Back Pain Treatments: Implantable Pain Relief Devices

While most procedures that involve delivering medications and other treatments directly to damaged structures of the back involve between one to several procedures in a year, other back pain treatments involve continuous applications directly to these structures. Back pain treatments that involve continuous delivery of medications and/or treatment directly to damaged back structures involve the use of implantable pain relief devices. There are two basic types of implantable devices for back pain relief: those that deliver medication to the spinal cord and those that deliver electrical stimulation to it.

Implanted Drug Infusion: Devices that deliver medication to the spinal cord. Implanted drug infusion (intraspinal drug infusion therapy) involves the surgical implantation of a device that continuously, or at a regular rate, delivers medication to the painful areas of the spine, or to block the transmission of pain signals from reaching the brain. Intraspinal drug infusion therapy involves implanting a "pump" in the body, near the damaged section of the spine, to deliver a regular, predetermined dose of pain medication via a thin tube, into the damages spinal structure(s). Unlike oral medications such as aspirin and ibuprofen and other NSAIDS and pain medications, this targeted secretion of medication requires much lower doses of potentially toxic chemicals into the body. Precise targeted delivery of medication directly to the structure(s) involved in back pain is potentially much less toxic to the body because it does not require that higher doses be ingested and processed by internal organs such as the GI tract and kidneys and liver. These smaller targeted doses reduce the risk or side effects such as stomach upset and kidney and liver damage.



Implanted drug infusion may be considered an option for patients who have had adverse reactions to oral medications, either in the short term through allergies, or from long term effects such as drug dependence of narcotic drugs, or more serious issues such as reduced kidney or liver functioning. Intraspinal drug infusion may be considered an option for patients who haven't responded to conservative treatments such as physical therapy or other drug therapies. Typically, patient's who are candidates for this type of treatment will have severe back pain or chronic back pain that has persisted for several months or years, and has persisted through several different types of therapies, including surgery. This types of devices that continuously deliver medication are a little different than other types of injections that deliver medication to the spine and spinal structures in that the medications are often designed to deliver medication to the spinal cord itself. These pain pumps deliver medication directly to the intrathecal space around the spinal cord. the pump device itself is implanted in a surgical procedure, and the medication in the pump can be filled periodically by injecting medication through the skin into the pump reservoir.

Spinal Cord Stimulation: Like pain pumps, spinal cord stimulators are surgically implanted near the damaged area of the spine, and they deliver their therapy, at regular timed intervals in order to block the transmission of pain signals up the spinal cord and to the brain. Spinal cord stimulation (SCS) is delivered through a set of electrodes that are inserted between the vertebrae into the epidural space.