expert type icon EXPERT

Dr. Sebastian Villarreal, MD

Pain Management Specialist

Dr. Sebastian Villarreal practices Pain Medicine in Katy, Texas. Pain medicine is concerned with the prevention of pain, and the evaluation, treatment, and rehabilitation of patients experiencing pain. Pain medicine physicians use a broad-based approach to treat all pain disorders, ranging from pain as a symptom of disease to pain as the primary disease. Dr. Villarreal serves as a consultant to other physicians but is often the principal treating physician, providing care at various levels; such as treating the patient directly, prescribing medication, prescribing rehabilitative services, performing pain relieving procedures, counseling patients and families, directing a multidisciplinary team, coordinating care with other healthcare providers, and providing consultative services.
15 years Experience
Dr. Sebastian Villarreal, MD
  • Katy, TX
  • University of Texas Medical Branch at Galveston
  • Accepting new patients

Are steroids often recommended for pain?

The use of steroids is very common to decrease pain and inflammation. Talk with your doctor about the risks and benefits. Steroids provide a minimally invasive approach to treatment READ MORE
The use of steroids is very common to decrease pain and inflammation. Talk with your doctor about the risks and benefits. Steroids provide a minimally invasive approach to treatment with the intent to either delay or eliminate the need for surgery. Usually, the pain comes from the inflammatory response the body produces in response to tissue damage and the body needs that inflammatory to decrease in order to heal.

I have severe back pain during my periods. Please help.

Hi, Pain during menstrual cycles are likely sign of gynecological pathology. Could be an ovarian issue or endometriosis for example. My recommendation is to see your OB/Gyn. READ MORE
Hi,

Pain during menstrual cycles are likely sign of gynecological pathology. Could be an ovarian issue or endometriosis for example. My recommendation is to see your OB/Gyn. She/he may order an ultrasound to assess the matter further. I know it's not as helpful when these answers tell you to see your doctor, but I hope the advice helped a little.

Can pain relieving drugs become addictive?

If you are asking about opioid medications for pain relief, then yes. All opioids have that addiction side effect profile. The research shows it doesn't take a long time to become READ MORE
If you are asking about opioid medications for pain relief, then yes. All opioids have that addiction side effect profile. The research shows it doesn't take a long time to become "addicted" to these meds. Some show time as little as 2 weeks. However, there are many factors that come into this such as reason for taking the pain medication. Many people take pain medication for the wrong reason, like stress or escape. These medicines are not meant for that use. Or use of these medications after the pain has subsided and some patients take it in fear of pain coming back.

There are other meds that don't have that side effect such as NSAIDs. These are very helpful in relieving pain without causing addiction.

How does alternative hot and cold packs help in relieving pain?

Usually cold is used in the immediate acute injury setting in the first 48 hours (RICE is an acronym used for Rest, Ice, Compression, Elevation). This helps decrease the inflammatory READ MORE
Usually cold is used in the immediate acute injury setting in the first 48 hours (RICE is an acronym used for Rest, Ice, Compression, Elevation). This helps decrease the inflammatory response as well as reduce swelling and pain. After this initial period, depending on the area of injury, it may be useful to alternate between hot and cold to expedite the removal of damaged tissue cells and improve mobility. Heat usually helps loosen muscular issues after these periods have passed. Hope this helps.

How can pain be managed in the elderly?

Pain in the elderly is difficult to treat because as we age, we become more sensitive to the side effects of medications. In the case of pain medication, the elderly become more READ MORE
Pain in the elderly is difficult to treat because as we age, we become more sensitive to the side effects of medications. In the case of pain medication, the elderly become more sensitive to the respiratory side effect of opioids which could be very dangerous. A qualified pain medicine specialist should however be able to navigate through your mother's
co-morbidities (other medical issues) and her current pain state. It may require him/her to start at a very low dose and increase slowly as needed. There are also many interventional procedures we can perform depending on the location of the pain which do not require opioid medication and provide good pain control.

When should I rely on a painkiller for a headache?

If the headache is a migraine headache, painkillers are actually not recommended anymore for treatment. I would recommend seeing a neurologist so they can determine what type of READ MORE
If the headache is a migraine headache, painkillers are actually not recommended anymore for treatment. I would recommend seeing a neurologist so they can determine what type of headache it is so as to give the appropriate treatment. For example, sinus headaches require a different treatment than cluster headaches or tension headaches.

I have a lot of body pain by the end of the day, mainly due to my weight. What should I do?

I am faced with this issue a lot in my practice. The advice I give my patients is simple. If you can't control the calories that you can expend then you MUST control the calories READ MORE
I am faced with this issue a lot in my practice. The advice I give my patients is simple. If you can't control the calories that you can expend then you MUST control the calories you intake. It's a diet issue. I would recommend decreasing or eliminating carbohydrates and sugars. Also eliminate processed foods (things that come out of a box or can) which may cause a low level of inflammation. Basically if it doesn't go bad, then you shouldn't eat it. Eat meats and vegetables primarily. This will help to decrease weight without the need for vigorous exercise. It's basically a lifestyle change which is needed. Is it easy? No. But it is worth it.

Why do I have pain every time before passing my bowels?

Abdominal pain is one of those issues that has so many possibilities as to why it's happening that it is very difficult to answer that question over this medium. My advice is to READ MORE
Abdominal pain is one of those issues that has so many possibilities as to why it's happening that it is very difficult to answer that question over this medium. My advice is to see your doctor or GI specialist. A colonoscopy may be in order.

I have a stabbing pain in my lower abdomen. Should I be worried?

Abdominal pain is a complicated symptom because it could come from so many sources. My best response is to see you physician so he can take a detailed history and perform a physical. READ MORE
Abdominal pain is a complicated symptom because it could come from so many sources. My best response is to see you physician so he can take a detailed history and perform a physical. Although there are many benign reasons (gas or constipation) to have abdominal pain, there are also many serious reasons (appendicitis, ectopic pregnancy, bowel obstruction) as well. All these may present with stabbing lower abdominal pain. I definitely wouldn’t take a pain killer without knowing the source of the pain. If you don’t improve, see your PCP.

How can i reduce my shoulder pain that arises due to long hours of working on the computer?

That’s a very tough question. If you do anything for 20 hours, you’re gonna find it hard to get relief in problem areas. Best thing to do is to find the best ergonomic position READ MORE
That’s a very tough question. If you do anything for 20 hours, you’re gonna find it hard to get relief in problem areas. Best thing to do is to find the best ergonomic position you can. Also, change positions often like with a stand up desk. This may help. If, again, you do anything for 20 hours a day, your problem areas are gonna hurt.

What is causing my chronic back pain?

There many causes of back pain. They range from degenerative disc disease to joint arthritis. The best way to diagnose it is to see your local Pain Medicine physician and he will READ MORE
There many causes of back pain. They range from degenerative disc disease to joint arthritis. The best way to diagnose it is to see your local Pain Medicine physician and he will likely order an MRI to help him assess the issue. Ibuprofen is a good anti-inflammatory, but when taken on a long-term basis has its own risks, particularly to the kidneys, stomach and heart. So it should be used sparingly, and when needed. Hope this helps.

What causes pain in the breasts?

This may be a question better answered by Ob/Gyn. But I can only assume it has to do with the change in hormones during your menstruation cycle and how your breast tissue is responding READ MORE
This may be a question better answered by Ob/Gyn. But I can only assume it has to do with the change in hormones during your menstruation cycle and how your breast tissue is responding to those changes.

My back hurts when I sit down. Why?

Very difficult to answer that question without performing a physical exam and imaging. It may be a Quadratus Lumborum issue. You may have strained it without realizing it. Sometimes READ MORE
Very difficult to answer that question without performing a physical exam and imaging. It may be a Quadratus Lumborum issue. You may have strained it without realizing it. Sometimes these things take a day to show up. The best thing to do is to go see your doctor. He/she may likely prescribe physical therapy to begin with as a conservative form of treatment and a muscle relaxer. If things don't improve after that he/she may do some imaging and the diagnostic process will begin. Hope this helps.

Dr. Villarreal

I am very intolerant of narcotics

The thought would give me serious anxiety as well. Your options are limited, but here are what they are. 1. A very light pain killer such as Tylenol #3, tramadol or nucynta. 2. READ MORE
The thought would give me serious anxiety as well. Your options are limited, but here are what they are.
1. A very light pain killer such as Tylenol #3, tramadol or nucynta.
2. NSAIDs such as meloxicam, ibuprofen, aleve, diclofenac or Tylenol
3. (DEPENDS ON WHICH JOINT YOU ARE HAVING REPLACED). Talk to your anesthesiologist about placing a nerve block with a catheter pump. This will work for about 3 days after your surgery (which are usually the worst pain wise). Most times anesthesiologists place a single shot block to help with pain immediately after the surgery and they last for about 8-10 hours post op. If they have the availability and expertise, they may also place a catheter next to the nerve and a pump filled with anesthetic which continues that block for 3 days. This option however depends on your surgeon and anesthesiologist. So ask about this before your surgery.
Hope the answer helped and good luck.

Long term narcotic use

There are many natural ways to improve constipation from eating prunes to higher fiber diet to increasing water intake.There are just too many to list. Many of my patients have READ MORE
There are many natural ways to improve constipation from eating prunes to higher fiber diet to increasing water intake.There are just too many to list. Many of my patients have improved their symptoms by changing their diet. I recommend you search your favorite search engine for this question and I know you will find an abundance of information. I would recommend staying away from laxatives. Your body tends to need it, thus making the problem worse. Stool softeners are a better option. If you need a prescription strength medication, there are two made specifically for this issue which are Movantik and Relistor.

Sharp, shooting pain in my right leg

Well yes and no. The sciatic nerve is compromised of a few nerve roots that exit in your lower back. This nerve may be pinched in two different areas. One is at the nerve root READ MORE
Well yes and no. The sciatic nerve is compromised of a few nerve roots that exit in your lower back. This nerve may be pinched in two different areas. One is at the nerve root as it exits the low back. The other is the piriformis muscle that is a deep buttock muscle. If you have pain that begins in your buttock and travels down the back of you leg, that is most likely the sciatic nerve trapped in the piriformis muscle (piriformis syndrome). If you have low back pain that travels down the leg, then it's most likely what we call "radiculopathy", which is nerve compression symptoms down that specific nerve root. I know it was a long answer to your question, but I hope it cleared up some of the terminology for you.

Dealing with pain anxiety depression

Unfortunately I cannot help you find doctors in your area. The problem is that the combination of opioids, muscle relaxants and benzodiazepines have contributed to many many patient READ MORE
Unfortunately I cannot help you find doctors in your area. The problem is that the combination of opioids, muscle relaxants and benzodiazepines have contributed to many many patient deaths. So where someone like yourself may have been responsible in taking this combination of medicine with good result, many others have had disastrous consquences. This combination was also a favorite of persons with illicit drug habits. For these reasons, you are now finding it more difficult to get this combination of medicines. I'm sure the doctors in you area "get it", it's just that this combination is no longer considered "safe". Best of luck and I'm sorry responsible patients like yourself now have a hard time getting the medicines they need.