What To Expect At Your Refill Appointment
At your appointment, your pain doctor will numb your skin so that you wont feel any pain. Then, they will put a needle through your skin and into the pump. Your doctor will take out any medication that is left in your pump and will put new medication into it . They will place a small bandage over the area where the needle was placed. You can remove the bandage after 1 day.
Each time your pump is refilled or changed, you will get a piece of paper with the following information:
- The kind of pain medication thats in your pump.
- The amount of medication that the pump gives you.
- The date that your pump will need to be refilled with new medication.
Its important to keep track of this information so that your pump doesnt run out of medication.
Figure 3. Refilling the pump
How Do It Pumps Help
An IT pump offers you superior pain relief, reduced side effects from medications, and more control over your treatment. Giving medications through an IT pump is very effective since the spinal cord is a place where pain-relief medications take effect. Giving medications directly to the spinal cord, requires smaller doses, around 1/300th of the same medication in pill-form. This results in lowered side effects like nausea, constipation, or drowsiness. Pumps are an excellent option for people with severe pain, who cant tolerate opioid pills.
Pump medications usually include an opioid and sometimes a muscle relaxant or another strong pain-relief agent . Your pump can give you medicine constantly, in a way that provides a reliable pain relief effect. You also have the option to use a remote control in order to give yourself extra medication, when you need it.
Overview Of Pain Pumps
An intrathecal drug pump, commonly referred to as a pain pump, is a small device that is implanted in the abdomen. A pain pump injects small doses of medication directly into the spinal cord. There are a number of advantages to this approach and it can help certain patients find relief from chronic pain while reducing some potential side effects of oral medication.
Weve provided the following information on this procedure to help patients make a treatment decision that matches their needs and lifestyles. To find out more about our procedures, the conditions we treat or our medical team, you can get in touch with our team at any time.
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Could An Intrathecal Pain Pump Be Right For You
If youre interested in learning more about pain pump technology or wondering if this innovative device could help you live with less pain, contact Integrated Pain Solutions today at to connect with our Columbus pain management specialists. We also have two additional locations for convenient service to our neighbors in Springfield and Dublin, OH. Call today!
What Is A Drug Pump
A drug pump is designed to reduce chronic pain by delivering pain medication to the intrathecal space, where fluid flows around the spinal cord. Since targeted drug delivery releases medication directly at the source of the pain, effective pain relief may be achieved at lower doses and with fewer or more tolerable side effects compared to oral medications, which go through your circulatory system.
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Its About The Medicine
After your surgical procedure, there are relatively few reported side effects of the intrathecal pain pump itself. When there are side effects, its usually because of the medications themselves, which is why the FDA recommends only using medications that are approved for the device.
At our practice, we follow these guidelines to the letter, and we would never use any medication that isnt cleared for the pump.
In fact, using an intrathecal pain pump properly may relieve many of the side effects that you may have encountered when taking medications orally, because were able to use a fraction of what you took in pill form.
What Happens During The Procedure
During the trial, a catheter is placed in the spine, often in the epidural space. The catheter and the pump are worn outside the body. For the permanent implantation and some types of trials, the catheter is placed deeper into the spinal cord, into an area known as the intrathecal space. The type of trial that inserts the catheter into the intrathecal space has the advantage of more closely simulating the final procedure and thus yielding more accurate data. The use of the external catheter raises the risk of infection. In people with cancer, the risk is even higher. Your healthcare provider will probably wait a few days between the end of the trial and the actual implantation procedure, to monitor for signs of infection.
As mentioned above, during the trial, the healthcare provider begins to establish the medication dosage offering the best possible balance between pain relief and side effects. The healthcare provider then decides if you should be given just one shot, several, or a continuous dosage.
Trials are done as an outpatient procedure, but for the permanent implantation, a hospital setting is needed to control possible infections. As with the permanent procedure, the pain pump trial is generally done by either a pain management specialist or a neurosurgeon.
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What To Expect Once You Have A Pump
- Your doctor will work closely with you to get the medication dose just right.
- You will learn how to use the optional remote control, that allows you to get extra pain relief medicine, as needed.
- There are follow-up visits every 3-5 months, so your doctors office can refill your pump medications.
- Magnetic resonance imaging scans are allowed, while you have a pump.
- A majority of patients prefer to have a pump for the rest of their life. However, a pump can be removed if your painful condition improves to the point you no longer need treatment.
Intrathecal Pain Pump Implant: What To Expect
- NSPC Team
An intrathecal pain pump is a small medical device, that delivers medications directly to the spinal cord, into the intrathecal space. Medications placed here, have a stronger and faster pain relief effect than medications taken in pill form.
A pain management specialist places the pain pump under the skin of your abdomen, right above the belt area. Other people cant see it, even if youre wearing a swimsuit. The pump is connected to a small tube that drips medications directly around your spinal cord.
The spinal cord is the mecca of pain sensations. Just like the brain, the spinal cord is very important in receiving pain signals from the rest of the body. It has many receptors , that can shut off the pain. Among these are the opioid receptors. Opioids are commonly used in pain pumps, sometimes in combination with other medications. When delivered through a pain pump, opioids have fewer systemic side effects. A pain pump is a great way to control long-lasting pain that has failed to improve with other treatments or with surgery.
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Pain Pump Trial For Chronic Back Pain Relief
If you and your healthcare provider have determined that a drug pump may be a good option for managing your chronic back pain, you’ll likely need to first agree to a trial before the device can be permanently implanted.
The trial for an implantable pain pump aka an infusion pump is done to tailor the treatment to you as an individual patient. From the trial, your healthcare provider will be able to answer two important questions necessary for continuing on to permanent implantation.
Pain Management And Anesthesia Physicians Located In Bloomfield Townshiip Mi
The CDC reports that more than 20% of the population in the United States has had some experience with chronic pain, with 8% dealing with high-impact chronic pain. These eye-opening numbers are why the team of pain specialists at Neuro Pain Consultants offers intrathecal pain pumps to patients whove exhausted almost every avenue to find relief. If youd like to learn more about intrathecal pain pumps, call one of the four locations in Bloomfield Hills, Clarkston, Macomb Township, and West Bloomfield, Michigan, or request an appointment online.
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What Is An Implanted Spinal Pump
An implanted pump is an Implanted Intrathecal Drug Delivery System that releases pain-relieving medication through a catheter directly to the intrathecal space surrounding the spinal cord where pain signals travel, interrupting pain signals before they reach the brain. Intrathecal drug delivery uses an infusion system to manage severe persistent pain.
How Does Intrathecal Pain Pump Work
The pump implant is surgically placed under the skin in the abdomen and delivers medication through a catheter that is sent directly to the spine, stopping the pain signals being sent to the brain from nerves surrounding the spinal cord.
The intrathecal pump allows patients to be in control of their symptoms while protecting them from addiction and other negative side effects.
The pump is programmed by a pain management specialist to release medication over a certain period of time. The physician may change its programming if the needs of the patient change.
Intrathecal pain pumps may be recommended for patients suffering from failed back surgery syndrome, cancer pain, arachnoiditis, chronic pancreatitis, and more.
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The Pain Pump: A Viable Option For Many
Pain pumps do miraculous work. Technically, they are intrathecal drug delivery implant systems, and when one is placed by your surgeon, it delivers a precise amount of pain medication directly into your cerebrospinal fluid through a catheter. This fluid that surrounds your spine is filled with pain receptors, so thats a key to the pain pumps effectiveness.
A pain pump can be beneficial for patients who have tried other treatments from oral pain medications to epidural steroid injections to no avail.
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How Is The Implantation Of A Spinal Pump Performed
Implanting a spinal pump is a surgical procedure carried out in the operation room under x-ray control and deep sedation or general anaesthesia. The catheter is introduced into the liquid around the spinal cord and anchored at the back. It is then connected to the pump, which is implanted in the abdominal wall.
Intrathecal Pumps And Epidural Catheters
Intrathecal pumps are different from epidural catheters, which is what women get during childbirth. While both pumps give pain medication directly to the nerves in your spine, there are some differences.
This table gives some examples of how intrathecal pumps and epidural catheters are different.
| Intrathecal Pump |
|---|
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What Are The Results
Results will vary depending on the underlying condition being treated and its severity. Chronic pain patients may experience a reduction in pain, as well as overall improvement in activities of daily living . Spasticity patients may experience a reduction in rigidity and muscle spasms . Oral medications are reduced because the medicine is delivered directly to the spinal cord and much smaller dosages are needed.
What To Expect After The Pump Implant
- While recovering from the implant, you can take oral pain medicine as directed by your doctor. Opioids may be used, for a limited time only, until the pump medication starts to work.
- For the next six weeks, you will need to avoid physical effort such as bending, lifting, twisting, or reaching overhead. This prevents the catheter from slipping out of place, while you are healing.
- The degree of pain relief depends on your underlying pain condition and its severity. Most patients feel a reduction in pain and are able to increase their activity level.
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Targeted Drug Delivery Process
While many chronic pain patients have had success with pain pump implantation, spinal drug delivery is not for everyone. A trial will be done first to determine if the intrathecal pain pump would be effective at relieving your pain. If you achieve a good level of pain relief during the trial of targeted drug delivery, you may be a candidate for the permanent implant of a pain pump.
View this video to learn how a spinal pump works.
The intrathecal pump implant is a round, metal device connected to a spinal catheter. The catheter is a thin tube that runs from the pump and into the spinal canal where it delivers medication to the spinal cord. Typically, the pain pump is implanted in the upper buttock region or the abdominal area. The pain pump is programmed to deliver medication directly to the spinal cord, which is the major pathway for pain signals. Applying medication directly to the spine via the pain pump provides powerful pain management and relief with very small doses by blocking pain impulses at the spinal level.
Specially trained staff refill the pump by placing a needle through anesthetized skin into the pump refill port. Refills occur on average every 1-3 months depending on drug doses required for pain relief.
Nura also provides a Home Infusion Service for patients who prefer to have their pain pumps refilled at home.
Implanting The Permanent Pain Pump
If the trial is successful, you will receive a permanent intrathecal pump implant. This surgery is performed under general anesthesia. During this procedure:
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Is A Spinal Pump Appropriate For My Pain
In the past this technology was used widely for pain due to non-cancer causes. More recently when employed over a period of years, specific adverse effects have been identified. These relate to the catheter that is implanted in the spine, the medication thats infused from the pump and the effects of the medication on other functions of the body such as fluid balance and hormones. In more recent years this technology is reserved largely for cancer pain and for patients with spinal injuries and other causes of spasticity. There remains very small percentage of patients who may benefit from this technique.
How Is An Intrathecal Pump Inserted
During the procedure your skin is numbed and through a small incision, one end of a catheter is placed in a fluid-filled area near the spinal cord. The other end goes under your skin and around your body, typically to your abdomen, where it is connected to a temporary pump.
The pump is programmed with a wireless controller outside of the body. This enables you to administer medication at the moments when you need it the most. If youre happy with the results, a permanent pump can be implanted.
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What Is A Spinal Cord Stimulator
Spinal cord stimulation is used to treat people who suffer from neuropathic pain. This typically means its intended for someone whose pain is caused by damage to their nervous system. With SCS, mild electrical impulses are sent to the brain. In some patients, these pulses can prevent pain signals from being received by the brain and succeed in relieving their back pain.
This option might be for you if youre tired of meds, want more control over your pain management, and are open to trying out a less conventional approach. As the patient, you get to program the electrical pulses with an external wireless programmer. You can adjust the power level and choose when the system is on or off.
Some potential benefits:
- Less dependence on bracing
Implanting An Intrathecal Pump
Before you get an intrathecal pump, well test the dose of medicine used. You may need to stay in the hospital for this.
During the implant procedure, you will get anesthesia. We make a small incision in your back and your abdomen to place this device. The pump is about the size of a hockey puck and will be placed in your abdomen. The pump is filled with medicine and connected to the catheter.
You might need to limit your activity for a short time as you heal after the surgery. Youll also need to wear an elastic brace to keep the pump in place as you heal.
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How Does A Drug Pump Work
The implanted pump and catheter release prescribed amounts of pain in close proximity to the spinal cord, to affect pain signals before they reach the brain. The programmability of the pump enables your doctor to customize the therapy to best meet your needs throughout the day. You return to your doctors office for more medication when the pump needs to be refilled.
