Villanueva Institute of Pain and Spine
Where Does It Hurt?
Pain can change the way you move, work, sleep, exercise, and handle everyday routines. Sometimes the source is easy to identify. Other times, where you feel pain is only part of the story. Hip or leg symptoms may begin in the lower back, headaches can be connected to the neck, and tingling or burning pain may point to a nerve problem rather than an injured muscle or joint.
At VIPS, Villanueva Institute of Pain and Spine, I take the time to understand both where you hurt and why. As a physician double board-certified in Physical Medicine and Rehabilitation, or PM&R, and Pain Medicine, I evaluate the musculoskeletal and neurological factors that may be contributing to your symptoms before recommending treatment. Beyond my double-board certifications, 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.
If pain has started interfering with the things you want or need to do, call our Burbank office at (818) 669-8895 or request an appointment online. We can start by figuring out what is causing your symptoms and what may help you move forward.
Quick Links
Back & Spine Pain
Back pain is one of the most common reasons people seek pain management, but the diagnosis can vary considerably from one person to another. The problem may involve a disc, spinal joint, nerve, narrowing within the spinal canal, or changes related to a previous surgery.
Chronic Back Pain
Chronic Back Pain may persist for months or years and can have several possible causes. I look at your symptoms, physical examination, medical history, and imaging together to determine what structures may be contributing and which treatment options make sense.
Herniated Disc
A Herniated Disc occurs when material from within a spinal disc pushes outward and may irritate nearby nerves. Depending on its location, a herniated disc can cause back or neck pain as well as radiating pain, numbness, tingling, or weakness in an arm or leg.
Degenerative Disc Disease
Degenerative Disc Disease refers to changes that occur as spinal discs lose hydration, height, or flexibility. Some people have little or no discomfort, while others develop ongoing back or neck pain, stiffness, or symptoms related to nearby nerves.
Sciatica
Sciatica describes pain caused by irritation or compression of the sciatic nerve or the nerve roots that form it. Symptoms often begin in the lower back or buttock and travel into the thigh, calf, or foot.
Failed Back Surgery
Persistent or recurring pain after spine surgery is sometimes referred to as Failed Back Surgery. This does not necessarily mean the original operation was performed incorrectly. There may be another source of pain, continued nerve irritation, scar tissue, degeneration at another spinal level, or a condition that requires a different approach.
Spinal Stenosis
Spinal Stenosis occurs when spaces within the spine narrow and place pressure on nerves. Lumbar spinal stenosis commonly causes back and leg symptoms that become worse with standing or walking and improve when sitting or leaning forward.
Neck & Nerve Pain
Pain involving the neck, arms, legs, hands, or feet can sometimes be neurological rather than purely musculoskeletal. Burning, electric, shooting, tingling, or numb sensations are particularly important clues.
Neck Pain
Neck Pain can develop from muscle strain, arthritis, disc problems, facet joint pain, nerve compression, injury, or other conditions affecting the cervical spine. Some people experience localized stiffness, while others have symptoms that travel into the shoulder, arm, or hand.
Nerve Pain
Nerve Pain may feel burning, shooting, electric, hypersensitive, numb, or tingling. Finding the affected nerve and understanding why it is irritated are important parts of deciding how to treat it.
Peripheral Neuropathy
Peripheral Neuropathy affects nerves outside the brain and spinal cord. Symptoms frequently involve the feet or hands and may include burning, numbness, tingling, unusual sensitivity, weakness, or problems with balance.
When necessary, I can perform EMG and nerve conduction studies to help evaluate certain nerve and muscle disorders more closely.
Joint & Muscle Pain
Not every painful movement begins in the spine. Arthritis, overuse, injury, inflammation, and changes in the muscles or joints can all interfere with mobility.
Arthritis
Arthritis can affect the spine as well as joints throughout the body. Symptoms may include aching, stiffness, swelling, reduced range of motion, or pain that becomes more noticeable with activity.
Shoulder Pain
Shoulder Pain may come from the shoulder joint itself, surrounding tendons or muscles, or even the cervical spine. Determining where the symptoms originate helps us avoid treating the wrong structure.
Knee Pain
Knee Pain may result from arthritis, inflammation, injury, degeneration, or other conditions affecting the joint and surrounding tissues. Treatment depends on the diagnosis, your activity level, and how much the pain is limiting your mobility.
Muscle Pain
Muscle Pain can occur after an injury or overuse, but persistent muscle pain may also involve trigger points, altered movement patterns, nerve irritation, or another underlying condition.
Headaches & Widespread Pain
Some painful conditions are not limited to one joint, muscle, or spinal level. These conditions often require a broader look at the nervous system, previous treatment, and the way symptoms affect daily function.
Headaches & Migraines
Headaches & Migraines can vary widely in their causes and presentation. For appropriate patients, pain management may include treatments such as headache injections, occipital nerve blocks, or other interventional options based on the headache pattern and diagnosis.
Fibromyalgia
Fibromyalgia is associated with widespread pain and tenderness and may also involve fatigue, sleep difficulties, and heightened sensitivity. Because symptoms are often complex, treatment generally requires a thoughtful, multidisciplinary approach rather than focusing on one isolated area.
When Pain Is More Complicated
Certain pain conditions can be particularly difficult to diagnose and manage. Patients may have already seen multiple physicians or tried several treatments before reaching a pain specialist.
Complex Regional Pain Syndrome (CRPS)
Complex Regional Pain Syndrome, or CRPS, is a chronic pain condition that most commonly develops in an arm or leg after an injury, surgery, or other physical trauma. Pain may be severe compared with the original injury and can occur alongside swelling, temperature or color changes, sensitivity, or changes in movement.
Failed Back Surgery
For patients who continue to hurt after spine surgery, I take a new look at the problem rather than assuming nothing else can be done. That may involve reviewing updated imaging, examining nerve function, looking for another pain generator, and considering treatments that were not appropriate before surgery.
Finding the Source of Your Pain
Where you hurt gives us a starting point. It does not always give us the diagnosis.
At your first visit, I want to hear how your symptoms started, where they travel, what makes them better or worse, and what they are preventing you from doing. I also review previous treatment and personally evaluate relevant MRIs, CT scans, and X-rays whenever those images are available.
From there, we can decide whether you need additional testing or whether the diagnosis is clear enough to begin discussing treatment.
The treatment itself may involve rehabilitation, medication management, an image-guided injection, radiofrequency ablation, regenerative medicine, nerve stimulation, or another option. In some situations, I may recommend evaluation by another specialist instead. The point is to choose treatment based on what the evidence shows rather than simply treating the place that hurts.
Pain Management in Burbank, CA
You do not need to know exactly what is causing your pain before making an appointment. Helping you understand that is part of what we do.
At VIPS, I treat patients with back, neck, joint, muscle, nerve, and chronic pain conditions from Burbank, Glendale, Toluca Lake, Studio City, North Hollywood, Pasadena, and communities throughout the greater Los Angeles area.
Call (818) 669-8895 or contact VIPS online to schedule a consultation and learn more about what may be causing your symptoms.
Where Does It Hurt? FAQs
Here are answers to a few questions patients often ask before their first visit at VIPS.
Can I see a pain management specialist if I am already seeing another doctor?
Yes. Pain management often works alongside primary care physicians, spine surgeons, neurologists, physical therapists, and other specialists. You may be referred to VIPS because your physician wants a closer evaluation of a particular pain problem or additional options for managing persistent symptoms. When possible, bringing records from your other providers helps me understand what has already been evaluated and treated.
What if I have pain in more than one part of my body?
Pain in several areas does not necessarily mean that each location represents a separate problem. Some conditions can cause symptoms in multiple parts of the body, while others may involve overlapping musculoskeletal and neurological issues. During your evaluation, I look at how the symptoms relate to one another rather than assuming every painful area needs to be treated independently.
Should I keep track of my symptoms before my appointment?
It can be helpful. Pay attention to when your pain occurs, what activities make it worse, what provides relief, whether it travels to another area, and whether you experience numbness, tingling, weakness, or other symptoms alongside it. You do not need to create an elaborate pain journal, but a few specific examples can help us better understand how the problem is affecting your everyday life.
What if my pain comes and goes?
Intermittent pain can still deserve evaluation, particularly when it keeps returning, limits certain activities, or is becoming more frequent or intense. The pattern itself can provide useful information. Knowing whether symptoms appear with walking, sitting, exercise, particular movements, or certain positions can help narrow down possible causes.
Can I have a pain condition even if my imaging does not show a major problem?
Yes. Imaging is only one part of a pain evaluation. An MRI or X-ray may not capture every possible source of symptoms, and findings that appear significant on a scan do not always explain why someone hurts. This is why I consider your history, physical and neurological examination, imaging, and other testing together rather than making a diagnosis from a scan alone.
When should pain be evaluated urgently?
Some symptoms should not wait for a routine pain management appointment. New or rapidly worsening weakness, loss of bowel or bladder control, significant numbness in the groin or saddle area, severe pain following a major injury, or pain accompanied by other concerning symptoms may require prompt medical evaluation. If you are unsure whether your symptoms represent an emergency, seek immediate medical care rather than waiting for a scheduled office visit.