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. The proximity of the clinicians from varying backgrounds with a common interest in pain management has encouraged collaboration in clinical care, research, and teaching. Dr. Winston Parris is the Medical Director of the Pain Clinic and Professor of Anesthesiology in the Anesthesiology Department at Duke University Medical Center.

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 such as cancer patients, post lumbar puncture headaches,  and evaluations for injection therapy from the Back and Spine Clinic. Drs. Winton Parris, 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.

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.

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.

Research Program

Innovative research continues in the division. Dr. Parris is investigating efficacy of neuroplasty on patients with spinal stenosis (failed back syndrome). He is also interested in evaluating effectiveness and safety of catheter directed cervical epidural steroid injection for patients with spinal stenosis. Dr. Huh is investigating long-term effectiveness of peripheral nerve stimulator in patients with chronic migraine headaches as well as safety of oral lubiprostone on patients with opioid induced constipation.  Dr. Fras and other are collaborating on pharmacologic therapies for fibromyalgia. The project designed by the fellows involves a comparison of different approaches to joint injection for the treatment of sacro-iliac arthropathy and effect of antiepileptics on patients with spinal stenosis.

Winston C.V. Parris, MBBS, DA, FACPM, DABPM

Chief, Division of Pain Management
Professor of Anesthesiology

Faculty

Anne Marie Fras, MD
Brain Ginsberg, MB, ChB (Acute Pain Service)
Joel S. Goldberg, MD (Director, Pain Management, Durham VAMC)
Billy K. Huh, MD
David Lindsey, MD (VAMC)
Lesco Rogers, MD
Dianne L. Scott, MD
Allison Taylor, PA-C

Fellows

Michael Lott, MD
Davin Mitchell, MD
Takia Oglesby, MD

Support Staff

Linda Hockaday
Lynda Zirillo
Stacy Morris