Back Pain Treatments: Implanted Devices

Implanted devices such as spinal pumps, pain pumps, and spinal cord stimulators provide back pain relief by interrupting the transmission of pain signals from the spinal cord to the brain. Implanted devices are internal devices that are implanted in the body, to block the transmission of pain from the nerves to the brain. Implanted devices block the transmission of pain from the spinal cord to the brain through the delivery of medications or by an electric current. This treatment may be considered under the following conditions.
  • The person has severe, chronic, disabling back pain that is disrupting the quality of the person's life.
  • Other back pain treatments to reduce the pain symptoms were unsuccessful.
  • Either other pain medications failed to provide significant relief for the patient or there was a risk of the patient developing an addiction or tolerance to the narcotic pain medications that were available.
Implanted devices may also be known as pain pumps. These devices prevent the transmission of the pain signal from reaching the brain. These devices may be successful at treating both neuropathic and nociceptive (somatic pain). Neuropathic pain is pain that originates in the misfiring nerves, and somatic pain is pain where the nerves respond to pathology in the body by transmitting pain signals from the peripheral nervous system to the spinal cord. The important thing to know is that medications or stimulation delivered from the pain pump blocks the pain signal from reaching the brain.

Spinal pumps or pain pumps deliver narcotic pain medication (typically morphine), at a pre-programmed rate and amount, directly into the intrathecal space around the spinal cord from a surgically implanted pump. Like a cardiac defibrillator, the device is implanted in the body. The medication in the Morphine pump delivers the medication to the intrathecal space via a catheter, at regular time intervals and regular amounts. The medication in the pump is replenished through monthly medical appoints where it is injected into the pump reservoir, through the skin.

These pumps may provide a significant benefit to the patients regardless of the source, type, or level of pain. Implantable devices may be provide back pain relief to patients with axial back pain, complications from back surgeries (see failed back syndrome), and neuropathic pain conditions such as multiple sclerosis.

The specific type of medication that the pump delivers may vary by the source or type of pain. For example, local anesthetics (such as bipuvicaine) may be used to treat neuropathic pain and morphine may be used to treat somatic (nociceptive) pain.

Spinal cord stimulation (SCS) delivers an electric current to the dorsal portion of the spinal cord to prevent the pain signal from travelling up towards the brain. The device may be a system with an external power source or a fully implanted system. Spinal cord. These spinal cord stimulators may provide significant pain relief when other back pain treatments, such as back surgery, nerve blocks, and oral medications have failed to provide benefits. These implants, once permanently implanted, may last as long as 20 years. The available data suggests that 50-60 percent of patients experience 50 percent pain relief or better.

Before each of these devices is surgically implanted permanently, a treatment trial is conducted to assess whether the treatment is safe and effective. Once it has been determined that the patient would benefit from either of these treatments, with minimal side effects, then the device will be implanted. These devices can be removed in the future if the patient or doctor decide to.