What is the intrathecal pain pump?

Intrathecal pain pump is a pump that sends medicine into your spinal canal through a thin tube (catheter). You may need an intrathecal pain pump if you have long-term pain that cannot be managed in other ways.

In some cases, these pumps can be used to deliver medicine that treats long-term muscle spasms (spasticity).

If you are using the pump for only a short time, the pump may be outside of your body. For long-term use, the pump and the catheter are implanted inside your body.

The pump is about the size of a hockey puck. It is usually placed under the skin of the abdomen. The catheter will run under your skin from your abdomen to your back. Your health care provider will program the pump to deliver pain medicine into your spinal canal continuously or at certain intervals. You may have a handheld device that allows you to give yourself a dose of pain medicine when needed.

The pump runs on a battery. The battery will last 7–10 years, and then the pump will need to be replaced.

What are the benefits?

Opioid pain medicines are strong medicines that are often used to control long-term and severe pain. When these medicines are placed in the fluid space (intrathecal space) that surrounds your spinal cord and brain, the medicine will block the pain signals that come from your body. This type of pump may be an option if you have long-term pain that cannot be managed with opioids that are taken by mouth or by injection. The pump may allow you to have better control of your pain with less medicine.

What are the risks?

You will need to have a surgical procedure to place the catheter and the pain pump. This surgery has some risks. There are also risks to long-term use of opioids.

Before you can have the pump placed, you will need to go through a pain control trial. Medicine will be placed into your intrathecal space to see if it controls your pain and to see how well you tolerate the medicine.

Risks of pain pump implantation and use include:

• Infection.
• Bleeding.
• Failure of the pump or the catheter.
• Leaking of fluid from your spinal canal (cerebrospinal fluid leak).
• A growth around the tip of the catheter inside your spinal canal (granuloma). This can put pressure on your spine.
• A need to remove the pump if problems develop.
• A need to replace the pump after 7–10 years.

Risks of long-term opioid use include:

• A breathing problem that prevents you from getting enough oxygen (respiratory depression).
• Physical and psychological dependence.
• Constipation or difficulty passing urine.
• Nausea and vomiting.
• Mental changes, including feeling high, dizzy, drowsy, confused, depressed, or anxious.

How do I use the pump?

Your health care provider will decide what type of pump is best for you. If you have a pump that gives a dose of medicine on demand, you may have a handheld device to trigger the release of your medicine.

You will need to see your health care provider often to make sure the pump is programmed correctly for your pain. This programming may need to be changed over time. You will also need to have the pump resupplied with medicine. Your health care provider may do this at your routine visits.

You should also know that:

• Electronic devices or scans will not damage your pump.
• You will need a device identification card to pass through security gates.
• Your device will have an alarm to warn you of a malfunction or low battery power. The alarm will sound if you need a medicine refill. Contact your health care provider if your alarm sounds.

When should I seek medical care?

Call your health care provider right away if:

• You have severe constipation or trouble passing urine.
• You have a severe headache or a headache that does not go away after 2 days.
• You have redness, swelling, or pain near your pump site.
• Your pain is not controlled.

When should I seek immediate medical care?

Seek emergency care or call your local emergency services (911 in the U.S.) if:

• You have trouble breathing.
• You have passed out or had a seizure.
• You suddenly have severe back pain, leg weakness, or loss of bladder or bowel control (incontinence).
• You feel very dizzy, confused, or drowsy.