Pain Pump Implantation

A pain pump, also known as an intrathecal drug delivery system, is a small, implantable device that delivers medication directly to the spinal fluid. This approach provides pain relief with smaller doses of medication than oral or intravenous pain medications, which can minimize side effects. Pain pumps can be an effective option for managing chronic pain that has not responded to other treatments.

What Conditions Can a Pain Pump Help With?

Pain pumps are used to manage chronic pain from conditions such as:

• Failed Back Surgery Syndrome (FBSS)
• Complex Regional Pain Syndrome (CRPS)
• Chronic cancer-related pain
• Severe nerve pain or spasticity that has not responded to other treatments

Because the medication is delivered directly to the spinal fluid, pain pumps can provide more targeted and effective pain relief, often allowing patients to reduce or eliminate other pain medications.

Procedure Overview

The process of obtaining a pain pump involves two main stages: a trial phase and, if successful, a permanent implantation phase.

1. The Trial Phase

The trial phase allows you and your physician to evaluate whether a pain pump will provide adequate pain relief before a permanent implant is placed. The trial phase generally takes place over a few days to a week.

Steps of the Trial Procedure:

• Preparation and Anesthesia: You may receive local anesthesia or light sedation.
• Catheter Placement: A thin catheter is temporarily placed in your spinal fluid (intrathecal space). This catheter is connected to an external pump that delivers a controlled dose of medication.
• Trial Monitoring: You will wear the external pump for a few days to see how well it relieves your pain. During this time, you’ll monitor your pain levels and any side effects to determine if the pain pump provides effective relief.

If the trial is successful, meaning you experience significant pain relief, you and your physician can discuss moving forward with a permanent pain pump implant.

2. Permanent Implantation

If the trial phase provides adequate relief, you can proceed with a permanent implant. This procedure is generally performed in an outpatient surgical setting and takes about 1-2 hours.

Steps of Permanent Implantation:

• Anesthesia: General or local anesthesia is used, based on your needs and preferences.
• Catheter Placement: A catheter is placed in the intrathecal space, similar to the trial procedure, but designed for long-term use.
• Implantation of the Pump: A small pump, about the size of a hockey puck, is implanted under the skin in your abdomen. The pump is connected to the catheter and programmed to deliver medication at a controlled rate.
• Programming: The pump is programmed to deliver a customized dose of medication. The dosage can be adjusted over time to meet your changing pain management needs.

Most patients are able to go home the same day or within 24 hours of the procedure.

Pre-Requisites for Pain Pump Implantation

Before undergoing pain pump implantation, there are several prerequisites to ensure the procedure is safe and appropriate for you:

• Medical Evaluation: A comprehensive medical evaluation, including a review of your pain history and previous treatments, is necessary to confirm that a pain pump is suitable for your condition.
• Bloodwork and Other Tests: Routine blood tests are often required to make sure there are no infections or other health issues that could impact healing.
• Medication Adjustment: In some cases, you may need to adjust or taper certain medications before the procedure. Your doctor will guide you on any specific preparations.

Post-Procedure Information

When Can I Go Home?

Most patients can go home the same day or within 24 hours after permanent implantation. You will be monitored for a few hours to ensure the device is working properly and that you are comfortable.

After the Procedure

• Activity Restrictions: After permanent implantation, you should avoid heavy lifting, bending, and twisting for a few weeks to allow for healing and to avoid dislodging the catheter or pump.
• Pain Management: Some soreness at the implant site is normal and can be managed with prescribed pain medications.
• Follow-Up Appointments: Regular follow-up appointments will be necessary to adjust the pump settings, refill the medication, and ensure the device is working properly. Pain pump refills are done in a clinic, usually every few weeks to months, depending on your medication needs.

Final thoughts

Many patients report significant pain relief after receiving a pain pump implant, which can allow them to reduce or stop oral pain medications. Pain relief from a pain pump may improve your overall function and quality of life, though the degree of relief can vary from person to person.

If you have any questions about your recovery or if you need further guidance after the procedure, please do not hesitate to contact our office.