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Intrathecal Pain Pump Questions

AnonymousUserAAnonymousUser Posts: 49,321
edited 06/11/2012 - 8:40 AM in Pain Management
I am new here, but not new to intractable pain or spinal surgeries. My PM Doc suggested to me back in December that I should consider an intrathecal pain pump. I have fail back surgery syndrome after 5 spinal surgeries, and an SCS that was installed in June of 08.

I want anyone that has a pain pump to give me some advice... How do you like the pump? Does it give you the same amount of pain relief that PO medications did, or more?
How many times have you gone for adjustments since you had it installed?
How long was the trial period? And how long were you in the hospital after the permanent was installed?

Have you had any issues with the pump itself? I have read that there are some issues with the Medtronics brand pump? Anyone had issues with that brand?

I know I have a lot of questions, but I want to make sure that I am going to make the right decision. I am currently on 80 Mg's of Methadone, 4 Mg's of Dilaudid for BT pain, and Zanaflex for muscle spasms.

I would appreciate any help from all of you. Thanks in advance,



  • First, I don't have the pump yet, but have done tons of research into them because I am considering going through the trial myself.
    The idea behind the pump- is to deliver much smaller amounts of medications to the intrathecal space, which is directly involved in pain perception. Because it is delivered into the spinal fluid, it covers the pain more directly because the pain medication does not have to go through the intestines, kidneys, liver first to get to the area of pain.
    It will not help neuropathic ( nerve pain) but will help with mechanical pain.
    The trial itself is done one of a couple of ways- sometimes it is a single injection done in the hospital so that they can check your pain relief over the course of several hours.
    Sometimes a catheter it inserted into the epidural space and the medication is delivered that way. Again you are observed for several hours to see if you get adequate pain relief.
    It is usually an overnight stay in the hospital for the trial.
    The implantation of the permanent pump is a couple of days in the hospital. First so that the pump is installed, to watch for any spinal headaches or leaking, and to get a baseline amount of medication flowing through the pump.
    As far as adjustments- you have to understand going into this that it will take a while to see how much pain medication you will require to manage the pain. Since the pain meds are delivered in micrograms instead of milligrams, doses have to be increased slowly so as not to cause breathing difficulties or other not nice side effects.
    There is a group on Yahoo called pumpsters that has members who are thinking about going through a trial, have gone through it but now are deciding if they want to have it implanted , those that have had it implanted and those who have not .
    It is a great place to learn about the pumps, trials, doctors who do the implantation and who take care of the meds afterward.
    Can I ask why you had the scs implanted if it didn't help your pain?
    Are you planning on removing it?
  • Sandi,
    Thanks so much for the information on the IPP. As far as the SCS goes.... The SCS has taken care of my neuropathic pain, but not my mechanical pain, so that is why my PM Doc is thinking about having the IPP implanted in me.
    I am planning to keep my SCS since it is serving it's purpose, which it was taking care of the nerve pain on my legs.

    I will go ahead and check out the pumpsters group on Yahoo.

    Thanks Again,

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  • I'm worried I won't be able to have an mri to look for additional tumors of the spine...ture?
    `I askeed dco a bout spasms ( i havebad muscle spasms as well as nerve pain) He said the pump woulddeal with that but I've seen alot of posts that say you need breakthough meds (oral) for that. I don't want baclofen. Several reasons. So....do some docs give extra meds for spasms like opiods you can take when you're in an attack? or is it really that the pump only takes care of
    ' regular pain' and not spasms or attacks?
    Thanks everyone.
  • I have nerve pain and muscle spasm pain...both severe. I see a post above saying the scs doesn't take care of muscular/movement? pain? I didn't know that. Well that rules that one out for me.
  • Hi Jan,
    A spinal cord stimulator is placed in the spinal column, near the spinal cord to help with neuropathic (nerve related) pain. It does not help with mechanical ( movement/structural) pain and/or low back or neck pain, unless it is caused by damage to the nerves exclusively and then it may or may not help, which is why each person who is contemplating having one placed must go through the trial period with the temporary unit and leads in place to see if they get a 50% or better reduction in pain levels. If they do not recieve a 50% or greater reduction in pain levels, then they should not have it implanted.
    Mechanical pain can be treated with a intrathecal pain pump- they use opiates, as well as lidocaine type of medications in the pump, as well as some muscle relaxers, however the medications that can be used in the pump are very selective since they are going to be pumped directly into the spinal fluid, so they must be very selective about the medications and the infusions of them. It will not help with nerve pain, just as the spinal cord stimulator will not help with mechanical pain......they are two very different machines used for very different purposes.
    Opiates are not used to treat muscle spasms. They are extremely ineffective for that, muscle spasms are treated using muscle relaxers and occassionally benzodiazepeines, as well as some other off label medications.
    Can I ask why you don't want to use baclofen? It is one of the most highly effective muscle relaxants available and I use it quite effectively for treating my muscle spasms, along with zanaflex.
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  • You WILL be able to have an MRI with a pain pump implant, you must let them know you have one.

    You CAN NOT have an MRI with the SCS (spinal cord stimulator)!! A lot of people get this confused.

    Pain apump implant....YES.

    SCS (spinal cord stimulator)......NO

    There is a med that can be added to the pain med that will help spasams. I believe it is blacofin(sp?) I understand it works really well.

    I only have pain meds in my pump and take a muscle relaxer for spasams and it works great for me.

    Best of luck.
    Patsy W
  • mri ok with drug pump, not with scs. Got it. I have nerve pain attacks so would probably need both. RFA WORKS for now (yea) but it will wear off. I so appreciate your advise. Alot of people get oral meds for attacks. I guess I'll need to find one.
    Thanks again so much for your time.
    My best to you.
    p.s. I live in Ohio
  • I read where oral baclofen doesn't cause cancer but the IV does. I went to the fda drug site for that info. I've had castlemans (like cancer) and have tumors so am afraid of the iv type. I take oral but it doesn't work. Maybe I need the dose upped.
    I appreciate your info/post so very much.
    Thank you.
  • Hi Lynne,
    I'm not sure what dose of oral baclofen you are taking, but it may need to be increased. Just remember with baclofen and many other medications, the dosages need to be slowly titrated up and down...never just stop taking baclofen, you must slowly go up and down, no matter what, otherwise you can create a withdrawal syndrome with it , especially if you have been taking it for awhile.
    Good luck to you,
  • I am sorry for shouting in my comment. I did not mean to shout but wanted to make it very clear to everyone reading this which device you could have an MRI if you had the implant.

    A lot of people are confused on this subject.

    I think I made it clear....don't you? LOL

    I am not much of a shouter but a very quiet person with a pain pump implant.

    Cheers :H
    Patsy W
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