What is it?

An intrathecal pain pump is a small medical device that delivers pain medications directly to the spinal cord. The pain pump consists of two parts: 1) the pump (reservoir) that holds pain medication, and 2) the medication tubing (catheter) that carries pain medication to the spinal cord nerves. Pain signals are nullified by targeted pain medication before reaching the brain.

Before a permanent pain pump is inserted, a trial run is performed. The purpose of the trial is to evaluate the degree of pain relief and side effects of having a pain pump without having to actually implant the full device.

If the trial run is successful, a minimally invasive procedure is performed to place a more permanent pain pump. First, a small tube (catheter) is placed into the fluid surrounding the spinal cord. During this portion of the procedure, the doctor uses real-time fluoroscopy to guide the catheter into the appropriate location. Next, through a small incision near the waistline, the reservoir/pump (similar in size to a pacemaker) is placed just beneath the skin. Most patients leave the day of or the morning after their procedure.

Full recovery usually takes 6–8 weeks. You may experience some initial discomfort and limits on movements; however, this usually resolves quickly. After a few weeks, you should be able to start getting back to many of the activities you enjoy, such as going for a walk, riding your bike, or going to a movie.

During refill appointments, your physician will assess your symptoms, check that your drug delivery system is working properly, and confirm you are receiving appropriate therapy. The pump will be emptied with a small needle that is inserted under local sedation (numbing medication). The pump will then be refilled with medication. Refill appointments usually take 10 to 15 minutes. How often your pump needs to be refilled depends on your individual dosing schedule and the size of your drug pump.

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