What Is an Intrathecal Pain Pump?
Intrathecal pain pump delivery is a proven, safe, and effective therapy for managing chronic pain. Unlike oral medications that must circulate throughout the bloodstream, an intrathecal pain pump system delivery releases medication directly into the fluid surrounding your spinal cord, which may lead to fewer or more tolerable drug side effects.
How It Works
The pump releases prescribed amounts of pain medication through the catheter directly to the fluid around the spinal cord, which is called the intrathecal space.
Many people experience significant improvements in their pain symptoms and quality of life after receiving an intrathecal drug delivery system. However, realistic expectations are essential to satisfaction with any pain treatment. Intrathecal medication delivery cannot eliminate the source of your pain or cure any underlying disease, but it may help you to better manage your pain.
Learn more about how the drug pump works on tamethepain.com.
Benefits of Intrathecal Pain Pumps
Micro Doses
An intrathecal pain pump allows targeted medication delivery to the spinal cord bypassing the full body route encountered by oral medications.
Improved Pain Control
Pain Pumps have been shown to manage more effectively than conventional medical management with less medication.
Less Medication Side Effects
An intrathecal pain pump allows targeted medication delivery to the spinal cord bypassing the full body route encountered by oral medications.
Quality of Life
With pain better managed people tend to be able to do more of their normal daily activities and participate in their own life again.
Who Can Intrathecal Pain Pumps Help?
Pain Pump Therapy can be beneficial to people with: degenerative disc disease, neuropathy, sciatica, headaches from cervical pain, scoliosis, chronic pelvic and abdominal pain, radiculopathy, chronic back and neck pain, or have had failed back surgeries.
If you’ve had surgery in the past for back or neck pain that left you in chronic pain after the surgery, that the surgeon hasn’t been able to help with, a pain pump can help manage the pain.
Pain pumps can also be beneficial for patients with memory issues and have difficulty remembering to take their pain medications, or dependent on caretakers to administer their medications.
Patients who do not like the effects of their current oral medications and experience fatigue, altered mental status, nausea, or other side effects.
Patients who do not want to take oral medications, or have a fear of oral opioid dependency can also make good candidates for pain pumps.
The Intrathecal Drug Pump System includes:
- Programmable drug pump – A battery-powered device that stores and dispenses medicine according to instructions programmed by your doctor
- Catheter – A thin, flexible tube that delivers pain medication from the pump to the fluid around the spinal cord
- Physician programmer – A computer at your doctor’s office that lets your doctor tailor your therapy to best meet your needs
- Personal therapy manager (PTM, or bolus button) – An optional handheld device that gives you more control over your pain by allowing you to receive an extra dose of morphine from your pump when needed and within physician-set limits
If an intrathecal pain pump is an option for you, Dr. Castillo implants and manages pain with Medtronic pain pumps.
Risks
The implanted pump and catheter are surgically placed under the skin. Surgical complications are possible and include: infection, spinal fluid leak, and headache. You should not undergo the implant procedure if you have an active infection at the time scheduled for implant.
Once the infusion system is implanted, device complications may occur which may require surgery to resolve. Drug overdose or underdose can result because of these complications and have serious and even life-threatening adverse effects. Possible complications include the catheter or pump moving within the body or wearing through the skin. The catheter could leak, tear, kink, or become disconnected. The pump could stop because the battery has run out or because of failure of another part of the infusion system. Additionally, inflammatory masses have been reported at the tip of the catheter which may lead to complications, including paralysis.
See Important safety information for more details. Also, please discuss the benefits and risks of this therapy with your doctor.
Advantages Over Other Therapies
Drug delivery therapy offers advantages over other therapies for severe chronic pain:
- A screening test serves as a temporary evaluation period so you can see if drug delivery therapy relieves your pain before committing to long-term therapy
- It does not have to be a permanent procedure like back surgery. The system can be turned off or surgically removed if you do not like it or of you decide to pursue a different treatment
The Process For Getting An Intrathecal Pain Pump
Pump Trial
Candidates for pain pumps will first go through pump education where you learn about the pump and can ask questions about life with a pump. Patients then complete a psychology evaluation to make sure the pump would be a good fit for your lifestyle. Once given the go ahead you will be scheduled on a Monday for a pump trial procedure, where the pump is temporarily implanted for a week to determine if it helps control your pain. Patients come back into office Tuesday thru Thursday for adjustments to the medication being delivered to achieve pain control, and the catheter will be pulled on Thursday – if trial is successful you will move onto surgery.
Pump Surgery
You’ve made it to your surgical implant! Patients are scheduled on a Friday at one of the hospitals Dr. Castillo has privileges at: Banner Estrella, or Banner Baywood. The pump will be surgically implanted in the lower abdomen, upper thigh, or buttocks. The catheter will be positioned in the spinal space at the appropriate level and connected to the pump. Most surgeries will be out patient procedures and you’ll be able to go home same day. You’ll then return to the office the following Wednesday for your first pump fill.
First Fill &
Life with Your Pump
Wednesday after your surgery is your first pump fill and post surgical evaluation, where the medication will be put into your pump. At this fill your pump will be programmed for the first time to dispense microdoses of the pain medication. From there patient’s will return to the office as needed to adjust the medications levels to get pain control. Once your pump is adjusted to what works best for your pain – you will the return to the office every few months to refill your pump medications.
Don’t lose another day to pain
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References
- Deer T, Chapple I, Classen A, et al. Intrathecal drug delivery for treatment of chronic low back pain: report from the National Outcomes Registry for Low Back Pain. Pain Med. 2004;5:6–13.
- Duarte RV, Raphael JH, Sparkes E, Southall JL, LeMarchand K, Ashford RL. Long-term intrathecal drug administration for chronic nonmalignant pain. J Neurosurg Anesthesiol. 2012;24:63-70.
- Ellis DJ, Dissanayake S, McGuire D, et al. Continuous intrathecal infusion of ziconotide for treatment of chronic malignant and nonmalignant pain over 12 months: a prospective, open-label study.Neuromodulation. 2008;11:40-49.
- Hamza M, Doleys D, Wells M, et al. Prospective study of 3-year follow-up of lowdose intrathecal opioids in the management of chronic nonmalignant pain. Pain Med. 2012;13:1304-1313.