In 1974, Dr. Bruno Urban became the first dedicated pain management specialist within Duke Anesthesiology. He was quickly joined by a multidisciplinary team, including Dr. Blaine Nashold in neurosurgery, Dr. Francis Keefe in psychology and other future leaders in the field of pain medicine. Dr. Urban set the stage and expectations that pain management needed to be a multidisciplinary approach that crossed specialty barriers. Patients were frequently evaluated by several members of the team prior to development of a multidisciplinary treatment plan, including neurosurgical and neurostimulation techniques. When the Pain Medicine Division was established in 1999, Dr. Urban served as its first chief, prior to retiring from clinical practice in 2000.
In the early 2000s, Dr. Winston Parris was recruited, and interventional and neurostimulation techniques were expanded, adding novel treatments, such as epidural lysis of adhesions. The Pain Medicine Fellowship expanded from one to three fellows and academic growth continued with program representation at multiple national meetings. A formalized educational process both within and outside of the division was solidified.
In 2014, with the growing needs for population health management, in addition to interventional-based pain therapies, the outpatient clinic relocated from Morreene Road to a dedicated clinical space (Medical Park Clinic) and several new physicians were recruited. Dr. Steve Prakken was brought in to lead the Medical Pain Service (MPS) and Dr. Richard Boortz-Marx was recruited for the interventional/implant program. The MPS was designed for care of the complex patient with chronic pain and co-existing disease, utilizing an APP team approach. Dr. Boortz-Marx continued the growth of the neurostimulation and implant program, solidified under Dr. Parris.
In 2017, the Duke Innovative Pain Therapies (DIPT) clinic opened as one of the only clinics in the nation to offer simultaneous services by specialists for orofacial pain, musculoskeletal and spine conditions. The clinic takes a patient-centered approach, incorporating additional therapies in acupuncture, massage and physical therapy. DIPT is the home for Duke’s Regenerative Pain Therapies Program.
In the same year, Duke Pain Medicine further expanded its collaboration with Duke Neurosurgery. Dr. Scott Runyon became the medical director of Duke Spine and Pain Management of Raleigh, where he has had a presence since 2015. This clinic, integrated with Neurosurgery, serves vital diagnostic and interventional needs for spine patients in the Raleigh area.
Also in 2017, Duke Anesthesiology opened the Duke Perioperative Pain Care clinic, one of the few in the country to optimize patients with chronic pain before surgery and to facilitate their recovery. Patients are evaluated early, identifying and eliminating barriers to successful surgical recovery.
In 2018, the Duke Raleigh Hospital Pain Clinic opened its doors, offering comprehensive spine and pain management under the direction of Dr. Kevin Vorenkamp. This clinic provides comprehensive evaluation, treatment and procedural care for patients across Raleigh.