In addition to pain preventive strategies, conscientious clinical care and risk reduction protocols, Duke Pain Medicine is actively working to shape the future of pain medicine in the United States. This team believes that the ideal solution to the co-existing chronic pain and opioid crisis is the development of novel non-opioid analgesics and the delivery of scientific discoveries to the bedside. Their mission is “to provide extraordinary care for the patient in pain through precision diagnosis, innovative interventions and refined medical therapies” while simultaneously seeking translational scientific discovery to reduce the future burden of chronic pain.
Neurostimulation Implant Program (multiple sites)
In recent years, the clinical and translational scientific programs have grown dramatically. Specific areas of targeted for growth include the Neurostimulation Service, which performed 257 neurostimulation cases in 2018, including cutting-edge techniques, such as dorsal root ganglion stimulation. Trials and implants take place across multiple clinical sites.
This clinic, located at Medical Park in Durham, houses both the Interventional and Medical Pain Services. The Interventional Service offers diagnostic and therapeutic interventions, including advanced neurostimulation techniques, fluoroscopically-guided spine procedures, ultrasound-guided musculoskeletal and peripheral nerve interventions, and radiofrequency lesioning techniques. In addition to the neurostimulation program, there is a comprehensive, targeted drug delivery (spinal infusion pumps) in the treatment of cancer-related pain. In 2018, the Duke Pain Medicine clinic had more than 18,000 visits and performed more than 2,000 procedures.
The outpatient Medical Pain Service team evaluates and manages high-risk pain patients, providing patient care, complex care coordination, and education for patients and clinicians throughout the Duke University Health System. With an extensive background in the management of chronic pain and psychiatric disorders, Dr. Prakken manages a team that includes four advanced practice practitioners: Karen McCain, Ashley Underwood, Deborah Stoia and Cher Nicholas.
This multispecialty clinic, located in Raleigh at Brier Creek, opened in 2017 and has seen steady growth, treating patients with orofacial, neuralgic, spine, and musculoskeletal conditions with fluoroscopically- and ultrasound-guided injection techniques, acupuncture and physical therapy. Massage therapy was added to the clinic repertoire in 2019. DIPT is also the home of the Regenerative Pain Therapies Program (RPTP) that offers a full spectrum of non-opioid, biological treatments, with a focus on Duke Autologous Serum (DAS).
Under the medical direction of Dr. Scott Runyon, this clinic performs approximately 6,500 visits per year, offering a full spectrum of fluoroscopic and ultrasound-guided procedures, medication management, radiofrequency rhizotomy, spinal cord stimulation, dorsal root ganglion stimulation, botox injection for chronic pain conditions, and kyphoplasty. This clinic is integrated with Duke Neurosurgery and serves vital diagnostic and interventional needs for spine patients in the Raleigh area.
Under the direction of Dr. Kevin Vorenkamp, this clinic successfully transitioned to Duke Anesthesiology in 2018, offering comprehensive spine and pain management. Dr. Vorenkamp began his role as medical director on August 27 after leaving his role as the director of the Pain Medicine Fellowship at Virginia Mason Medical Center in Seattle. The clinic is now fully staffed with pain medicine (Anesthesiology) physicians, including the addition of Dr. Brian Starr, and nurse practitioners, Emily Davis, Natalie Miller and Sarah Baxt. The clinic provides comprehensive evaluation, treatment and procedural care and is now providing access within 72 hours for all new patient visits. The clinic is also offering services, including perioperative pain management, for the Duke Raleigh medical campus.
This clinic, located at Duke Medicine Circle in Durham, is an innovative program that focuses on care of the patient around the time of surgery. Patients are evaluated before surgery to identify and eliminate barriers to optimize pain management. A comprehensive plan is developed for the pre-, intra- and post-operative period by a team of physicians and a licensed clinical social worker. Many of its providers also work in the Inpatient Pain Service, providing continuity and a seamless transition between the clinic’s plan of care and inpatient management.
Inpatient Pain Service
The Inpatient Pain Service is a comprehensive, multidisciplinary consult service focused on providing specialized care for acute postoperative pain, acute-on-chronic pain, and cancer-related pain. Led by specialized pain physicians, the Inpatient Pain Service utilizes a variety of advanced medical and interventional therapies, including peripheral nerve catheters, epidural analgesia, non-opioid analgesic medicines, and psychosocial support. This team provides 24/7 inpatient pain services and conducts daily rounds in close collaboration with the patient’s primary management team. It vigorously supports acute pain medicine research initiatives aimed at maintaining a state-of-the-art capability to provide care for complex acute pain conditions. To ensure a smooth transition at discharge, the Inpatient Pain Service strives to assist primary management teams in the development of continuous pain care pathways.