Duke Regenerative Pain Therapies Program

About the Program

Duke Regenerative Pain Therapies Program (RPTP) offers a spectrum of treatments for musculoskeletal and arthritic conditions. These treatments are based on the inflammation-resolving research in the Center for Translational Pain Medicine (CTPM) in addition to years of investigation by the eminent physician scientist, Dr. Peter Wehling, adjunct professor in Duke Anesthesiology, who is an internationally-renowned expert in molecular orthopedics in Dusseldorf, Germany. Regenerative therapies harness the body’s own healing potential and are customized to meet the needs of each individual patient.

Meet the Team

Erica Chambers RN, MSN, CPN

Erica Chambers RN, MSN, CPN

Regional Director, Division of Pain Medicine

Julie Mitchell, BSN, RN, WCC

Julie Mitchell, BSN, RN, WCC

Nursing Program Manager

Regenerative medicine – therapies that promote the body’s natural healing mechanisms; one of the important tools in reducing the burden of chronic pain.

Message from the Director

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Conditions Treated

  • Osteoarthritis
  • Degenerative Joint and Soft Tissue Disorders
  • Sacroiliac Joint and Facet Disorders
  • Temporomandibular Joint (TMJ) Pain


Regenerative Treatments

  • Autologous Conditioned serum (ACS)

Other Services

  • Injection Therapy (Steroids, Prolotherapy, Trigger Points) for Joint, Spine, and Musculoskeletal Disorders
  • Orofacial Pain Treatments (Migraine, TMJ, Trigeminal Neuralgia, Facial Pain)
  • Sleep Medicine (Sleep Apnea Treatment Appliances)
  • Psychology (Biobehavioral Therapy)
  • Medical Massage Therapy
  • Physical Therapy

Evidence Based Research

Including the Team’s 2020 Publication on Mechanisms of Regenerative Pain Therapies

Overview Duke Autologous Serum (DAS®) Publications


  1. Buchheit T, Huh Y, Maixner W, Cheng J, Ji RR. Neuroimmune modulation of pain and regenerative pain medicine. J Clin Invest. 2020 Apr 6. pii: 134439. doi: 10.1172/JCI134439. [Epub ahead of print]


  1. Tassara M et al.: Autologous conditioned serum (ACS) for intra-articular treatment in Osteoarthritis: retrospective report of 28 cases. Transfusion and Apheresis Science. http://doi.org/10.1016/j.transci. 2018.07.021
  2. Damjanov N et al.:The efficacy and safety of autologous conditioned serum (ACS)injections compared with betamethasone and placebo injections in the treatment of chronic shoulder joint pain due to supraspinatus tendinopathy: a prospective, randomized, double-blind, controlled study. Med Ultrason (2018), 1-7, DOI: 10.11152/mu-1495
  3. Genç E et al.: Investigation of the biomechanical and histopathological effects of autologous condi- tioned serum on healing of Achilles tendon. Acta Orthop Traumatol Turc, 1–6. http://doi.org/10.1016/j. aott.2018.01.005


  1. Pecin M et al.: Accelerated Achilles tendon healing with interleukin-1 receptor antagonist protein in rabbits. Turk J Vet Anim Sci, (2017) 41: 118-126; TÜBİTAK doi:10.3906/vet-1604-32
  2. Arbel R: Bio-orthopaedics: A new approach. ORTHOKINE. In A. Gobbi, J. G. Lane, J. Espregueira- Mendes, & M. Karahan (Eds.), Bio-orthopaedics: A New Approach (pp. 1–696). ISAKOS. http://doi. org/10.1007/978-3-662-54181-4
  3. Caggiari G et al.: Chondroprotective Effects of Intra-Articular Autologous Conditioned Serum (ACS) Injection A Human Literature. International Journal of Innovative Science, Engineering & Technology, 4(3), 289–293
  4. Strümper R: Intra-Articular Injections of Autologous Conditioned Serum to Treat Pain from Meniscal Lesions, Sports Medicine International Open 2017; 1: E200–E205
  5. Wehling P et al.:Effectiveness of intra-articular therapies in osteoarthritis: a literature review; Ther Adv Musculoskel Dis 1-14: https://doi.org/10.1177/1759720X17712695, 2017


  1. WehlingPetal:Howdoessurgerycomparewithadvancedintra-articulartherapiesinkneeosteoarthri- tis: current thoughts; Ther Adv Musculoskel Dis 1-14, Volume: 9 issue: 8, page(s): 183–196, DOI: 10.1177/ 1759720X16642405, 2016
  2. Evans CH et al.: Autologous Conditioned Serum. Phys Med Rehabil Clin N Am 27 (2016) 893–908
  3. GodekP:UseofAutologousSeruminTreatmentofLumbarRadiculopathyPain.PilotStudy.Ortopedia 
Traumatologia Rehabilitacja, MEDSPORTPRESS, 2016; 1(6); Vol. 18, 11-20 DOI: 10.5604/15093492.1198829
  4. RichardsMMetal.:Intra-articular treatment ofkneeosteoarthritis:from anti-inflammatories to products of regenerative medicine. Phys Sportsmed. 2016; 44(2):101-8. doi: 10.1080/00913847.2016.1168272. Epub 2016 Apr 4. Review. PubMed PMID: 26985986; PubMed Central PMCID: PMC4932822


  1. Frisbie DD: Autologous-conditioned serum: evidence for use in the knee. J Knee Surg. 2015 Feb; 28(1):63-6. doi: 10.1055/s-0034-1543956. Epub 2015 Jan 19. PubMed PMID: 25599270
  2. BaselgaJetal:TreatmentofOsteoarthritisoftheKneewithaCombinationofAutologousConditioned Serum and Physiotherapy: A Two-Year Observational Study. PLoS ONE 10(12): e0145551.
  3. GeburekFetal.:Effectofasingleinjectionofautologousconditionedserum(ACS)ontendonhealing in equine naturally occurring tendinopathies; Stem Cell Research & Therapy 6:126 (2015)
  4. TorreroJI,MartĂ­nezC:Newdevelopmentsinthetreatmentofosteoarthritis-focusonbiologicagents. Open Access Rheumatol. 2015 Jul 22;7:33-43. eCollection 2015. Review. PubMed PMID: 27790043; PubMed Central PMCID: PMC5045124.


  1. Astolfi M, McGuire K, Kaminski TW: The effectiveness of autologous conditioned serum in the treat- ment of knee osteoarthritis. J Sport Rehabil. 2014 Nov;23(4):365-9. doi: 10.1123/jsr.2013-0029. Epub 2014 May 2. Review. PubMed PMID: 24810293.
  2. Beyzadeoglu T: Cytokines in Sports Medicine. ISAKOS NEWSLETTER 2014: Volume I. Current Con- cepts, 1–44.
  3. Majewski M, von Wehren L, & Blanke F: Treatment Of Achillodynia With Local Injections Of Autolo- gous Conditioned Serum (acs). British Journal of Sports Medicine, 48(Suppl_2), A38–A39. http://doi. org/10.1136/bjsports-2014-094114.60


  1. Alvarez CaminoJ Cetal.: Use of autologous conditioned serum (ORTHOKINE) for the treatment of the degenerative osteoarthritis of the temporomandibular joint. Review of the literature. Med Oral Patol Oral Cir Bucal (2013) 18 (3): 433–438
  2. Frizziero A et al.: Autologous conditioned serum for the treatment of osteoarthritis and other possible applications in musculoskeletal disorders. Br Med Bull (2013) 105: 169–184
  3. Baltzer AWA et al.: A new treatment for hip osteoarthritis: clinical evidence for the efficacy of autolo- gous conditioned serum. Orthop Rev (2013) 5(2):e13
  4. Weisshaar MP, Gaji S: Signaling Proteins (Growth Factors and Cytokines) in Orthopaedics. Comparison of two blood processing techniques: ORTHOKINE® and ACP®. CORS congress 2013 Venice, Italy
  5. MorgensternDRetal.:AdjunctiveBiologicalTreatmentforDegenerativeHipDiseasewithFocalChon- dro Labral Defects. ISHA Annual Meeting, Munich, Poster 58 (2013)


  1. Heisterbach PE et al.: Effect of BMP-12, TGF-β1 and autologous conditioned serum on growth factor expression in Achilles tendon healing. Knee Surg Sports Traumatol Arthrosc (2012) 20(10): 1907–1914


  1. Textor J: Autologous biologic treatment for equine musculoskeletal injuries: platelet-rich plasma and IL-1 receptor antagonist protein. Vet Clin North Am Equine Pract. 2011 Aug; 27(2): 275–298. doi: 10.1016/j.cveq.2011.05.001. PubMed PMID: 21872759
  2. Darabos N et al.: Intraarticular application of autologous conditioned serum (ACS) reduces bone tunnel widening after ACL reconstructive surgery in a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc (2011) 19: 36–46
  3. GeburekF,StadlerP:Regenerativetherapyfortendonandligamentdisordersinhorses.Terminology, production, biologic potential and in vitro effects. Tierarztl Prax Ausg G Grosstiere Nutztiere. 2011; 39(6): 373–83. Review. German. PubMed PMID: 22167082


  1. Fox BA, Stephens MM: Treatment of knee osteoarthritis with ORTHOKINE-derived autologous condi- tioned serum. Expert Rev Clin Immunol (2010) 6(3): 335–345


  1. Wehling P et al.: Use of Autologous Conditioned Cell-free Serum (ORTHOKINE®) in Treating Osteoar- thritis and Sciatic Back Pain. European Musculoskeletal Review (2009) 4(1): 8–11
  2. Majewski M et al.: Accelerated Healing of the Rat Achilles Tendon in Response to Autologous Condi- tioned Serum. The American Journal of Sports Medicine (2009) 11: 2117–2125
  3. Chevalier X et al.: Intraarticular injection of anakinra in osteoarthritis of the knee: a multicenter, rando- mized, double-blind, placebo-controlled study. Arthritis & Rheumatism (2009) 61(3): 344–352
  4. Baltzer AWA et al.: Autologous conditioned serum (ORTHOKINE®) is an effective treatment for knee osteoarthritis. Osteoarthritis and Cartilage (2009) 17(2): 152–160
  5. Darabos N et al.: Correlation between synovial fluid and serum IL-1Ăź levels after ACL surgery – prelimi- nary report. International Orthopedics (SICOT) (2009) 33: 413–418


  1. Yang KG et al.: Autologous interleukin-1 receptor antagonist improves function and symptoms in osteoarthritis when compared to placebo in a prospective randomized controlled trial. Osteoarthritis and Cartilage (2008) 16(4): 498–505
  2. Ă–sterdahl J: Evaluation of autologous conditioned serum. Degree project 2008:67 at Swedish Univer- sity of Agricultural Sciences, Uppsala (2008) ISSN 1652-8697
  3. Creaney L, Hamilton B: Growth factor delivery methods in the management of sports injuries: the state of play. Br J Sports Med (2008) 42: 314–320
  4. Jöstingmeier U: Vergleichende Betrachtung des Behandlungserfolges der intra-artikulären kombi- nierten Behandlung mit Natriumhyaluronat und Betamethason mit der intraartikulären Behandlung mit autologem konditionierten Serum (IL-1Ra) bei Pferden mit positiver Hufgelenksanästhesie – Eine Anwendungsbeobachtung. In-augural-Dissertation an der Freien Universität Berlin (2008) ISBN 978-3- 86664-665-0
  5. Martinelli MJ et al.: Biochemical Characterization and Clinical Assessment of Autologous Conditioned Serum Treatment in Race Horses. Annual Meeting of the Orthopaedic Research Society 2008, San Francisco, USA
  6. Weinberger T: Klinische Erfahrungen mit der Anwendung von ACS / ORTHOKIN® / IRAP beim Pferd. pferde spiegel 3/2008
  7. Weinberger T.: Clinical experience with ACS/ORTHOKINE/IRAP in horses. Equine Sports Medicine 3/2008
  8. Weinberger T.: Regenerative Therapiemöglichkeiten beim Pferd – eine Übersicht. pferde spiegel 3/2008


  1. BeckerCetal.:Efficacyofepiduralperineuralinjectionswithautologousconditionedserumforlumbar radicular compression: an investigator-initiated, prospective, double-blind, reference-controlled study. Spine (2007) 32(17): 1803–1808
  2. FrisbieDDetal.:Clinical,biochemical,andhistologiceffectsofintra-articularadministrationofauto- logous conditioned serum in horses with experimentally induced osteoarthritis. Am J Vet Res (2007) 68(3): 290–296
  3. Wehling P et al.: Autologous Conditioned Serum in the treatment of Orthopaedic diseases – The ORTHOKINE® Therapy. Biodrugs (2007) 21(5): 323–332


  1. Glawe H: ORTHOKIN®-Therapie: Autologes Conditioniertes Serum an der Wirbelsäule. Eine Anwen- dungsbeobachtung an 261 Patienten. Poster 2006
  2. Theodoridis T, Krämer J: Interleukin-1-Rezeptor-Antagonist-Protein (IRAP). In: Injektionstherapie an der Wirbelsäule. Manual und Atlas, 37-40. Georg Thieme Verlag (2006) ISBN 3-13-141041-8A


  1. Moser C et al.: Die Rolle der Zytokine bei Knorpeldefekten und in der Knorpeltherapie. Interleukin-1 und TNF-a: Schlüsselfaktoren der Knorpeldestruktion. Arthroskopie (2005) 18(3): 181–185
  2. Levy E et al.: Intraartikuläre Behandlung mit autologem irap conditionierten Serum – Teil 1. pferde spiegel 3/2005: 120–124
  3. Hague BA: Clinical Impression of ORTHOKINE (IRAP) Treating Joint Disease in the Performance Horse. ACVS conference 2005, San Diego, USA


  1. Wright-Carpenter T et al.: Treatment of muscle injuries by local administration of autologous conditio- ned serum: animal experiments using a muscle contusion model. Int J Sports Med (2004) 25(8): 582-587
  2. Wright-Carpenter T et al.: Treatment of muscle injuries by local administration of autologous condi- tioned serum: a pilot study on sportsmen with muscle strains. Int J Sports Med (2004) 25(8): 588–593


  1. Meijer H et al.: The production of anti-inflammatory cytokines in whole blood by physico-chemical induction. Inflamm Res (2003) 52(10): 404–407
  2. Baltzer AWA et al: Intraartikuläre Therapie der Gonarthrose mit autologem Interleukin-1 Rezeptor Ant- agonisten (IL-1Ra). Deutsche Zeitschrift für Sportmedizin (2003) 54(6): 209–211

Updated: April 2020

The Regenerative Pain Therapies Program and Duke’s Center for Translational Pain Medicine has expanded our understanding how to promote healing, and how to use the chemistry of blood and tissue to create an environment that reduces pain and improves function.

Dr Thomas Buchheit
Chris KeithDuke Regenerative Pain Therapies Program