Intrathecal Pain Pumps
Most medications for pain management are taken by mouth or injection. There are some disadvantages to this: the medication has to travel through the entire bloodstream before it begins to have an effect on the nerves, brain, and other parts of the body to relieve pain. For some patients, this causes side effects including drowsiness, confusion, nausea, constipation, and respiratory depression. Over time, the body may become used to the medication, requiring higher doses to manage pain.
An intrathecal pain pump is considered after oral pain medications and other methods of pain control have been exhausted or proven ineffective.
Intrathecal pain pumps can be used to treat nociceptive and neuropathic pain conditions. Examples of conditions that can be treated with an intrathecal pain pump are: complex regional pain syndrome or reflex sympathetic dystrophy, cancer pain, phantom limb pain, post herpetic neuralgia (shingles), carpal tunnel syndrome, failed back surgical syndrome, and peripheral neuropathy from diabetes mellitus or vitamin deficiencies.
Procedure Overview: Trial
The best part of this treatment option is that a patient can trial it before they decide to have the pump surgically implanted. An intrathecal medication trial can be performed in the office. This procedure is no different than having a lumbar epidural done except, instead of an injection of steroids into the epidural space, an injection of pain medication is done into the spinal fluid (intrathecal space). Following the procedure, the patient will then be assessed for pain relief and function. If adequate pain relief and improved function is noted with the trial, you and your physician will then determine if a permanent pain pump should be surgically implanted.
A permanent intrathecal pain pump is a surgical procedure that usually lasts one to three hours and will take place at a hospital or surgical center.You will be comfortably sedated and monitored by an anesthesiologist during the surgery. The physician will make an incision in the skin of your abdomen or flank region to place the pump. Then, a second incision will be made in your back to allow the catheter to be placed near the spinal cord. Then, the other end of the catheter will be threaded under your skin and connected to the pump in your abdomen or flank, making the entire system internal and fully implanted. There are no components on the outside of the body. Once the system has been tested and checked, the incisions are closed and the surgery is completed.