Implanted Pain Pumps

About 20% of the world's population suffers from chronic pain. Chronic pain is when the pain signals keep firing in the nervous system for weeks, months and even years. There are many types of chronic pain. Some conditions that can cause chronic pain are arthritis, cancer, headache, back pain, neurogenic pain (this is pain resulting from damage to the peripheral nerves or to the central nervous system itself), psychogenic pain (this is pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system) fibromyalgia and chronic fatigue syndrome, and pancreatitis just to name a few.

Many other treatments for chronic pain are available, but many are ineffectual for some chronic pain sufferers. Intrathecal drug delivery is a relatively new method to manage chronic pain. This is a drug delivery system that is implanted in the abdomen in a 'pocket' made from the skin. The catheter that delivers the medication is inserted into the intrathecal space of the spin and is tunneled under the skin and connected to the pump in the 'pocket' in the abdomen. Medications can be delivered at variable intervals or at a constant flow. This system usually is used to deliver Opioids; medications which 'block' the message of pain before it reaches the brain and the patient perceives (feels) the pain.

Intrathecal drug delivery places the medication directly into the cerebrospinal fluid that is around the spinal cord. Morphine is particularly effective because it does not have to circulate through the system to reach the cerebrospinal fluid. This allows for much smaller doses to be needed--approximately 1/300 of an oral morphine dose and the frequency of side effects is reduced.

More than 50,000 chronic pain sufferers worldwide have received a drug infusion system. Intrathecal drug infusion systems have been in use since the early 1980's. The first implant was for a morphine pump in 1982. The intraspinal pump was released in the United States in 1991.

The benefits of the intrathecal drug delivery system include:

Pain relief for sufferers who have not been controlled with other treatments.

The reduction in side effects such as nausea, vomiting, sedation and constipation.

The decrease need for oral medications

Improved physical assessment and increased ability to perform the activities of daily living.

While there are some risks and complications, the majority of adverse drug reactions are usually dose-related. There is also some risk of infection and sometimes the pump must be removed. Also, programming errors can happen, and of course, equipment related complications and mechanical pump failure.

Another use for the intrathecal pump is to help lessen the painful spasms and muscle rigidity seen in cerebral palsy and multiple sclerosis patients.

If you suffer from chronic pain, you may be a candidate for the intrathecal pump if you meet the following criteria:

Other conservative therapies have failed.

Additional surgery would not benefit your condition.

You are dependent on pain medications

You do not have psychological problems.

You have no medical condition that would keep you from undergoing implantation.

You are not allergic to any of the medications used in the pump.

You have had positive responsive with a trial dose of medication.

The pump's battery will eventually need to be replaced, depending on how much medication the pump delivers, but this is usually only needed every 5 to 7 years.