Permanent Pain Pumps

Intrathecal drug infusion with an implantable pump

Intrathecal drug administration via a “pain pump” is a method of administering drugs directly into the spinal cord. It can be used in cancer and non-cancer pain.


What does the pump look like?

The pump is a round metal device that is surgically implanted into the patient’s abdomen (under the skin). A small plastic tube (catheter) is placed in the intrathecal space of the spine and is connected to the pump, i.e., the reservoir containing the drugs.
The pump is programmed to slowly release medication over a period of time (0.5 ml/day or 1 ml/day). There are electronic pumps that can be programmed to release amounts of medication at a variable rate, depending on the patient’s needs.
When the reservoir is empty, the doctor refills the pump by inserting a needle into the fill port on top of the reservoir.


Criteria for eligible patients:
• Conservative treatments have failed
• additional surgery has no benefit
• there is an addiction to pain medication
• there is no known allergy to the drugs that will be used in the pump
• test-dose results are favorable.

Patient eligibility

Ενδείξεις τοποθέτησης μόνιμης αντλίας για την διαχείριση χρόνιου πόνου:

Indications for a permanent pain pump

  • Cancer pain
  • Failed back surgery syndrome
  • Reflex sympathetic dystrophy (progressive disease of the nervous system in which patients experience constant chronic pain)
  • Causalgia (pain caused by peripheral nerve damage)
  • Arachnoiditis (painful inflammation and scarring of the meninges [protective layers] of the spinal nerves)
  • Chronic pancreatitis


Pump implantation procedure

The patient is admitted to the hospital and prepared for the surgery. The whole procedure may be performed under local anesthesia and sedation, or under general anesthesia if the patient wishes to do so.
Using surgical antisepsis, the intrathecal space is punctured with a fine needle and the special catheter is advanced. The special pump is then implanted in a subcutaneous pouch created in the lateral abdominal wall. Next, after forming a tunnel under the skin, the catheter is connected to the pump.
The patient is monitored in the hospital for 2 to 3 days following the procedure. Post their discharge, patients are advised to avoid activities (driving, lifting weights, etc.) for a minimum period of 6 to 8 weeks.

Potential complications:

  • Headaches
  • Infection
  • Bleeding
  • Catheter displacement or occlusion
    Side effects from medications include: respiratory compromise, convulsions, muscle spasms, urinary retention, constipation, nausea, vomiting, dizziness, anxiety, depression, and edema.
    Device removal may be necessary due to infection, ineffective pain management, or patient misuse.

Living with an intrathecal pump

The objective is to deliver optimal pain management with the least side effects and better Quality of Life for the patient. Patients are advised to immediately inform the doctor should any unusual symptoms occur. There is no interaction between the pump and other devices, i.e., mobile phones, microwaves, or security doors. In addition, the pump is MRI compatible. Implanted patients should carry their Pump ID Card as well as their Emergency Contact Card at all times, as the device is detectable by airport security gates.


1. Winkelmuller Μ, Winkelmuller W. Long-term effects of continuous intrathecal opioid treatment in chronic pain of nonmalignant etiology. J Neurosurg 85: 458-467, 1996.
2. Coffey RJ, Cahill D, Steers W. Intrathecal baclofen for intractable spasticity of spinal origin: results of a long-term multicenter study. J Neurosurg 78: 226-232.1993.