A patient suffering intractable pain from a variety of conditions — including cancer; severe spinal conditions, including stenosis or recurrent vertebral fractures; and other neuropathic conditions — may often receive only limited relief with standard medication therapy. That’s because many pain medications including opioids have side effects, such as sedation or nausea, when they are taken in doses high enough to manage pain. But when the dose is limited or reduced, the pain is not adequately controlled.
Fortunately, we can now offer some pain medications in an intrathecal pain pump, which delivers the drug directly to the spinal fluid. When released into the spinal fluid, a drug is far more efficiently delivered than when given other ways – in fact it would take 300 mg of intravenous morphine to equal the pain relief of just 1 mg of intrathecal morphine. This allows similar or better pain relief with much less nausea, constipation, or sedation.
Intrathecal drug delivery provides medication directly to the spinal fluid from a pump implanted under the abdominal skin. The medication in the pump lasts from two to three months and can be refilled easily in the pain clinic through a small needle.
A pump can help lessen chronic pain caused by:
A pump can also help lessen spasticity (muscle rigidity and spasms that make movement of the arms and legs difficult) caused by:
Reviewed by: Neel Mehta, M.D.
Last reviewed/last updated: December 2021