteric ischemia (decreased blood flow to the intestines)
  • Mesenteric lymphadenitis (swollen lymph nodes in the folds of the membrane that hold the abdominal organs in place)
  • Mesenteric thrombosis (blood clot in a vein carrying blood away from your intestines)
  • Pancreatitis
  • Pericarditis (inflammation of the tissue around the heart)
  • Peritonitis (infection of the abdominal lining)
  • Pleurisy (inflammation of the membrane surrounding the lungs)
  • Pneumonia
  • Pulmonary infarction (loss of blood flow to the lungs)
  • Ruptured spleen
  • Salpingitis (inflammation of the fallopian tubes)
  • Sclerosing mesenteritis
  • Shingles (herpes zoster infection)
  • Spleen infection
  • Splenic abscess (pus-filled pocket in the spleen)
  • Torn colon
  • Urinary tract infection (UTI)
  • Viral gastroenteritis (stomach flu)

Chronic abdominal pain can be intermittent or episodic (comes and goes). They may last for weeks to months or even years.

Severity ranges from mild to severe, but does not usually worsen over time. These conditions may include:

  • Angina (reduced blood flow to the heart)
  • Celiac disease
  • Endometriosis
  • Gallstones
  • Gastritis (inflammation of the stomach lining)
  • Gastroesophageal reflux disease (GERD)
  • Hiatal hernia
  • Inguinal hernia
  • Irritable bowel syndrome
  • Mittelschmerz (ovulation pain)
  • Nonulcer stomach pain
  • Ovarian cysts
  • Pelvic inflammatory disease (PID)
  • Peptic ulcer
  • Sickle cell anemia
  • Strained or pulled abdominal muscle
  • Ulcerative colitis

Progressive abdominal pain steadily gets worse with time, oven accompanied by the development of other symptoms. The different causes may include:

  • Cancer
  • Crohn's disease
  • Enlarged spleen (splenomegaly)
  • Gallbladder cancer
  • Hepatitis
  • Kidney cancer
  • Lead poisoning
  • Liver cancer
  • Non-Hodgkin's lymphoma
  • Pancreatic cancer
  • Stomach cancer
  • Tubo-ovarian abscess (pus-filled pocket involving a fallopian tube and an ovary)
  • Uremia (buildup of waste products in your blood)

What are the treatments a pain management physician can do for chronic abdominal pain?

After a patient has already had an extensive gastrointestinal workup and treatment by primary care, surgeons, or gastrointestinal specialists, they may still experience chronic abdominal pain.

A pain management physician can perform interventional diagnostic injections that can help differentiate between muscle versus organ reasons for your abdominal pain. These may include:

  • Trigger Point Injections
  • Transversus Abdominal Plane (TAP) Block
  • Retrograde Differential Epidural Block

If it determined that the chronic abdominal pain is due to the viscera – the internal organs of the abdomen such as the intestines—the pain management physician may try different interventional therapies:

  • Celiac Plexus Nerve Block
  • Splanchnic Block
  • Spinal Cord Stimulation
  • Radiofrequency Ablation

Call 911 or emergency medical assistance

Seek help if your abdominal pain is severe and is associated with:

  •     Trauma, such as an accident or injury
  •     Pressure or pain in your chest

Seek immediate medical attention

Have someone drive you to urgent care or the emergency room if you have:

  •     Severe pain
  •     Fever
  •     Bloody stools
  •     Persistent nausea and vomiting
  •     Weight loss
  •     Skin that appears yellow
  •     Severe tenderness when you touch your abdomen
  •     Swelling of the abdomen

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Listed are the headache issues

  • Migraines
  • Occipital Neuralgia
  • Tension Headaches
  • Other Headaches

Headache is pain in any region of the head. Headaches may occur on one or both sides of the head, be isolated to a certain location, radiate across the head from one point, or have a viselike quality.

A headache may appear as a sharp pain, a throbbing sensation or a dull ache. Headaches can develop gradually or suddenly, and may last from less than an hour to several days.

What Causes Headaches?
Your headache symptoms can help your doctor determine its cause and the appropriate treatment. Most headaches aren’t the result of a serious illness, but some may result from a life-threatening condition requiring emergency care.
Headaches are generally classified by cause: primary vs. secondary headaches
A primary headache is caused by overactivity of or problems with pain-sensitive structures in your head. A primary headache isn’t a symptom of an underlying disease.
Chemical activity in your brain, the nerves or blood vessels surrounding your skull, or the muscles of your head and neck (or some combination of these factors) can play a role in primary headaches. Some people may also carry genes that make them more likely to develop such headaches.

  • The most common primary headaches are:
  • Cluster headache
  • Migraine
  • Migraine with aura
  • Tension headache
  • Trigeminal autonomic cephalalgia (TAC), such as cluster headache and paroxysmal hemicrania

A few headache patterns also are generally considered types of primary headache, but are less common. These headaches have distinct features, such as an unusual duration or pain associated with a certain activity.
Although generally considered primary, each could be a symptom of an underlying disease. They include:

  • Chronic daily headaches (for example, chronic migraine, chronic tension-type headache, or hemicranias continua)
  • Cough headaches
  • Exercise headaches
  • Sex headaches

Some primary headaches can be triggered by lifestyle factors, including:

  • Alcohol, particularly red wineCertain foods, such as processed meats that contain nitrates
  • Changes in sleep or lack of sleep
  • Poor posture
  • Skipped meals
  • Stress

Secondary Headaches:
Possible causes of secondary headaches include:
A secondary headache is a symptom of a disease that can activate the pain-sensitive nerves of the head. Any number of conditions — varying greatly in severity — may cause secondary headaches.

  1. Acute sinusitis (sinus infection)
  2. Arterial tears (carotid or vertebral dissections)
  3. Blood clot (venous thrombosis) within the brain — separate from stroke
  4. Brain aneurysm (a bulge in an artery in your brain)
  5. Brain AVM (arteriovenous malformation) — an abnormal formation of brain blood vessels
  6. Brain tumor
  7. Carbon monoxide poisoning
  8. Chiari malformation (structural problem at the base of your skull)
  9. Concussion
  10. Dehydration
  11. Dental problems
  12. Ear infection (middle ear)
  13. Encephalitis (brain inflammation)
  14. Giant cell arteritis (inflammation of the lining of the arteries)
  15. Glaucoma (acute angle closure glaucoma)
  16. Hangovers
  17. High blood pressure (hypertension)
  18. Influenza (flu) and other febrile (fever) illnesses
  19. Intracranial hematoma
  20. Medications to treat other disorders
  21. Meningitis
  22. Monosodium glutamate (MSG)
  23. Overuse of pain medication
  24. Panic attacks and panic disorder
  25. Post-concussion syndrome
  26. Pressure from tight headgear, such as a helmet or goggles
  27. Pseudotumor cerebri
  28. Stroke
  29. Toxoplasmosis
  30. Trigeminal neuralgia (as well as other neuralgias, all involving irritation of certain nerves connecting the face and brain)

Some types of secondary headaches include:

  1. External compression headaches (a result of pressure-causing headgear)
  2. Ice cream headaches (commonly called brain freeze)
  3. Medication overuse headaches (caused by overuse of pain medication)
  4. Sinus headaches (caused by inflammation and congestion in sinus cavities)
  5. Spinal headaches (caused by low pressure or volume of cerebrospinal fluid, possibly the result of spontaneous cerebrospinal fluid leak, spinal tap or spinal anesthesia)
  6. Thunderclap headaches (a group of disorders that involves sudden, severe headaches with multiple causes)

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Arthritis has multiple forms, but every one of them causes chronic pain, inflammation, and loss of function that often worsens over time. At John Villanueva, MD, Pain and Spine Management in Burbank, California, serving the greater Los Angeles area, Dr. Villanueva is a leading pain specialist who offers a range of therapies to reduce pain and inflammation and improve function. Find out more by calling Dr. Villanueva today, or book an appointment online.

What is arthritis?

Arthritis is characterized by the inflammation of one or more joints, There are a variety of forms of the disease, all with the common symptoms of joint pain, inflammation, and reduction in the range of movement. The most common types of arthritis are:


Osteoarthritis, or degenerative joint disease, the most prevalent form of arthritis, is a condition related to wear-and-tear damage to your joints over time, typically developing later in life. It’s caused by the deterioration of the cartilage that protects the ends of the bones in your joints, which leads to increased inflammation of the surrounding tissues and a painful meeting of the unprotected ends of the bones.

Rheumatoid arthritis

Rheumatoid arthritis often occurs at a younger age and is caused by an autoimmune disorder that makes your body attack your joint linings.


Gout is a condition that usually affects the feet, most often the big toe. It’s caused by a buildup of uric acid crystals in the joints.

Psoriatic arthritis

Psoriatic arthritis is similar to rheumatoid arthritis, but it also causes skin problems, so patients develop scaly, flaky skin in addition to joint pain and inflammation.

Bacterial arthritis

Bacterial arthritis, or septic arthritis, causes inflammation when the joints get infected with specific bacteria.

What are the symptoms of arthritis?

Pain is the chief symptom felt by people who have arthritis, which can vary from an aching or soreness in the joints to a throbbing crescendo of pain. The pain often responds to changes in the weather, so as the barometric pressure falls, pain tends to increase.

Other symptoms that are typical of most forms of arthritis are:

  • Stiff and swollen joints
  • Restricted range of movement or reduced mobility
  • Stiffness when getting up after lying, sitting, or kneeling
  • Joints that visibly twist and distort, especially in the hands

Arthritis usually causes an increase in joint deterioration over time, resulting in worsening symptoms and increasing pain. Some people who have arthritis become seriously impaired, losing strength and dexterity in their hands or becoming unable to walk.

What treatments are available for arthritis?

Unfortunately, most forms of arthritis aren’t curable, but Dr. Villanueva can help you optimize your range of movement and reduce the level of pain you endure with a program of effective therapies and lifestyle changes.

A healthy lifestyle helps keep your muscles and organs stronger and more resilient, while being overweight, smoking, drinking excess alcohol, and eating a poor quality diet can all make symptoms worse. Keeping yourself moving despite the pain is also very important because if you don’t, you’re at a greater risk of developing serious physical impairment.

In addition to making lifestyle changes, there are a number of different treatment options available to help minimize your symptoms. Dr. Villanueva may recommend:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief
  • Prescription painkillers
  • Steroid injections into the joints
  • Hyaluronic acid injections
  • Regenerative medicine techniques

If you have any symptoms of arthritis or are looking for more effective treatments, call John Villanueva, MD, Pain and Spine Management today, or book an appointment online.

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Back Pain

Back pain is something very few people are lucky enough to escape altogether, and it can be severely debilitating for some. At John Villanueva, MD, Pain and Spine Management, in Burbank, California, serving the greater Los Angeles area, Dr. Villanueva is a leading pain specialist who provides the most advanced solutions for all forms of back pain. Find out how Dr. Villanueva can help by calling the clinic today, or book an appointment online.

What causes back pain?

Acute and chronic back pain are some of the most common causes of discomfort and reduced mobility, which may be brought on by:

  • Exceeding your fitness level
  • Falling
  • Having poor posture
  • Repeating the same movements for extended periods
  • Moving suddenly or awkwardly
  • Adopting unsafe lifting techniques

These can all result in damage to tendons, ligaments, discs, and vertebrae that cause pain in the back. You could also have a genetic condition that affects your back, like scoliosis, or develop a degenerative condition such as osteoarthritis, degenerative disc disease, or osteoporosis.

Can I prevent back pain?

Looking after your back and thinking about how you sit, stand, and move, can all help keep your back strong and unharmed. Regular exercise keeps you flexible and builds strong muscles that can do a better job of supporting your spine, and being careful of how you lift heavy or awkward weights can help you avoid many acute muscle and spine injuries.

You should sleep on a good quality, supportive mattress that keeps your spine in the right position during the night, and keep your neck in line with the rest of your spine rather than propped up on lots of pillows.

What treatments are available for back pain?

Mild back pain from a low-grade muscle strain or similar injury usually responds to gentle heat, stretching exercises, and refraining from the activity that brought the pain on in the first place. You shouldn’t stop moving altogether, as research shows staying immobile doesn’t help heal your back and may, in fact, make it worse.

If this approach doesn’t work within a couple of days, or you’re more severely affected, Dr. Villanueva can examine your back and run diagnostic tests to find the source of the pain. Once you have an accurate diagnosis, treatment to address the cause of the pain should heal the tissues and help prevent further problems.

Treatment options include:

  • Pain-killing medications
  • Anti-inflammatory drugs
  • Heat treatments
  • Ice or cold therapies
  • Therapeutic massage
  • Ultrasound therapy
  • Electrical stimulation
  • Regenerative medicine techniques
  • Stretching
  • Back braces
  • Manipulation therapies
  • Pilates or yoga

Dr. Villanueva also uses a range of injectable treatments for back pain, and he also employs neuromodulation techniques, including:

  • Epidural steroid injections
  • Facet joint injections
  • Medial branch nerve block
  • Selective nerve root block
  • Sacroiliac joint injection
  • Spinal cord stimulation
  • Peripheral nerve stimulation
  • Radiofrequency ablation of pain nerves

If back pain is reducing your quality of life, call John Villanueva, MD, Pain and Spine Management today to schedule a consultation, or book an appointment online.

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Neck Pain

As many as 70% of Americans will have neck pain at some point during their lives. If you have neck pain that limits your mobility or disrupts your quality of life, contact John Villanueva, MD, Pain and Spine Management, in Burbank, California, serving the greater Los Angeles area. Dr. Villanueva is a double-board certified physician who offers expert diagnosis of the cause of neck pain and customized treatments to relieve your pain and restore your quality of life. Call or schedule an appointment online today.

What causes neck pain?

Poor posture is a leading cause of neck pain. For example, if you, like the average American, spend five hours a day or more with your head tilted down to scroll on your phone, or if your working day is spent hunched over a desk, your posture can put considerable strain on the muscles in your neck. Other causes of neck pain include:

  • Osteoarthritis
  • Herniated discs
  • Injuries like whiplash
  • Spinal stenosis
  • Temporomandibular joint disorder

Other lifestyle factors such as smoking, obesity, and a sedentary lifestyle can also contribute to neck pain.

When should I talk to a doctor about neck pain?

You should schedule an appointment with Dr. Villanueva if you have neck pain that lasts for more than a couple of days and doesn’t subside with rest, over-the-counter pain relievers, and other at-home therapies. Also, if your neck pain is so severe that you can’t turn your head or if you have numbness and weakness in your arms or hands, you should schedule a consultation.

How is the cause of neck pain diagnosed?

Dr. Villanueva offers comprehensive exams and consultations to identify the condition causing your pain. He talks to you about your symptoms as well as your lifestyle and overall health. He will feel your neck for abnormalities and guide you through some gentle stretches to see how your mobility is impaired and to gauge your pain.

Dr. Villanueva may also order diagnostic imaging studies such as X-rays, MRIs, and CT scans to study the structures of your neck in more detail.

How is neck pain treated?

Dr. Villanueva offers personalized treatment plans that combine a variety of therapies to relieve your neck pain and address the condition causing it. For example, he may recommend:

  • Physical therapy
  • Transcutaneous electrical nerve stimulation (TENS)
  • Traction
  • Steroid injections

The doctor may also recommend lifestyle modifications to reduce your risk of recurring neck pain, such as setting up your workstation correctly or practicing yoga or pilates to improve your core strength and posture. In rare cases, you may need surgery to repair a nerve root problem or reduce spinal compression.

If you’re living with neck pain, call Dr. Villanueva or schedule a consultation online today.

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The constant, debilitating pain and whole body discomfort of fibromyalgia are hard to imagine for anyone who’s never had this chronic pain condition. At John Villanueva, MD, Pain and Spine Management, in Burbank, California, serving the greater Los Angeles area, Dr. Villanueva’s experience as a double-board certified pain management physician contributes to his understanding of fibromyalgia. Dr. Villanueva effectively diagnoses fibromyalgia and offers effective therapies to ease the pain. Find out more by calling Dr. Villanueva today, or book an appointment online.

What is fibromyalgia?

Fibromyalgia is one of the most common causes of chronic pain, affecting around 12 million people in the US alone. Fibromyalgia pain is widespread throughout the body, being felt in muscles, connective tissues, and bones all over the body. It can cause chronic fatigue as well as a collection of other symptoms.

People who have fibromyalgia seem to become overly sensitive to pain signals, and although the cause isn’t definitively understood, there are indications that fibromyalgia relates to another chronic pain condition called myofascial pain syndrome.

It’s not uncommon for people who have fibromyalgia to have other family members with the condition, so it’s likely there is a genetic link as well.

What are the symptoms of fibromyalgia?

The dominant symptom of fibromyalgia is widespread pain all through the body, which may vary in intensity but never goes away completely.

People who have fibromyalgia describe the pain as an intense kind of ache, which flares up to an acute pain if you apply pressure. There are certain points around the body, such as the sides of the knees and the top of the shoulders, where pressure causes even more intense pain.

You may also experience some or all of the other symptoms associated with fibromyalgia, such as:

  • Chronic fatigue
  • Problems with sleeping
  • Memory and concentration problems (known as fibro fog)
  • Headaches
  • Depression

Patients who have fibromyalgia are also more likely to have other conditions at the same time, such as:

  • Arthritis
  • Autoimmune disorders
  • Endometriosis
  • IBS (irritable bowel syndrome)
  • PTSD (post-traumatic stress disorder)
  • Restless leg syndrome
  • Sleep apnea

Dr. Villanueva diagnoses fibromyalgia based on your individual symptoms and by excluding other possible causes, as there’s no definitive diagnostic test that can confirm fibromyalgia.

What treatments are available for fibromyalgia?

There is no cure today for fibromyalgia, however, Dr. Villanueva can help you manage your pain and reduce the severity of your symptoms so you can lead a more comfortable, active life. He’s had great success with a variety of treatments, including trigger point injections that contain a local anesthetic and corticosteroids.

Other potential treatments include medication such as prescription pain relievers, antidepressants, and antiseizure medications. These can be effective in masking the pain, but they should form one element of an effective management program rather than its core.

Other forms of therapy are also highly beneficial and can help you learn to manage your pain, for example:

  • Physical therapy
  • Occupational therapy
  • Psychological counseling

It’s also important to stay active and keep your muscles and joints working. Yoga, pilates, and tai chi are excellent forms of gentle exercise for people who have been diagnosed with fibromyalgia.

If you have fibromyalgia or are suffering from chronic pain, call John Villanueva, MD, Pain and Spine Management today, or book an appointment online.

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Joint Pain

If you wake up with stiff, painful joints, or feel like your knees, shoulders, or elbows are on fire after physical activity, contact John Villanueva, MD, Pain and Spine Management, in Burbank, California, serving the greater Los Angeles area. Dr. Villanueva is a double board-certified pain management expert who offers expert diagnosis of the cause of your joint pain as well as customized treatments to relieve your pain and get you back to your regular activities. Call or make an appointment online today.

What are the common causes of joint pain?

Many conditions and injuries could be causing your joint pain. For example, arthritis is by far the most common cause of joint pain, but you may also have an injury to your tendons and ligaments that connect your muscles to your bones and facilitate joint movement, or your bursa, small pockets of fluid that cushion your joints.

Arthritis is an umbrella term for around 100 conditions that cause inflammation and pain in your joints. Osteoarthritis is the degenerative form of the disease that develops when the cartilage that covers the ends of your bones that meet in your joints wears away, leaving your joints vulnerable to irritating friction.

Rheumatoid arthritis is another common type of arthritis. It’s an autoimmune disease in which your immune system attacks the synovial lining of your joints

You may also develop joint pain as a symptom of conditions, including:

  • Lupus
  • Cancer
  • Osteoporosis
  • Dislocation
  • Tendon tears
  • Sprains

If you have any musculoskeletal pain in your joints or elsewhere in your body that lasts for more than a couple of days and doesn’t subside with rest and other at-home treatment, you should make an appointment with Dr. Villanueva.

How is the cause of my joint pain diagnosed?

Dr. Villanueva provides comprehensive exams to diagnose the condition causing your joint pain and identify the best way to treat it. He begins by asking questions about your pain, lifestyle, and overall health. He will feel your painful joint for signs of inflammation and other abnormalities and may guide you through some movements to see how your range of motion is affected.

Dr. Villanueva also uses diagnostic imaging studies such as X-rays, MRIs, and CT scans to study the structures of your joints, connective tissue, and muscle in more detail. He may recommend a minimally invasive arthroscopic procedure to examine the inside of your painful joint.

How is joint pain treated?

Dr. Villanueva offers customized treatment plans to alleviate your joint pain, whether it’s located in your shoulder, wrist, hands, hips, knees, ankles, or feet. He often combined treatments such as anti-inflammatory medication, regenerative medicine, or joint injections with physical therapy to provide rapid relief while also reducing your risk of recurring pain.

If joint pain is interfering with your life, call Dr. Villanueva or make an appointment online today.

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Knee Pain

Your knees do a lot of work every day supporting your body and enabling you to carry out all your work and leisure activities, so unsurprisingly, when they’re not working correctly, they can sometimes be a source of considerable pain. At John Villanueva, MD, Pain and Spine Management, in Burbank, California, serving the greater Los Angeles area, Dr. Villanueva has extensive experience of helping people suffering from a variety of painful knee related disorders. Find out how Dr. Villanueva can help by calling the clinic today, or book an appointment online.

What causes knee pain?

There are many potential causes of knee pain, as knees take a tremendous amount of strain in daily life and even more if you participate in sports or exercise regularly.

The knee is a complex junction consisting of bones, tendons, ligaments, and muscles, all working in harmony to enable you to run, jump, and change direction quickly. If any of these structures that make up the knee sustain damage, knee pain is the result.

What conditions affect knees most often?

Knees can sustain acute damage from an accident or sporting injury, or they may develop problems from gradual strain or degeneration of the tissues. Principal causes of knee pain include:

  • Fractured bones
  • Anterior cruciate ligament (ACL) tear
  • Medial collateral ligament (MCL) tear
  • Meniscus tear
  • Patellofemoral syndrome (repetitive friction of the kneecap against the thigh bone)
  • Patellar tendinitis (runner’s knee)
  • Articular cartilage injuries
  • Patellar (kneecap) instability
  • Patellar dislocation
  • Knee dislocation
  • Iliotibial (IT) band injury
  • Arthritis

Meniscus tears and ACL tears are particularly common among athletes, due to the potential for the knee to twist during a game or when training.

How is knee pain diagnosed?

Dr. Villanueva needs to examine your knee, check for movement restrictions, and find out more about the pain and how it began. In some cases, this is sufficient for a diagnosis, but he may also order diagnostic imaging tests such as:

  • X-rays to check the bones
  • Ultrasound to check muscles, ligaments, and tendons
  • Magnetic resonance imaging (MRI) to check hard and soft tissues

The information from the diagnostic images can give Dr. Villanueva the details he needs in more complex cases, and help guide treatments such as cortisone injections that require precise placement.

How is knee pain treated?

Unless you have a type of injury that can’t heal on its own (which can be the case with certain ligament tears) treatment for knee pain starts with nonsurgical options such as:

  • Activity modification (avoiding stress to the injured tissue)
  • Braces to take the pressure off the knee as it heals
  • Cortisone injections
  • Joint fluid replacement
  • Physical therapy to rebuild strength and keep the knee flexible

Dr. Villanueva may also recommend regenerative therapies to help heal chronic soft tissue injuries.

These therapies are effective in the majority of cases. However, some situations may require surgery, including torn ligaments or severe cases of osteoarthritis that may necessitate knee replacement.

To diagnose the source of your knee pain and receive the most up-to-date treatments, call John Villanueva, MD, Pain and Spine Management, or book an appointment online.

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Migraines can disrupt your life for hours or even days at a time, making it impossible to function normally. At John Villanueva, MD, Pain and Spine Management in Burbank, California, serving the greater Los Angeles area, Dr. Villanueva is a leading pain specialist, who provides effective therapies to help prevent migraines and reduce their severity. Find out more by calling Dr. Villanueva today, or book an appointment online.

What are migraines?

Migraines are a type of headache that has its own set of symptoms in addition to intense physical head pain. These symptoms can include:

  • Nausea
  • Vomiting
  • Sensitivity to light, sound, touch, and smell
  • Blurred vision
  • Lightheadedness

Migraine pain is typically severe and intense, to the extent that many patients are unable to carry on with their day and have to lie down in a dark, quiet place until the pain subsides.

Many people who experience migraines do so regularly and learn to notice signs that a migraine is on the way. You may suffer from mood changes or digestive upsets before a migraine strikes, for example.

Some migraines cause auras, or disturbances to the senses generated by the nervous system. Auras can make you see such things as flashing lights or spots in front of your eyes, and affect the way you talk, or how your sense of touch works.

What causes a migraine?

Research indicates that migraines develop because of a problem with the trigeminal nerve and brainstem. The exact cause of migraines isn’t known for sure, but medical evidence has demonstrated that there are triggers for migraine attacks. For example, women taking estrogen-based medication such as birth control pills or HRT (hormone replacement therapy) are more likely to experience migraines.

Each individual may have different triggers, however, migraines have been known to be brought on by:

  • Chemical imbalances in the brain
  • Eating processed foods
  • Eating highly salted foods or aged cheeses
  • Eating irregularly or fasting
  • Food additives like aspartame and monosodium glutamate
  • Alcohol
  • Caffeinated drinks
  • Stress
  • Bright lights
  • Sun glare
  • Strong odors
  • Getting too much or too little sleep
  • Intense physical activity
  • Changes in the weather

If you can make a note of everything you do before experiencing a migraine, it could help you narrow down your own trigger factors and help you avoid them.

What treatments are available for migraines?

Current medical treatments for migraines are primarily medications that are intended to prevent a migraine from starting or from getting worse, or to reduce their overall frequency. Dr. Villanueva evaluates your medical history and history of migraines and recommends the best course of action for your particular situation. However, possible medications that could help alleviate migraines include:

  • NSAIDs (non-steroidal anti-inflammatory drugs)
  • Triptans
  • Ergotamine and caffeine
  • Anti-nausea medicine
  • Glucocorticoids
  • Beta-blockers
  • Calcium channel blockers
  • Lisinopril (angiotensin-converting enzyme inhibitor)
  • Tricyclic antidepressants
  • Anti-seizure drugs
  • Steroid trigger point injections

Dr. Villanueva also uses Botox® injections to relieve migraine for people if other treatments aren’t working. If you experience headaches on at least 15 days of every month and more than half of them are migraines, Dr. Villanueva might recommend a course of Botox to help reduce the frequency and intensity of your headaches.

Get the most effective treatment options for migraine and chronic headaches by calling John Villanueva, MD, Pain and Spine Management today or booking an appointment online.

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Muscle Pain

Sore, stiff, aching muscles can cause intense pain that interferes with your mobility and disrupts your life. John Villanueva, MD, Pain and Spine Management, in Burbank, California, serving the greater Los Angeles area, offers expert diagnosis and treatments for muscle pain, to help you get back to your regular activities. If you have chronic muscle pain, call Dr. Villanueva, or schedule an appointment online today.

What causes muscle pain?

Some of the most common causes of muscle pain include overuse, tension, stress, and injuries like strains or tears. Many athletes are vulnerable to muscle strains and tears because of the regular stress placed on their bodies.

You might also have myofascial pain or a trigger point from the repetitive use of a particular muscle. Muscle pain can also stem from another illness, such as:

  • Fibromyalgia
  • Chronic fatigue syndrome
  • Complex regional pain syndrome
  • Lupus
  • Infections
  • Hypoactive thyroid disorders

Your risk of developing chronic muscle pain increases if:

  • You’re overweight
  • You have a sedentary lifestyle
  • You start or return to exercise too rapidly

Regardless of the cause of your pain or your lifestyle, Dr. Villanueva works with you to implement a customized pain management plan to alleviate your symptoms and get you back to a healthy, active lifestyle.

How is the cause of muscle pain diagnosed?

If you have muscle pain that doesn’t subside with a couple of days of rest and at-home care, including over-the-counter pain relievers, ice packs, and heat, make an appointment with Dr. Villanueva. He offers comprehensive exams to identify the root cause of your pain.

He asks you about your symptoms as well as your overall health and lifestyle. He will ask about recent injuries. He may feel your muscles or ask you to walk around his office and perform certain movements or stretches so he can see how your pain is affecting your mobility.

In some cases, he will order diagnostic imaging studies such as MRIs, CT scans, and X-rays to see your bones, muscles, and connective tissues in more detail to confirm your diagnosis.

How is muscle pain treated?

Dr. Villanueva offers customized treatment plans to alleviate chronic and debilitating muscle pain. After he diagnoses the cause of your pain, he creates a multidisciplinary treatment plan to approach your condition from several angles. For example, he may prescribe medication to reduce inflammation or muscle spasm combined with physical therapy to restore your strength, flexibility, and mobility, both relieving pain and reducing your risk of future pain.

Dr. Villanueva may also suggest trigger point injections or massage to reduce muscle strain and tension. You may also benefit from adding exercise to your daily activities. In addition to reducing pain, exercise can also help you lose weight, which reduces one of your risk factors for chronic musculoskeletal pain.

Don’t let muscle pain get in the way of your life, call Dr. Villanueva or schedule a consultation online today for customized pain management services.

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Peripheral Neuropathy

Peripheral neuropathy is a painful condition that can lead to severe complications, including infections, gangrene, and amputation. John Villanueva, MD, Pain and Spine Management, in Burbank, California, serving the greater Los Angeles area, offers expert diagnosis and treatment for peripheral neuropathy to reduce your pain and risk of injury. If you’re concerned about nerve damage, call or schedule an appointment online today.

What is peripheral neuropathy?

Peripheral neuropathy is a neurological condition that occurs when something damages the nerves that extend out from your spinal cord to carry messages between your brain and the rest of your body.

You have three types of peripheral nerves: motor, sensory, and autonomic nerves. Your motor nerves control your movements. Your sensory nerves provide sensation. Your autonomic nerves control your bodily functions such as digestion and respiration.

Peripheral neuropathy can affect any of these types of nerves and cause a wide range of disruptive symptoms.

What are the symptoms of peripheral neuropathy?

Your peripheral neuropathy symptoms depend on the type of nerve affected and the location of the nerve damage. However, some of the common symptoms of peripheral neuropathy include:

  • Numbness in your hands and feet that eventually spreads to your arms and legs
  • Sharp, burning pain
  • Sensitivity to touch
  • Lost coordination or frequent falls or stumbles
  • Muscle weakness
  • Temperature sensitivity
  • Excessive sweating
  • Bowel or bladder problems
  • Digestive problems
  • Changes in blood pressure

If you experience any of these symptoms, you should schedule an appointment with Dr. Villanueva right away.

What causes peripheral neuropathy?

A wide range of conditions contributes to peripheral neuropathy. For example, diabetes is one of the most common causes of the condition. When your blood sugar is continuously elevated, it can damage your nerves. When people with diabetes have peripheral neuropathy, they have to be extra careful to avoid damaging their feet, as they’re unlikely to notice a small injury. Diabetes also interferes with your circulation and healing process. These factors combine to create an increased risk of foot ulcers and infection.

Other causes of peripheral neuropathy include:

  • Autoimmune diseases such as lupus and rheumatoid arthritis
  • Thyroid disorders
  • Infections such as Lyme disease or shingles
  • Tumors
  • Bone marrow disorders
  • Alcoholism
  • Vitamin deficiencies
  • Medicines such as chemotherapy
  • Injury or trauma to your nerves

If you have peripheral neuropathy, you need to be careful as your risk of falling increases as does your chance of damaging your skin and getting an infection.

How is peripheral neuropathy treated?

Dr. Villanueva provides personalized treatments for peripheral neuropathy, depending on the extent of your condition and how it affects your overall health. You may benefit from medications, including pain relievers and topical treatments to relieve pain and other symptoms. You may also find that physical therapy provides some relief and help you improve your strength and coordination. Transcutaneous electrical nerve stimulation (TENS) is also known to reduce pain and other symptoms.

If you’re concerned about peripheral neuropathy, call or make an appointment online today.

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Complex Regional Pain Syndrome

Listed are the complex regional pain syndrome issues

  • CRPS Lower Limbs
  • CRPS Upper Limbs

What is Complex Regional Pain Syndrome?

Complex regional pain syndrome (CRPS) is a chronic condition typically affecting your arms, legs, hands, or feet. It usually occurs following an injury or trauma to your affected limb. CRPS pain is disproportionate to the original injury or trauma.
CRPS can strike at any age and affects both men and women, although it disproportionately affects women and is rare in the elderly. The average age of affected individuals is about 40.
The most common triggers of CRPS are:

  • Fractures
  • Muscle sprains or strains
  • Soft tissue injury (like burns, cuts, or bruises)
  • Immobile limbs (being in a cast)
  • Surgical procedures

What are symptoms of CRPS?

Signs and symptoms of CRPS can include:

  • Recurring throbbing pain, usually in one of your arms, legs, hands, or feet
  • Swelling near the affected area
  • Changes to the color of your skin (can range from white to red or blue)
  • Changes to the texture of your skin
  • Changes to your hair and nail growth
  • Joint stiffness
  • Weakened muscles
  • Muscle spasms

Symptoms often change over time and differ from person to person. In most cases, pain, swelling, and redness to the affected area occur first.

What causes CRPS?

There are two distinct types of CRPS:
Type 1
This is also called reflex sympathetic dystrophy syndrome. It occurs after an illness or injury that didn’t directly affect the nerves in your hurt limb. About 90% of
CRPS patients have Type 1.
Type 2
This is much less common. Once referred to as causalgia, Type 2 occurs after a nerve injury.
Many cases of CRPS are the result of trauma to your arm or a leg, such as a fracture. Other major and minor traumas, including from surgeries, heart attacks, and even sprained ankles, can cause CRPS. Emotional stress can also play a role in developing CRPS.

How do you treat CRPS?

Dr. Villanueva evaluates you to understand your condition better to formulate a diagnosis. Doing so helps him deliver personalized treatment to relieve your pain and restore function.
Treatment may include a combination of prescribed medication, physical therapy, or a variety of minimally invasive treatment options, such as spinal cord stimulation.
If you’re experiencing constant pain that makes touching or moving one of your limbs problematic, call or schedule an appointment online with Dr. John Villanueva right away to figure out the cause. It’s critical to treat CRPS early.

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Nerve Pain

Listed are the nerve pain & conditions issues

  • NERVE PAIN (Post Herpetic Neuralgia, Trigeminal Neuralgia)
  • Peripheral Neuropathy
  • Spasticity
  • Phantom Limb Pain
  • Central Pain
    • (after Stroke, Traumatic Brain Injury, or Spinal Cord Injury)

Pain caused by nerve damage

Sometimes pain results from damage to one or more peripheral or spinal nerves. This can happen as a result of an accident, infection, surgery or disease. The damaged nerves will misfire and send pain signals spontaneously, rather than in response to an injury.
This type of pain, called neuropathic pain, is often described as burning, freezing, numbing or tingling. It can also create a “pins and needles” sensation. A common form of neuropathic pain occurs when diabetes damages the small nerves in the hands and feet, producing a painful burning sensation.
Another form of neuropathic pain happens when pain pathways in the peripheral nerves and spinal cord become persistently activated. This process, called sensitization, amplifies the pain message. It’s out of proportion to or even disconnected from the original disease or injury. This is what happens in so-called phantom limb pain — even though an injured limb is gone, the pain transmission pathways along the nerves are still activated, as if the limb is still there.

What is Post-Herpetic Neuralgia?

Postherpetic neuralgia (post-hur-PET-ik noo-RAL-juh) is the most common complication of shingles. The condition affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear.
The chickenpox (herpes zoster) virus causes shingles. The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60. There’s no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time.


Spasticity is a condition in which certain muscles are continuously contracted. This contraction causes stiffness or tightness of the muscles and can interfere with normal movement, speech and gait. Spasticity is usually caused by damage to the portion of the brain or spinal cord that controls voluntary movement. The damage causes a change in the balance of signals between the nervous system and the muscles. This imbalance leads to increased activity in the muscles. Spasticity negatively affects muscles and joints of the extremities and is particularly harmful to growing children.
Conditions that may cause spasticity include:

  • Traumatic brain injury (TBI)
  • Spinal cord injury (SCI)
  • Brain damage due to a lack of oxygen
  • Stroke
  • Encephalitis
  • Meningitis
  • Adrenoleukodystrophy
  • Amyotrophic lateral sclerosis (Lou Gehrig’s disease)
  • Phenylketonuria

What is Phantom Limb Pain from Amputation?

Phantom pain is pain that feels like it’s coming from a body part that’s no longer there. Doctors once believed this post-amputation phenomenon was a psychological problem, but experts now recognize that these real sensations originate in the spinal cord and brain.

Most people who’ve had a limb removed report that it sometimes feels as if the amputated limb is still there. This painless phenomenon, known as phantom limb sensation, isn’t the same as phantom pain.

For some people, phantom pain gets better over time without treatment. For others, managing phantom pain can be challenging. You and your doctor can work together to treat phantom pain effectively with medication or other therapies.


Central pain syndrome is a neurological disorder caused by damage to the sensory pathways of the central nervous system (CNS). Common symptoms include pain (but also pruritus) and loss of sensation, usually in the face, arms and/or legs. Pain is often constant (but can be intermittent) and can be mild, moderate, or severe in intensity. Affected individuals may become hypersensitive to painful stimuli. The specific type of pain experience can vary from one individual to another based, in part, upon the underlying cause of the disorder and the area of the central nervous system affected. Central pain syndrome can potentially disrupt an individual’s daily routine. In severe cases, the pain can be agonizing and unrelenting and dramatically affect a person’s quality of life. Central pain syndrome can develop following a variety of conditions including:

  • stroke
  • multiple sclerosis
  • spinal cord injury
  • brain tumors
  • iatrogenic damage to the central nervous system.

Opioid pain medications often provide little or no relief for those affected by central pain syndrome. However, some antidepressants and anticonvulsants can be useful in treating central pain syndrome.

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Related Injuries

Listed are the related injuries issues

  • Sports Related Injury
  • Personal Injury
  • Workman Compensation

What are the Most Common Sports Related Injuries?

  1. Ankle sprain
  2. Groin pull
  3. Hamstring strain
  4. Shin splints
  5. Knee injury: ACL tear
  6. Knee injury: Patellofemoral syndrome — injury resulting from the repetitive movement of your kneecap against your thigh bone
  7. Tennis elbow (epicondylitis)

The most common sports injuries are strains and sprains

  • Sprains are injuries to ligaments, the tough bands connecting bones in a joint. Suddenly stretching ligaments past their limits deforms or tears them. Strains are injuries to muscle fibers or tendons, which anchor muscles to bones. Strains are called “pulled muscles” for a reason: Over-stretching or overusing a muscle causes tears in the muscle fibers or tendons. The tissue lengthens with stress and returns to its normal length — unless it is pulled too far out of its normal range.

When to get medical attention for common sports injuries

  • We know you’re tough — but you also need to be smart. If you suspect a serious injury or if you have any of these signs, see a doctor:
  • Deformities in the joint or bone — it looks “crooked,” or moves abnormally
  • You cannot bear weight or can’t use the limb without it “giving way”
  • Excessive swelling
  • Changes in skin color beyond mild bruising
  • It’s not getting any better after a few days of conservative RICE (rest, ice, compression, elevation) therapy

Personal Injury

  • Over 100 Los Angeles lawyers have had one or more of the personal injury accident clients treated at our clinic by Dr. John Villanueva. We specialize in all personal injury medical cases including:
  • Automobile Collisions
  • Motorcycle Accidents
  • Pedestrian Accidents
  • Whiplash
  • Back/Neck Strain
  • Knee Injuries
  • Shoulder/Arm Injuries
  • Slips and Falls
  • Animal Bites
  • Battery


  • Same day appointments available
  • Flexible Office Hours
  • Physician on-call 24/7 for emergency cases

Customer Service

  • Rapid turn-around on Reports and Billing
  • Liens accepted
  • Specialty Referral Available
  • Friendly, Courteous, and Efficient Staff

Workers’ Compensation

  • Dr. John Villanueva aims to provide top quality healthcare to all injured workers, help employers reduce costs by offering expert occupational healthcare services including drug testing and workers compensation, and to communicate with our clients in a clear and precise manner. We are committed to timely and appropriate medical treatment that will eliminate or reduce lost work days.

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