Intrathecal Pain Pump: What is it used for?

intrathecal pain pump surgery

An intrathecal pain pump is a surgically implanted device that is used to relieve prolonged pain or cancer pain. It gives the medicine in the form of fluid present in a thin and flexible tube inserted around the spinal cord. Intrathecal space is an area between the spinal cord and the tissue covering the cord. The space is filled with cerebrospinal fluid. It is also known as a pain pump and implanted intrathecal drug delivery system.

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To begin with, a pain pump is a small device that directly delivers medication to the spinal cord. It consists of many parts like a reservoir placed in the abdomen, a pump, and a catheter present in the intrathecal space of the spinal cord. A tube connects with a small round pump and is further implanted under the skin for minor surgery. An electronic device controls the pump. The pump contains the medicine and sends it with the help of a tube directly to the area and powerful relief can be achieved.

Image source: Delhaas, E. M., & Huygen, F. J. P. M. (2020). Complications associated with intrathecal drug delivery systems. BJA education, 20(2), 51-57.


  • Use to treat prolonged pain or cancer pain.
  • It is a very easy process because a person is fed off with medicine or injections. Further, it may be used if surgery is done to treat the pain.
  • A pain pump removes the chance of accidentally taking medication in large amounts. The intake of the dose is in a limited amount and there will be less risk of any type of problem.
  • An intrathecal pain pump helps to provide an accurate amount of medication. As the pain level change amount of the dose of medication may be changed. It is flexible and greater control over the pain.
  • It has very fewer side effects because no oral medication is necessary. By delivering medication straight to your spine, the pain pump helps you avoid many of those negative side effects.

How an intrathecal pain pump is implanted?

Before inserting the intrathecal pain pump, the doctor tests whether this test will work on the patient or not. This is known as a trial.
Then the intrathecal pain pump procedure start:

  1. Firstly, a patient lies down on the medical table and an area of the spine is numbed. A medicine is given to relax and make the patient sleep.
  2.  A doctor makes a small incision over the part of the spine and puts a stiff tube through the skin and it goes into the intrathecal space.
  3.  A thin flexible tube is inserted into the intrathecal space and pain medicine is sent for a few days to see pain is reducing or not.

Ways of trials:

  • Lumbar puncture is done in the intrathecal space if one dose is given.
  • Lumbar puncture is done with or without a catheter if multiple doses are given.

If the trial procedure works then the pump is implanted. The further procedure is :

  1. A patient lies on the medical table and a medicine is given to relax and make the patient sleep.
  2.  The doctor first removes the previous catheter and put a catheter into the skin.
  3.  The doctor put a pump 1 inch under the skin on one side of the lower belly. This pump is 3 inches wide and 1 inch thick. It contains medicine and a battery life lasts for 5 to 7 years.
  4. The catheter connects to the pump.
  5.  The doctor controls the pump by connecting a small device outside the pump.

The pain pump medicine depends upon the type of pain and other factors. The pump will be refilled with medicine when necessary. This may happen after every 1 to 3 months.

intrathecal pain pump

Image source: Delhaas, E. M., & Huygen, F. J. P. M. (2020). Complications associated with intrathecal drug delivery systems. BJA education, 20(2), 51-57.

Recovering from intrathecal pain pump surgery

After a few hours of observation to make sure that the heart rate and blood pressure of the patient are returned to normal and further patient is discharged to home.
The patient may experience pain or swelling on the incision sites for a few days. The patient should follow all the instructions and make sure to remove the bandage and take a shower after the incision is healed.
Before going home make sure that your pump is delivering the actual amount of drug.
After two weeks must consult with your surgeon, to check whether the incision is healing or not.

For four to six weeks after surgery:
Do not lift more than 10 pounds.
Do not bend your waist to pick up anything from the floor.
Avoid extreme temperatures such as hot tubes, saunas, and ice baths.

Side effects of intrathecal pump

Complications of Intrathecal pain pump are very rare, but it includes:

  •  Cerebrospinal fluid leak
  • Infections
  • Mechanical problems with the pump or shifting of the device after strenuous exercise may require repositioning or replacement.
  • Damage to the spinal nerve.
  • Some changes occur in endocrine function.
  • Medicine dose may be high or low due to programming mistakes in the device.
  • Side effects of other medicine or opioid.

How long does an intrathecal pump last?

The battery of the Intrathecal pain pump will last at least five years. The doctor will give the signal when it needs to be refilled.
Replacement of the uncharged intrathecal pump is very necessary before it stops working.

Some common doubts related to this?

1. Can a pain pump be removed?

Yes, if it is not needed anymore or if there is mechanical damage in the machine.

2. How is the intrathecal pump refilled?

After every 1 to 3 months must consult with your doctor. The doctor will check and let you know if you need to refill it or not.

3. Can a person have MRI  with an intrathecal pump?

Before the MRI test, must consult with the doctor and inform the technologist that the patient has implanted an intrathecal pain pump. While the imaging is taking place, the pain pump will stop working and may alert with an alarm.


To conclude, the side effects of intrathecal pain pumps are less as compared to oral medication. It is a long procedure in which the first trial is done after that full procedure is done. The battery life of this pump is 5 years must consult with the doctor before replacing it.

Team MBD


  1. Delhaas, E. M., & Huygen, F. J. P. M. (2020). Complications associated with intrathecal drug delivery systems. BJA education20(2), 51-57.

Read more- Intrathecal Pump Implantation -What is it? – Sound Pain Alliance

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