Clinical Program

The Pain Service at Duke treats patients on both an inpatient and outpatient basis. Both services continue to see strong growth in the number of patient encounters. This multidisciplinary clinic includes clinicians from anesthesiology, neurology, psychiatry, neurosurgery, psychology and physical therapy. The range of services provided includes comprehensive evaluation of pain problems and therapies including medical management, comprehensive Interventional pain procedures including nerve blocks, infusion therapies, evaluation for invasive procedures such as intrathecal pumps and spinal cord stimulators, neuroablative procedures, acupuncture, biofeedback, guided imagery, relaxation techniques, and physical therapy. This truly unique pain program is one of the few successful multidisciplinary pain clinics in the country.

Anesthesiologists in the pain clinic evaluate and treat all types of chronic pain syndromes including neuropathic pain, musculoskeletal pain, headaches, cancer pain, as well as sympathetic and visceral pain syndromes. The comprehensive evaluation in the clinic includes a detailed pain history, physical examination, and laboratory assessments as indicated. Patients seen in the multidisciplinary clinic complete a comprehensive pain perception profile to evaluate the multiple factors involved in the generation of chronic pain syndromes. The emphasis on the multidimensional aspect of pain evaluation and treatment is in accordance with the original mission of the pain clinic.

Since opening in October of 2000, patient volumes at the Morreene Road Pain Clinic remain high for clinic visits and injections. This volume has not compromised the thorough patient evaluations on which the attending staff takes great pride. Despite the busy clinic schedule, the anesthesiology pain clinic continues to accommodate same-day consultations for urgent issues.

Drs. Anne Marie Fras, Billy Huh, Lesco Rogers, and Dianne Scott provide new patient consultations in the Pain Clinic. Allison Taylor, PA-C, assists in patient evaluations, continuity of care, and performs the refilling and reprogramming of the intrathecal pumps.

Under the supervision of Dr Billy Huh, the pain clincic provides in-patient and out-patient consultations for cancer pain management.  We utilize latest advances in pain management tools including  implantable devices such as intrathecal pump and spinal cord stimulation, neurolysis, acupuncture, biofeedback, and physical therapy.

The inpatient Acute Pain Service (APS) continues to provide patient care 24-hours per day, 7 days per week. The coverage that Dr. Brian Ginsberg and his team provide is extensive. The APS establishes continuous catheters and maintains those established in the operating room for post-operative pain control. In addition, consultations are provided for difficult postoperative patients without catheters and for inpatients with chronic pain syndromes.

Duke faculty and affiliate faculty provide pain services at the Durham Veterans Administration Hospital.  Under the ongoing direction of Dr. Joel Goldberg, the VA Pain Clinic has been in operation since 1988 and is third longest-running pain clinic within the Veterans Administration Health System.  Drs. Thomas Buchheit, Harry Goforth, Joel Goldberg, David Lindsay, and Srinivas Pyati will be joined this year by Dr. Thomas Van De Ven.  Hali Bakelaar, NP is a valuable member of the team, performing patient evaluations and treatment as well as initial review of the many consultation requests the Pain Clinic receives each week.

In addition to outpatient pain management services, the VA Pain Clinic providers assist in the management of pain for inpatients on a consultative basis and provide interventional pain management services to patients on the Palliative Care service.

Duke Pain Clinic Now Performing Balloon Kyphoplasty

Kyphoplasty is designed to repair vertebral compression fractures and restore the vertebrae to the correct position, reducing back pain, reducing the number of days in bed, significantly improving mobility and increasing overall quality of life. The procedure generally takes less than one hour perfracture and has been performed under both local and general anesthesia.

Training Program

This year's fellows have acquired valuable experience with the medical, psychological, and procedural aspects of the treatment of the patient in pain. The fellows have learned not only pain management injection techniques and the use of the fluoroscope, but also advanced, interventional techniques such spinal cord stimulation, radio-frequency lesioning, intrathecal pump insertion, diagnostic discography, and neuro-ablative techniques for cancer pain management.

Billy K. Huh, MD, PhD

Medical Director and Interim Chief, Division of Pain Management
Professor, Department of Anesthesiology
Duke University Medical Center

Faculty

Anne Marie Fras, MD
Lesco Rogers, MD
Dianne Scott, MD
Allison Taylor, PA-C

VAMC Acute Pain Service

Joel S. Goldberg, MD, Director
David R. Lindsay, MD, Fellowship Director
Srinivas Pyati, MD
Thomas E. Buchheit, MD

Fellows

Nam-Ku Pham, MD
Lance Roy, MD

Support Staff

Lynda Zirillo, Pain Management
Julie Rosato, VAMC APS