Intrathecal Pain Pump

Principal method
Pain propagation within the spinal cord can be treated directly with medication (such as morphine) delivered to the fluid surrounding the spinal cord. An intrathecal pain pump is a small device implanted surgically underneath the skin (usually the abdomen or belly), which can continuously deliver medication to the fluid (intrathecal space) surrounding the spinal cord (via catheter) and thus interrupt irregular nerve signaling.

The intrathecal space holds the cerebrospinal fluid that bathes the spinal cord. Infusing medication directly into this area achieves powerful pain relief at much higher potency. Powerful relief can be achieved with a much lower (300 fold lower) dosage than with oral intake. Using a pump may also reduce medication side effects common with long-term pill use.

Filling the pump
Inside the pump is a hollow, refillable reservoir that holds the medication. When the reservoir is empty, it can be refilled with a needle in intervals (of 4 to 12 weeks). The pain pump can be individually programmed and thus modified as needed.

Advantages
• Efficient pain management can be achieved with minimal medication dosage
• Less side effects compared with oral intake
• Depending on the pain type different medications can be combined for most effective treatment (thus using additive effects of specific combinations)
• A fixed infusion rate allows for an evenly distributed medication level.
• Individually programed pain pumps allow for individual dosing as needed

Test-phase
Not every patient is the ideal candidate for an intrathecal pain pump. It is time for a test implantation of an external pump when most other treatment options have failed and the patient meets the indications. The test-phase is performed over a period of 1-2 weeks. If successful, the decision for a definite implantation can be made.

Indications
• Tumor pain
• Spasticity due to spinal cord injury
• Extremely high opioid requirements and refractory chronic pain for example after surgical procedures or osteoporosis.