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Intrathecal Drug Delivery

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Some pain medications can be administered by an intrathecal pump, which delivers the drug directly to the spinal fluid.

A patient suffering intractable pain from a variety of conditions — including cancer; severe spinal conditions, including stenosis or recurrent vertebral fractures; and other neuropathic conditions — may often receive only limited relief with standard medication therapy. That’s because many pain medications including opioids have side effects, such as sedation or nausea, when they are taken in doses high enough to manage pain. But when the dose is limited or reduced, the pain is not adequately controlled.  

Fortunately, we can now offer some pain medications in an intrathecal pain pump, which delivers the drug directly to the spinal fluid. When released into the spinal fluid, a drug is far more efficiently delivered than when given other ways – in fact it would take 300 mg of intravenous morphine to equal the pain relief of just 1 mg of intrathecal morphine. This allows similar or better pain relief with much less nausea, constipation, or sedation.

Intrathecal drug delivery provides medication directly to the spinal fluid from a pump implanted under the abdominal skin. The medication in the pump lasts from two to three months and can be refilled easily in the pain clinic through a small needle.

A pump can help lessen chronic pain caused by:

  • Post-laminectomy surgery syndrome: Failure of one or more surgeries to control persistent leg pain (sciatica), but not technical failure of the original procedure.
  • Cancer pain: Constant pain caused by tumors compressing the spinal nerves, or scarring from previous radiation therapy.
  • Complex regional pain syndrome: A progressive disease of the nervous system in which patients feel constant chronic burning pain.
  • Severe scoliosis-related pain
  • Recurrent vertebral fractures
  • Peripheral neuropathy

A pump can also help lessen spasticity (muscle rigidity and spasms that make movement of the arms and legs difficult) caused by:

  • Cerebral palsy: A nervous disorder that impairs control of body movement.
  • Multiple sclerosis: A disorder of the brain and spinal cord caused by damage to the outer layer (myelin) of nerve cells.
  • StrokeDamage to the brain from lack of oxygen due to an interruption of the blood supply.
  • Brain injury
  • Spinal cord injury

Reviewed by: Neel Mehta, M.D.
Last reviewed/last updated: December 2021