Pain Management

We offer a full range of pain relief treatments, including medication, physical therapy, steroid injections, biofeedback, and more. If you need more advanced techniques, we have pain experts who perform a variety of procedures, including nerve blocks, spinal cord stimulation, intrathecal pump placements, radiofrequency ablation, and regenerative therapies. Our goal is to understand your condition and recommend the most effective treatments to alleviate your pain quickly and consistently. 

Our team specializes in the disease of pain from every source. We offer you relief whether you experience chronic back pain, nerve-related discomfort, or pain from injury, cancer, headaches, or another source. Our skilled specialists include anesthesiologists, physiatrists (physical medicine and rehabilitation specialists), neurologists, physical therapists, and psychologists who work with you to create a personalized pain-management plan.

Before prescribing treatment for chronic pain, our team of specialists performs a comprehensive evaluation, taking into account your personal health history and current symptoms.

Therapies

• Biofeedback: Relaxation techniques help you control your body’s automatic responses to pain, including muscle tension, fast breathing, and rapid heart rate.
• Counseling: Clinical psychologists help you manage depression, anxiety, and other emotional side effects that can result from living with chronic pain.
• Mind-Body Therapy: We offer alternative treatments including acupuncture, yoga, and meditation to treat your mind, body, and soul.
• Physical Therapy: An exercise routine that improves flexibility and strength may help relieve stress on the muscles and joints and alleviate pain.

Medications and Injections

• Oral Medication: A variety of medications may be used to help control your pain, including over-the-counter medications such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (Advil). If those are unsuccessful, prescription medications including muscle relaxers and pain medications may be considered.
• Nerve Blocks: Medication can be injected on or near the nerves that are the source of pain. This numbs the nerves and blocks pain signals. Injections are performed as an outpatient procedure.
• Steroid Injections: Injections of cortisone (a type of steroid) may offer relief for pain caused by inflamed nerves. This injection may go into the area that surrounds the spinal cord for pain that originates in the spine, or directly into a joint. We deliver the medication to the correct location using X-ray or ultrasound guidance during the procedure.

Minimally Invasive Procedures

• Intrathecal Pump Therapy: A surgically implanted pump releases low doses of medication into the space around the spine to reduce pain signals. This minimizes the side effects of high-dose medications and results in better pain control. This procedure requires general anesthesia.
• Spinal Cord Stimulation (Neurostimulation): During this minimally invasive outpatient procedure, electrodes are implanted on your spinal cord and a generator is implanted under the skin on the abdomen or buttocks. The generator sends electrical impulses that travel through the electrodes to block pain signals. 
• Peripheral Nerve Stimulation (PNS): Small electrodes are implanted next to a peripheral nerve -- a nerve outside of the brain or spinal cord -- and a generator is implanted under the skin. Electricity from the generator travels to the electrode to block pain signals sent out by the peripheral nerve.
• Radiofrequency Ablation: For pain that radiates from the spine to other areas of the body -- including the legs, arms, and head -- this minimally invasive procedure may be used to block the source of those pain signals. Using an X-ray to pinpoint the location of the appropriate nerve, we insert a heat source that burns the nerve and prevents the pain signal from traveling to the brain.

Patient-Focused Care
Living with chronic pain affects your body, mind, and spirit. We consider the big picture and address more than physical pain; we treat the whole person using a variety of mind-body techniques.

Responsible Medication Management
If medications like morphine and other opiates are recommended, we offer ongoing counseling and guidance to avoid the risk of addiction or overdose. We also provide advanced options for drug delivery that limit side effects. These include intrathecal pump therapy, which minimizes the dose you need by delivering the medicine directly to the source of your pain.

Seamless Referrals
If the source of your pain is a condition or injury that is treatable, you have access to Duke’s highly skilled surgeons and orthopaedists.

More Alternatives for Treatment
Through Duke's wellness programs, you have access to options like acupuncture, meditation, and yoga to help you cope with pain and the anxiety associated with persistent pain.

Open Communication
You are the most important member of your care team. We make sure that you and your caregivers are well informed about your treatment options and any associated side effects.

Access to Clinical Trials
You may be eligible to participate in clinical trials that are evaluating novel treatments for pain relief. This gives you access to options that are not yet widely available.

Palliative Care
The debilitating effects of serious illness are often magnified by physical, mental, and spiritual pain and suffering. Our palliative care experts partner with you, your family, and your medical team to help you find relief.