Who Is a Good Candidate for an Implantable Pain Pump?

An implantable pain pump, or intrathecal pain pump, is a device that is surgically implanted under the skin; it delivers pain medication directly into the fluid-filled area around the spinal cord (the intrathecal space). The pain medication prevents pain receptors near the spine from sending pain signals to the brain. The medication is delivered through a thin tube connected to a small pump, which is typically implanted under the skin in the abdominal area.

Treatment with an implantable pain pump is typically only considered after noninvasive treatments have been attempted and deemed unsuccessful. Examples of noninvasive treatments include oral pain medications, injections, physical therapy, cognitive behavioral therapy, relaxation techniques, and alternative treatments, such as acupuncture.

A trial phase is often completed to determine if a pain pump will be an effective treatment for a specific individual. Psychological testing may also be required to indicate if an individual is mentally suited and prepared for treatment with an intrathecal pain pump.

Who is a good candidate for an implantable pain pump?

Implantable pain pumps can help provide pain relief for individuals with severe, long-lasting pain. Types of pain that may benefit from the use of a pain pump include cancer pain, pain associated with complex regional pain syndrome, and severe back pain, such as pain related to a compression fracture or spinal stenosis.

Individuals who have experienced pain relief from treatment with opioid medications but have developed increased pain or side effects despite rotating the type of opioid may also benefit from a pain pump. Individuals who need pain medications around the clock are also good candidates.

Who is not a good candidate for an implantable pain pump?

Some individuals are not good candidates for implantable pain pumps. In general, pain pumps are not recommended for individuals who:

• have active or untreated addiction
• have certain medical conditions, such as an infection or intracranial hypertension.
• have certain psychological conditions, such as depression or a personality disorder.
• require anticoagulants or experience abnormal bleeding or blood clots.
• have a terminal illness with a life expectancy of less than six months.
• are unable or unwilling to have the pump refilled when needed.