Intrathecal Pain Pump Placement – How it Works and What to Expect from the Procedure
An intrathecal pain pump is a small device that administers pain medication directly to the spinal cord. The pump is surgically implanted under the skin at the side of your abdomen and delivers the medication to the nerves of the spine through a thin tube, or catheter. The goal of an intrathecal pain pump placement is to provide faster pain relief than medications that are taken in pill form. The spine has several receptors, including opioid receptors, that can cut off pain signals before they reach the brain. Thus, opioids are frequently used in pain pumps and can sometimes be combined with other medications to reduce pain and other symptoms.
Why are Intrathecal Pain Pumps Needed?
While an intrathecal pain pump does not treat underlying conditions, it can be very effective for providing some relief from chronic pain and improving quality of life. It is also useful for alleviating pain and muscle spasms due to certain neurological disorders. A pain pump may be recommended by your doctor if you have one of the following conditions:
- Cancer – A tumor is putting pressure on spinal nerves causing persistent pain or scarring formation after radiation or previous surgeries to remove the tumor.
- Failed Back Surgery Syndrome – Chronic pain caused by multiple failed back surgeries.
- Causalgia – A burning pain sensation in the arm or leg caused by a direct injury to the nerve.
- Arachnoiditis – Inflammation and scarring of the protective layers surrounding the brain and spinal cord.
- Chronic Pancreatitis – Abdominal pain due to inflammation or a blockage of the pancreatic duct.
- Muscle Spasms – Body-wide muscle spasms that are the result of various illnesses such as cerebral palsy and multiple sclerosis or injuries to the brain and spinal cord.
What to Expect during an Intrathecal Pain Pump Placement
Before implanting the device, you may undergo a trial. Your doctor will administer a shot of medication in your back that allows the doctor to figure out the best type of medication to treat your pain. If the pain decreases by at least 50%, the trial is determined to be successful and you are scheduled for an intrathecal pain pump placement. Here is a closer look at what you can expect before, during and after the procedure:
- Before the Procedure: Presurgical testing including a psychological evaluation may be performed to rule out psychological pain. Fasting is required beginning at midnight the night before your surgery. The procedure is usually performed under sedation and local anesthesia and an anesthesiologist will go over its risks and effects with you, prior to the surgery. Afterwards, an IV line is started in your arm.
- During the Procedure: Once asleep, you will be rolled onto your side and the areas on your back and stomach are shaved and cleaned to prepare for the insertion. A small incision is made in the back where the catheter will be placed and another incision is made below the waistline on your abdomen for the pump. Once the catheter is put into place, an extension is passed from the spine and around your torso where it can be connected to the pump. Once the catheter is attached, the pump is positioned correctly so it won’t bulge under the skin and the incisions are closed with sutures or staples.
- After the Procedure: During the recovery phase, you may have to take oral pain medication as directed by your healthcare professional. For the next six weeks, avoid any strenuous activities such as bending, twisting, lifting or reaching overhead as these actions may cause your catheter to slip out of place. Depending on the severity of your underlying condition, pain relief will vary, but most patients can expect to feel a significant reduction in pain and resume normal activities.
The Benefits of an Intrathecal Pain Pump
Receiving your pain medication through an implanted pump, rather than in pill form, offers several advantages, including the following:
- Only a small amount of medication is needed to feel significant pain relief with a pain pump. Oral pain medications require a higher dosage since they work over the entire body before reaching the source of pain in the spinal cord. Therefore, when pain medication, like opioids, are taken in pill form, there is a higher risk of tolerance, addiction and other side effects.
- Medication that is delivered through a pain pump provides pain relief without unwanted side effects, including nausea, drowsiness and constipation.
- Since the pain pump delivers medication directly to the nerves in the spinal cord, only a small dose of opioids is necessary which considerably reduces the risk of addiction. Therefore, this device is an ideal option for individuals with severe pain and an intolerance for opioid pills.
- The pump is programmed to administer medications in a controlled and constant manner. It can also be adjusted to give you extra medication when you need it. It can store information about your dose and prescription, helping you avoid having to constantly refill prescriptions or remembering to take your pain medication.
An intrathecal pain pump is a safe and effective alternative for managing your chronic pain. However, it may not be suitable for all patients and only a certified specialist can determine if this device is right for you. At Jackson Neurosurgery Clinic, Dr. Lewis provides patients with advanced pain management strategies. By integrating the latest medical technology with innovative surgical techniques, he helps to target pain and treat the underlying condition, significantly improving the outlook of your long-term health.
Contact us today to learn more about intrathecal pain pump placement or to schedule a consultation. We’ll find a solution that works for you. Call us at (601) 366-1011.