A “pain pump” is a method of giving medication directly to your spinal cord. The system uses a small pump that is surgically placed under the skin of your abdomen. The pump delivers medication through a catheter to the area around your spinal cord. Because the drug is delivered directly to the pain area, your symptoms can be controlled with a much smaller dose than is needed with oral medication. Thus reducing the side effects of medication.
What is an intrathecal drug pump?
The fluid filled space around your spinal cord is called the subarachnoid or intrathecal space. Cerebrospinal fluid (CSF) flows through this area, bathing and protecting your brain and spinal cord. An intrathecal drug pump works more efficiently than oral medication because it delivers medicine directly into the CSF, bypassing the path that oral medication takes through your body. In fact, you generally need about 1/300 the amount of medication (morphine or baclofen) with a pump than when taken orally.
The pump is a round metal device about the size of a hockey puck that is surgically implanted beneath the skin of your abdomen. A small plastic tube, called a catheter, is surgically placed in the intrathecal space of the spine and is connected to the pump. A space inside the pump called the reservoir holds the medication.
The intrathecal pump system consists of a pump/reservoir implanted between the muscle and skin of your abdomen and a catheter that carries pain medication (blue area) from the pump to the spinal cord and nerves.
The pump is programmed to slowly release medication over a period of time. It can also be programmed to release different amounts of medication at different times of the day, depending on your changing needs. The pump stores the information about your prescription in its memory, and your doctor can easily review this information with the programmer. When the reservoir is empty, the doctor or nurse refills the pump by inserting a needle through your skin and into the fill port on top of the reservoir.
This therapy is completely reversible if you should ever decide to have the pump removed.
Who is a candidate?
You may be a candidate for intrathecal drug delivery if you meet the following criteria:
- Conservative therapies have failed
- You would not benefit from additional surgery
- You are dependent on pain medication
- You do not have psychological problems
- You have no medical conditions that would keep you from undergoing implantation
- You are not allergic to any of the drugs used in the pump
- You have had positive response with a trial dose of medication
A pump can help lessen chronic pain caused by:
- Failed back surgery syndrome: failure of one or more surgeries to control persistent leg pain (sciatica), but not technical failure of the original procedure.
- Cancer pain: constant pain caused by tumors compressing the spinal nerves, or scarring from previous radiation therapy.
- Reflex sympathetic dystrophy: a progressive disease of the nervous system in which patients feel constant chronic burning pain.
- Causalgia: a burning pain caused by peripheral nerve injury.
- Arachnoiditis: painful inflammation and scarring of the meninges (protective layers) of the spinal nerves.
- Chronic pancreatitis: chronic abdominal pain caused by inflammation or blockage of the pancreatic duct.
A pump can help lessen spasticity (muscle rigidity and spasms that make movement of the arms and legs difficult) caused by:
- Cerebral palsy: a nervous disorder that impairs control of body movement.
- Multiple sclerosis: a disorder of the brain and spinal cord caused by damage to the outer layer (myelin) of nerve cells.
- Stroke: damage to the brain from lack of oxygen; due to an interruption of the blood supply.
- Brain injury
- Spinal cord injury