Duke Anesthesiology’s Pain Medicine Division delivers state-of-the-art diagnostic and interventional therapies and provides population health-level care for chronic pain patients. Under the direction of Dr. Thomas Buchheit, the Pain Medicine Program is tailored to simultaneously address two public health challenges: the treatment of 100 million American adults suffering from chronic pain (more than diabetes, heart disease and cancer combined, according to a 2012 Institute of Medicine report) and a devastating opioid epidemic.
To address these challenges, the Pain Medicine Program has expanded outpatient services to include a section of Interventional Pain Medicine, led by Dr. Richard Boortz-Marx, and created a Medical Pain Service team, developed and led by Dr. Steve Prakken. These teams work in collaboration with the Inpatient Pain Service and employ comprehensive, multimodal care and risk reduction strategies to treat patients across the care continuum.
The outpatient Interventional Pain Medicine Service offers diagnostic and therapeutic interventions for spine and back pain, sciatica, nerve injury, arthritis, cancer pain, and spasticity. This team also operates a well-developed implantation service for neurostimulation techniques such as spinal cord, dorsal root ganglion and peripheral nerve stimulation. Fluoroscopic and ultrasound-guided radiofrequency lesioning techniques are commonplace for patients with spine disease, joint arthritis and peripheral nerve injuries. There is additionally a comprehensive service for targeted drug delivery systems (spinal infusion pumps), especially for the treatment of cancer-related pain.
The outpatient Medical Pain Service team provides patient care, care coordination, and education for complex pain patients and community practitioners throughout the Duke University Health System. With an extensive background in the management of chronic pain and its comorbid diagnoses, Dr. Prakken is able to bring a unique synthesis of disciplines to the clinic.
The Inpatient Pain Service (IPS) provides consultation and active management for patients with both acute and chronic conditions at Duke University Hospital. In addition to these hospital and perioperative services, the IPS works closely with the oncologists and Palliative Care Service of the Duke Cancer Institute to offer advanced interventional therapies (neurolytic procedures, spinal drug delivery, etc.) for cancer patients. The synergy between these three arms of the Pain Medicine Program facilitates care coordination throughout the health system.
With compelling goals and the need for new, non-opioid therapies to treat chronic pain in a safe and comprehensive manner, the Pain Medicine Program also works directly with world-renowned pain researcher, Dr. William Maixner, along with leading basic scientists, clinicians and clinical researchers at the department’s newly established Center for Translational Pain Medicine to achieve its mission statement: “provide extraordinary care for the patient in pain through precision diagnosis, appropriate intervention, and medication optimization” while simultaneously seeking translational scientific discovery to reduce the future burden of chronic pain.