Treatments · Neuromodulation
Intrathecal Pain Pumps
An implantable pump that delivers medication directly to the spinal fluid, achieving meaningful pain control at a fraction of the systemic dose and side-effect burden of oral medication.
What it involves
A small pump is implanted under the skin, typically in the abdomen, connected to a thin catheter that delivers medication directly into the intrathecal space — the fluid surrounding the spinal cord. Because medication is delivered right where pain signals are processed, effective doses are dramatically smaller than an equivalent oral dose, often a fraction of a percent.
As with other neuromodulation options, treatment starts with a trial — a temporary catheter delivering medication for a short period — to confirm meaningful relief before committing to a permanent implant.
How it works
Delivering medication directly to the spinal fluid bypasses the digestive system and bloodstream entirely, which is why such a small dose produces meaningful pain relief — and why the systemic side effects common with oral opioids or other medications at effective doses are dramatically reduced. The pump is programmed and refilled periodically by percutaneous injection through the skin, without additional surgery.
This is typically reserved for patients with severe, complex chronic pain who haven't achieved adequate relief from other interventional options, including spinal cord stimulation — a bigger step reserved for a smaller, more complex population.
How We Build Your Plan
The clinical reasoning behind this recommendation
What's the diagnosis?
Severe, complex chronic pain — often after spine surgery or in another refractory chronic pain condition — that hasn't achieved adequate relief from other interventional options, including neuromodulation.
What's the mechanism?
Medication delivered directly into the spinal fluid acts right at the level where pain signals are processed, achieving meaningful relief at a small fraction of the systemic dose required for an equivalent oral medication.
What are the options?
A temporary trial catheter to confirm meaningful relief, followed by permanent implantation for patients who respond well — considered after other interventional and neuromodulation options haven't provided adequate relief.
Why this approach?
Because an intrathecal pump is a bigger step involving an implanted device and ongoing management, Dr. Foster reserves it for patients with genuinely severe, complex pain where the dramatic reduction in systemic medication burden meaningfully outweighs that added complexity.
What are the tradeoffs?
Intrathecal pumps can achieve pain control that's difficult to reach with oral medication alone, with far less systemic side-effect burden, but they require an implanted device, periodic refills, and ongoing management — a bigger commitment reserved for patients who've already tried less involved options.
What to Expect
A trial first, then an implanted, refillable pump
The trial phase uses a temporary catheter over a short, monitored period to confirm meaningful pain relief before moving forward. Permanent implantation is a surgical procedure, typically requiring a short hospital stay, with recovery measured in a few weeks as the implant site heals.
Once implanted, the pump requires periodic refills — a quick, in-office procedure where medication is injected through the skin into the pump's reservoir — along with occasional dose adjustments as needed.
Conditions This Treats
Conditions this treatment addresses
For more information about intrathecal pain pumps, visit the manufacturer's official resource: Medtronic Targeted Drug Delivery.
Living with severe, complex chronic pain that hasn't responded to other options?
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