For people living with chronic pain that hasn’t improved with conservative care, medications, injections, or even certain surgeries, a pain pump may offer meaningful relief. Also known as an intrathecal drug delivery system, a pain pump delivers medication directly to the spinal fluid, providing targeted pain control with far smaller doses than oral medications.
If you’ve been wondering whether this therapy is right for you, understanding how it works and who it helps is the first step.
What Is a Pain Pump?
A pain pump is a small, implantable device placed under the skin of the abdomen. It is connected to a thin catheter that delivers medication directly into the intrathecal space around the spinal cord.
Because the medication bypasses the digestive system and bloodstream, patients often achieve the same — or better — level of relief with a fraction of the usual dose.
Conditions a Pain Pump May Help
Pain pumps can be effective for chronic conditions such as:
• Failed back surgery syndrome
• Severe spinal arthritis
• Nerve-related pain, including neuropathy
• Complex Regional Pain Syndrome (CRPS)
• Cancer-related pain
• Chronic pancreatitis or abdominal pain
• Certain types of spasticity requiring muscle relaxant delivery
How Intrathecal Delivery Works
Intrathecal therapy uses highly targeted drug delivery to calm pain signals at the spinal level. Here’s what makes it different:
1. Direct-to-Spine Medication Delivery
Instead of circulating through the entire body, the medication is delivered into the spinal fluid, where pain signals originate.
2. More Relief with Less Medication
Intrathecal delivery is powerful. Patients may use less than 1% of the equivalent oral dose. This dramatically lowers systemic side effects like drowsiness, constipation, or mental fogginess.
3. Adjustable and Programmable
The pump can be programmed to release medication at steady intervals or provide extra dosing during flare times. It can also be adjusted in the clinic without another surgery.
Who Is a Good Candidate?
A pain pump may be considered if you:
• Have chronic pain that affects daily life
• Have tried conservative treatments without meaningful relief
• Cannot tolerate side effects of oral pain medications
• Have pain that responds well to trial intrathecal medications
• Are not a candidate for, or have already undergone, spine surgery
• Want a long-term, low-dose pain management option
Before implantation, patients undergo a trial, where a temporary intrathecal dose is given to measure relief and ensure compatibility.
Benefits of a Pain Pump
Patients often appreciate that intrathecal therapy offers:
• Improved pain control
• Lower reliance on oral opioids
• Fewer medication side effects
• More stable pain relief throughout the day
• A reversible and adjustable treatment option
• Reduced sedation or cognitive impairment compared to systemic medication
Potential Risks and Considerations
As with any implanted device, risks exist. These may include infection, catheter issues, or pump malfunction. Some patients may experience changes in medication tolerance or side effects from intrathecal drugs.
Your pain specialist will discuss these risks and determine whether you are an ideal candidate.
What to Expect from the Procedure
The trial: A temporary injection or catheter delivers medication to evaluate pain response.
The implantation: If the trial is successful, the pump is surgically implanted under the skin, typically in an outpatient setting.
Follow-up: The pump requires periodic refills in the clinic, usually every one to six months depending on your dosing.
Is a Pain Pump Right for You?
Pain pumps are not for everyone, but for the right patient, they can be life-changing. If you’re struggling with chronic pain that has not responded to other treatments, a consultation with a pain management specialist can help determine whether intrathecal drug delivery is a safe and effective option for long-term relief.