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Medications in a pain pump for your back

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:20 AM in Pain Management
I was wondering if anyone knew all the common medications that are used when an indivdual gets a pain pump put into them from back pain?

Also could anyone tell me if they have ever heard of putting Fentanyl in the pump? Thanks


  • I am going in for a pre-op consultation on Tuesday for a Medtronic pain pump that will be implanted in my stomach area. The doctor I have has talked about filling it with a combination of Morphine and Baclaphine (sp?) I need a combo of muscle relaxer and pain control for my muscle spasm plus pain issues with my back. Unfortunately this combination hasn't been approved by the FDA, so I will be agreeing to do it off label....
    I haven't heard of Fentanyl being used, but I'm not any type of expert in the area! In most of my research prior to opting for the surgery I saw morphine being the most common drug. Just remember that you do a trial before implantation, and this can allow you to try different meds to see what works best. Also, whatever meds you get you'll only need approximately 1/100th of the amount you were taking previously since it goes right to your spine, so if you can back down from fentenayl to morphine all the better.
    Hope this helps a little!
  • Listen Please do not have fentanyl put in the pump. I had the morphine removed and replaced with fentanyl on the 17 of June and I ended up in the E R. They were determined to keep the fentanyl in so they lowered the dose but I still ran a fever and suffered the worst upset stomach I ever had. I survived kidney cancer and my wife thought she was going to loose me to a bad medicine reaction. I got the drug removed July 1 and now I am waiting for the morphine to get through the plpe line to the spine. But PLEASE do not get the Fentanyl. I have had Didlodid with no problems, But please stay very far away from the Fentanyl. This message for Pinkgirl
  • bohica2753, I hope you're still out there and get this question. I have had my pump for 2 years and it is not as effective as it once was. Was the Dilaudid in the pump or taken as a tablet for break through pain? I am having excrutiating painfel legs and seems to be progressing to my cervical spine. I have stenoswis in the majority of my spine along with degenration in the entire lumbar region, parts of my thoracic and at least half of my cervical. I am only 48 and need a combination that I can live with for a long time. Again hope you're still out there and anyone who cares to comment please,please feel free. Thank you Marene or littlefishmamag
  • Again, this is another piece of info that stears me away from the pump,
  • I have a pain pump with Diladuid in it. Yes, they do put Fentanyl in them or Morphine or Prialt(this has serious side effects)
    Yes, some do have side effects from Fentanyl and some do not.
    They can also put a blend of meds in a pain pump. Bupivacaine is one that is sometimes added to the pain meds. It is a numbing agent that helps to reduce pain. I already have numbness in my legs so I can't use it.
    I have no problems at all with the Diladuid and it is a bit stronger than Morphine.
    Doses are in micrograms not milligrams and because it goes directly to the spinal cord much less is needed and side effects are reduced because it does not go through your system first.
    Hope this information helps you.
    Cheers :H
    Patsy W
  • Thanks Patsy, once again thank you! Your info is always very helpful!
  • I am going to do the trial pain pump shortly & would like to know any experiences, good or bad that anyone's had. I'll remember the fentanyl. Was it put in your stomach or back. Mine wll be in the back.
  • Was your pump put in your stomach or back?
  • Sorry its taken this long to answer but I'm slowly but surely learning how to navigate thru chat rooms and forums. But, after my initial run with the test pump w/morphine I realized that for me this was almost a miracle. I hadn't felt that well in years. The side effects are minimal and the pain relief was thorough. Its been 3 years(almost) and I'm still doing well. I am at the top of the limit for the drip and am now using vicadin for breakthru and muscle relaxants for the twitches. I started to feel more intense pain than was normal about 6 mnths ago but after one test and much evaluation my dr and I understood the pain I now have is neuropathy. I'll soon be starting with nerve pain relievers. One of the features of having the pump is that because of the very small amount of drug that is used to be effective it leaves more room for additional meds if needed. My pump is intrathecal and is in my right abdomen closer to my waist. I had a choice of sides r or l but not front or back. I put mine on the side I did not sleep on. I hope this helped.
  • thank you for the response.
  • Fentanyl really helped me, morphine made me too sick. Now just added bupivcaine for nerve pain in legs due to front and back, back surgery. I play golf and walk, I walk on off golf days. Walking is best. I do love to work in yard, weeding and just cleaning up. I'm trying bupivacaine to hopefully get off of Lyica. I do get tired, sleepy in late afternoon, and rest for 30-60 min. daily.
  • sstathemssstathem Posts: 3
    edited 07/29/2013 - 7:38 AM
    Yes, I have had fentanyl in my pump for about 2 yrs. now. Love it. It doesn't make me sick or sleepy. I also have bupivacaine in pump too. It is for pain, in legs due to surgery of back (front & back).

    Post edited to remove specific medical facility . Please read the Forum rules
  • anyone used the drug derived from this puppy in their pump?
  • can have very negative consequences when it is used to treat pain. Make sure to do your research into it's use in the pump before agreeing to it.
  • I have Dilaudid in mine and so far I haven't had any significant side effects. When I was on oral morphine it made me extra drowsy and I'm pretty sure it would have affected me similarly with it in the pump. I haven't tried any other meds in my pump besides the Dilaudid but I am aware Fentanyl, Prialt, and muscle relaxers being combine like Baclofen for spasms. It's been 3 years now and the pump took me from almost bedridden to a better quality of life- I can sit, stand, walk around much better. I do have pain but thankfully there are more better days than bad. Unfortunately I developed cervical radiculitis and was told the pain pump does cover the whole spine. That's wonderful because I had it put in to deal with all the lumbar problems and was surprised to hear it will help everywhere else. I do however take Norco for BT pain again after I had weaned off of all oral narcotics because of my recent problems
  • I don't have a pump, but my PM doctor whom I chat with comfortably about general pain management and treatment challenges has told me before that he doesn't like fentanyl in pumps. He explained that due to the potency of the medication, such small physical amounts of solution are released that even a small bit of scar tissue or similar problem that impedes the flow from the pump into the spine can result in patients getting less than half of the actual intended dose, which definitely does not seem worth it after having a device for pain control implanted directly into your body. I'd say stick to morphine or hydromorphone
  • YME22YYME22 Posts: 1
    edited 02/28/2014 - 3:32 AM
    hello everyone I have been dealing with pain for 15 years now and my pain Dr. has giving me two options, the pain pump or the nerve stimulator. I just had my 3rd back surgery on my L5-S1 fusion with the plates and rods. I do have nerve damage so I don't think the nerve stimulator would be a good idea, and my pain Dr. is pushing the stimulator. and the Dr. doesn't want to put me on meds because of my age I'm only 40 yea that's young but I know of many patients younger on heavy pain meds. and because of my insurance I'm limited to a few pain Dr.s so I'm don't know what to think. If anyone can give any info good or bad would help so much
    Yvonne shows
  • are "last resort" options when it comes to pain managment. There are several things that must be done before undergoing either option- a trial period consisting of a test run of either option, to see what, if any relief of pain there will be, and depending on the option, the results determine whether or not implanting the device is a good option.
    As far as the pain pump goes, usually that is reserved for someone who has been on medications for a long time, and usually at high doses orally , and then the intrathecal option is considered, because a tiny amount of medication delivered intrathecally is considered a better long term option.
    Since you are talking about nerve damage, generally drugs like Lyrica or gabapentin are trialed first, to see if the nerve pain can be managed during the recovery period and for up to two years or so to see if the nerves will recover some on their own. There are several other medications that are also used to treat nerve related pain- Cymbalta and Topamax are also options , as well as others. I think that I would try those before jumping into another surgical option that you may not need at this point.
    I would be concerned if a doctor is trying to get you to have a medical device implanted that you may not need once you get out of the immediate recovery period. It might be worthwhile to make an appointment and talk to another PM doctor about options for treating you.
    There is a link to the Step by Step Guide to getting chronic back pain treated below. It is worth reading.
  • i have had my implanted pain pump for 2 1/2 years now. I have fentanyl dilaudid and bupivacaine in mine. It has given me my life back. I sill take break through med, but I can now remember what happened yesterday and last week and Christmas and stuff. I can also be more active because I am not so sleepy. I was on 125 fentanyl patches every 48 hours and oxycodone every 4-6. I have had 2 - 2 level lumbar fusions and in Sept had a revision of the 2nd fusion because of non fusion. I am still in a lot of pain, and holding my breath that it shows some bone growth this month when we take 6 month xrays. I am so happy to not have to take so many oral meds and wouldn't change a thing.
  • I get so hopeful when I read posts talking about how much people's lives have changed for the better. Mine seems to have gotten worse since I had my put in. I'm trying to find the right medications for my pump, and I hope that it will start helping. Right now I'm on Prialt (yes, the snail meds), and morphine was added last week. I've been hearing things (music, voices) which I believe is from the Prialt. My doctor turned that down, and it has started getting better. Anyway, does anyone know where I can find all the medications that be put in the pain pump? I think I might need a muscle relaxer because my leg gets to tight and painful at times. I also wonder if my leg is having issues because the pump was placed wrong, or there was nerve tissue damage throughout the whole ordeal.
    2000- spinal fusion, complete spine due to scoliosis
    2012- pain began, started treatment for chronic pain
    2013- install of pain pump, procedures to address complications
    2014-blood patch, spinal fluid leak
  • I believe that all of the available muscle relaxants can be used in the pump, but baclofen seems to the one used most often, when it comes to muscle relaxers.
    I will look around and see if I can find a more specific answer for you but I believe that this is accurate......
  • I have been off fentanyl for one year, I have had a bad bout of coughing and vomiting all the time vomit. Has narrowed down to at least twice a week my dosage was 380mg I was on it for 7 years cold turkey 100 first week ...then 280 six days prior to surgery...due to insurance non coverage I had to wait till dec. and just had it removed ...lost confused and outta my mind on this
  • I would recommend the pump ovr the stimulator any day! Especially if u have a lot of metal in the spine. My mother had a fusion&a stimulator. She ended up having an allergic reaction causing her to lose her fusion&sum bone. The pump has given me pain relief that I never thought possible. It's an easy day surgery....depending on the person. Remember this is the rest of a chronic pain persons life so if anyone out there is given the choice, I'd say get the pump.
  • deb4tc1ddeb4tc1 Posts: 1
    edited 09/11/2015 - 7:37 AM
    I got my pump in 2005 and had it replaced 10 yrs later I have been on morphine but u get to a point where your as high as dose as you can go so we changed to fentnyl and I have been back to the Dr since Xmas so many times to go up r down now I'm wondering if my body is trying to tell me this is no right i. Sneezing dirreah and feel tinginging all over also I have this ugly sweet taste I can't get rid of so now I'm back at the Dr to ask where we go from here . If I go back to morphine then I'm at a point of no where to go up when In pain.

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    Deborah spann robeson
  • Laura1956LLaura1956 Posts: 1
    edited 09/11/2015 - 7:36 AM
    I have had a pump for over 30 years. I was one of the first to get one(so my Dr said), I have had morphine, diladuid and tried sufenta. it is a sister to fentanyl. the sufenta made me so sick I lost 50 lbs in 6 months. My dr insisted that I keep trying for that long. When he put the diladuid back I was fine, for a year. Now I have used this drug for so many years that my body has become immune to it. The Dr. wants to put in fentanyl in my pump. I don't want to because I am so afraid it will make me sick again. Tomorrow he is putting prealt in with the diladuid and baclofen. It is worth a try. Any comments or questions?

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  • gtwggtw Posts: 1
    edited 07/03/2015 - 6:34 AM
    I've only received my pump a few months ago. They used fentanyl. I had some bad side effects. They are going to change it to dilaudid. Does anyone know what mcg is a good setting for the pump. I'm on 6.996mcg of fentanyl and it helps a little but not much. I'm waiting for it to be changed to dilaudid before saying anything. I was told that 6.996mvg is a very low setting so I'd like anyone that might know, what is a good stting.
    Thank you.

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  • ThePainGuruTThePainGuru Posts: 2
    edited 07/28/2015 - 9:54 PM
    I've never had full relief and been conscious. Has anyone here taken more medication than 150ug Fentanyl patch, 240mg daily methadone, 240mg daily Oxycodone, 1400mg daily Soma, 30mg daily valium, 3mg daily klonopin. Just wondering if I should try pushing for a pump. My PM doctor doesn't want to give me one. I think my tolerance is extremely high. I've been told i should just quit the medications if they no longer work. Ummm, ok!! Then what? I seem to be at an impasse here.

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  • dilaurodilauro ConnecticutPosts: 9,818
    Far beyond what I believe anyone would even consider normal

    What are your medical problems/conditions that require that amount of medication. Are all those medications coming prescribed from the same doctor?
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Brandon QBBrandon Q Posts: 1
    edited 09/11/2015 - 7:35 AM

    had my pump for 3 years and I've had dilaudid in it for 2 years and it works wonderfully for me morphine did nothing so they switched it I've had no negative side effects whatsoever I hope this helps you

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  • Since my last post, my doctor added Bupivicaine to the Dilaudid in my pump to help with nerve pain. I started at 2mg Dilaudid daily and am now at 15mg after several years. I take oral meds including Norco for BT pain.

    PainGuru, I also agree with Ron that it's a ton of medication. There is nothing out there to take all your pain away, and being conscious IS a GOOD THING!!
    Ol' Spiney...Microdiscectomy L4-L5, TLIF L4-S1 -post op central disc herniation L4-S1, sciatic nerve damage, retrolisthesis, epidural fibrosis, facet arthropathy, severe DDD & OA.FBSS- Medtronic SynchroMed II pump.
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