Learning About Implanted Pain Pumps for Long-Term Pain

What is an implanted pain pump?

A surgically implanted pain pump is a device that helps control long-term (chronic) pain. It pumps medicine into the fluid around your spinal cord. The spinal cord is a bundle of nerves that carry signals, including pain, between your body and your brain.

A thin tube (catheter) is placed into the space around your spinal cord. The tube is attached to a pump that is placed under the skin of your lower belly. The device can stay there as long as you need it. Your doctor can refill the pump with more medicine.

The device is sometimes called an intrathecal pain pump.

Why is it used?

The pump helps relieve chronic pain that makes it hard to enjoy daily life. It may also be used for pain from cancer and end-of-life pain. Pain pumps deliver medicine directly to the spinal cord to block pain.

How does it work?

The doctor decides where to place the catheter along your spine based on where your symptoms come from. The other end of the catheter is connected to the pump. The pump holds the medicine.

The pump releases medicine through the catheter into the fluid around your spinal cord. Your doctor will program the device to give you a certain amount of medicine over time. In some cases, it may be set to give you extra medicine, if needed. You will have a hand-held device to give yourself the added dose.

How is it implanted?

Before your pain pump is implanted, your doctor will check to see if it will give you enough pain relief or help you function better. During a trial of the pump, you may be given medicine into your spine through a catheter attached to a pump outside your body. Or you may get one or more shots of medicine into your spine. If you respond well, you may get a long-term pump.

You may be asleep during the surgery to place the catheter and pump. Or the doctor may make the area numb and give you medicine to relax you. The doctor will make a small cut (incision) next to your spine. The catheter is placed into the space next to your spinal cord. X-rays will be used to make sure it's set in the right spot.

The pump with the medicine will be placed under your skin on one side of your belly. The catheter from your spine will be guided under your skin and connected to the pump. The incisions will then be closed with stitches or staples.

What are the risks?

Risks from the surgery include:

• Possible infection and bleeding, as with any surgery.
• Side effects from the anesthesia. These include nausea and feeling tired.
• Problems from the surgery itself, like a headache afterward.

Risks from the device include:

• Problems with the catheter. If it moves, gets pinched, or breaks, your pain may come back. Depending on the medicine, you may also have withdrawal symptoms if it is stopped too quickly.
• Problems with the pump. These include the pump not working, mistakes when refilling it, and pump programming errors.

Risks from the medicine include:

• Tolerance to the medicine. This can lead to needing more medicine to get the same level of relief.
• Side effects from the medicine. These include constipation, itching, trouble urinating, and trouble breathing, which may be severe.

What can you expect after getting the pump?

Depending on the model you receive, the pump may last several years. You will have surgery when the battery or the whole pump needs to be replaced.

You'll have follow-up visits with your doctor to refill the pump. Your doctor will put a needle into the pump to empty it. Then the doctor will use the needle to fill the pump with more medicine. The doctor will also check to make sure that the pump is working well and that the medicine is helping you.

Let your other doctors know what medicine is in your pump. Also tell them that you have a pump before you have any procedure, such as an MRI.

When you travel, carry a card that explains that you have an implanted device.