A “pain pump” is a method of giving pain medication directly to your spinal cord to provide an analgesic effect in the corresponding area of distribution. The pump is surgically placed under the skin of one’s abdomen, which delivers medication through a catheter to the area around the spinal cord. As this system allows delivery of the pain medication directly to the pain area, the effect is maximum, the dose is small, and the side effects are minimal.
An intrathecal drug pump provides access to cerebrospinal fluid-filled space around the spinal cord and administered pain medicine works more efficiently than oral medication because it delivers medicine directly into the CSF. In fact, only 1/300 the amount of medication (morphine or baclofen) can be sufficient when administered through a pump as opposed to being orally administered.
The pump is a round metal device that is surgically implanted beneath the skin of the abdomen. A small plastic catheter is surgically placed in the intrathecal space of the spine, which connects with the pump. A reservoir inside the pump holds the medication. The medication is slowly released in the intrathecal space slowly. It can also be programmed to release at different rates depending on your changing needs. Newer pumps can even store the information about your prescription in its memory, which can be assessed later to see drug administration over time. When the reservoir is empty, it can be filled by inserting a needle through your skin and into the reservoir. The pump can be removed if the therapy is no longer required.
Patients who are considered to be the best candidates for intrathecal drug delivery include those who have failed conservative therapies, those who would not benefit from additional surgery, or those who are dependent on pain medication. One must also have no psychiatric history or allergic history yo the pain medication.
The types of pain this pump is best suited to provide relief for include failed back surgery syndrome, sciatica, cancer pain (when the tumor impinges on the spinal cord), reflex sympathetic dystrophy, causalgia (due to peripheral nerve injury), arachnoiditis, chronic pancreatitis, etc. This pump can also be used to treat spasticity disorders, such as cerebral palsy, multiple sclerosis, post-stroke states, brain or spinal cord injury, etc.
Results vary depending on the underlying condition being treated and its severity. It has been to significantly reduce chronic pain and improve the ability to perform activities of daily life. Spasticity patients have been shown to have a reduction in rigidity and muscle spasms as well. It also reduces the need to take oral medications which have a higher addiction potential.
However, it’s not without risks. Complications for intrathecal drug pumps although minimal, including infection and bleeding (common for all surgical procedures). The catheter could become blocked or stop working, but that’s rare. A CSF leak can occur around the pump resulting in a headache. Cases in which the pump needs to be removed including infection, failure to relieve pain, and patient misuse. Depending on how much medication the pump delivers, the battery will need to be replaced every 5 to 7 years as well, which is a fairly minor procedure.