Effectiveness of Intrathecal Pumps for Pain Management

Back pain is one of the most common complaints doctors hear. Unfortunately, it is also one of the most difficult ailments to treat. There are many causes of back pain, including disk breakdown, tension, muscle spasms and disc ruptures. Many of these are causes from accidents, but others, such as scoliosis, are generally genetic in nature.


Treatments for back pain vary widely; however, the first recommendation is usually mild exercise and physical therapy, along with heat or ice treatments. If this does not work, then doctors might prescribe some anti-inflammatories. Sometimes these treatments do not resolve the problem, and the doctor might recommend a series of MRIs, X-rays or even electrical imaging in order to determine whether there is a more serious problem. If these tests show ruptured discs or nerve damage, the doctor may recommend steroid injections or intrathecal drug delivery (pain pumps).

How Pain Pumps Work

Intrathecal drugs work by delivering the medication to the spine. This requires a minor surgery to place the pump under the skin of the abdomen. It then delivers the medicine via a catheter directly to the spinal cord. One of the benefits to this method is that the dosage can be significantly smaller, and yet still be effective in treating pain. In fact, oral medication is typically several hundred times stronger to get the same amount of relief.

What Patients Should Expect

Before any surgery, there are a number of tests that must be taken. For example, another series of X-rays, blood tests and possibly even tests to determine whether the patient’s heart is strong enough for the surgery. The surgery itself is fairly simple outpatient or day surgery. However, it requires a specialist due to the location. Often this type of surgery is completed by a neurosurgeon. The surgeon places the catheter into the intrathecal space that surrounds the spine. Then an extension is passed through to the abdomen, which is where the pump is located. Once the pump is in place, the incision is either sewn or stapled closed. Generally speaking, most patients can go home later in the day, and report back to the doctor for follow-up care. Any signs of infection should be immediately reported to the treating physician.

Expected Results From the Intrathecal Pump

As with most procedures, results can vary. However, most patients report a reduction in pain, and overall experience an improvement in their quality of life. Additionally, patients are able to reduce the amount of oral medication as the pump is usually able to manage the pain effectively. The pump does contain medication, so periodic visits are required to refill the pump. During those visits, the amount of the medication can be adjusted up or down, if needed. Since the pump is battery operated the batteries should also be checked and replaced as recommended by the manufacturer; this typically takes place approximately every five to seven years.

Patients should also be aware that few side effects have been reported, but may include those similar to oral medications of the same class.

Luis Fandos is a pain management specialist from NY.