A pain pump is an alternative for the treatment of therapy-resistant chronic pain or severe spasticity. With a pain pump, medication is administered directly into the spinal cord area via a catheter. Like spinal cord stimulation or spinal ganglion stimulation, this therapy method is a neuromodulation procedure.

When to use a pain pump?

Areas of application for a pain pump are:

What are the advantages of a pain pump?

Patients suffering from chronic pain or spasticity often have to take high doses of medication to relieve their symptoms. Depending on the medication, a certain habituation effect can occur over time, which means that even higher doses are still needed to achieve an effect. This leads to increased side effects and eventual drug dependence, which significantly affects the quality of life of those affected. For example, opiates in high doses can lead to constipation, fatigue and drowsiness, and may ultimately even increase pain, which is referred to as opiate-induced hyperalgesia.

The pain pump has the advantage of requiring much smaller doses of medication to achieve the desired pain or spasticity-relieving effect. This means that the oral dose can be significantly reduced or even discontinued.

How is the pain pump implanted?

Test phase

A distinction is made in pain treatment between tumor pain and other pain. In patients with tumor pain, the drug pump is implanted directly under general anesthesia without a prior test phase.

For patients with spasticity or other pain, a test phase is carried out to determine whether they will benefit from a pain pump. This is done by first inserting a temporary catheter under general anesthesia through a small puncture in the spinal canal and connecting it to an external pump.

In patients with muscle spasms, this test phase can vary in duration depending on the severity of the spasticity. In the case of very pronounced spasticity, the test phase can be combined with rehabilitation.

If the patient does not respond to the therapy, the catheter is removed again.

Implantation of the permanent pain pump

If the patient benefits from the treatment, the definitive implantation of the catheter and the pump takes place under general anesthesia after three weeks at the earliest. The pump is now implanted in the abdominal region.

The definitive implantation is followed by intensive rehabilitation.

The duration of hospitalization amounts to two to three days each for the test phase and the definitive implantation.

The pain pump must be filled at regular intervals. The pump is refilled on an outpatient basis with a small needle puncture through the skin.

What are the risks of a pain pump?

Complications are very rare. They include, for example

  • catheter blockage or kinking
  • catheter leak or even rupture
  • over- or underdosing of medication
  • bleeding
  • infections
  • wound healing disorders
  • loss of cerebrospinal fluid
  • complications during pump filling

What is the follow-up care for an implanted pain pump?

After 2 weeks: patients return to our clinic for suture removal and a wound check.

After 6 weeks: clinical postoperative monitoring takes place.

Additional follow-ups take place as part of the regular pump fillings.