A small implanted pump that delivers medication directly to the spinal fluid at a fraction of the oral dose — providing superior pain control with significantly fewer side effects for patients with severe or refractory chronic and cancer pain.
Candidacy
Who This May Help
Intrathecal drug delivery may be an option if you have severe or refractory pain from cancer, persistent pain after spine surgery, CRPS, degenerative scoliosis, severe degenerative disc disease, chronic pancreatitis, chronic pelvic pain, painful diabetic neuropathy, or peripheral neuropathy — particularly when oral medications have not provided adequate relief or are causing significant systemic side effects. It is also an important option for patients with cancer pain who require high doses of oral medications to control their symptoms.
A consultation with our clinical team will determine whether you are a candidate.
Procedure Overview
How Intrathecal Drug Delivery Works
When medication is taken orally, it must travel through the digestive system and bloodstream before reaching the spinal fluid — requiring a much higher dose to achieve the same effect at the target site. Intrathecal drug delivery bypasses this process entirely. A thin catheter delivers medication directly into the intrathecal space — the fluid-filled area surrounding the spinal cord — where it can act on pain receptors with far less medication. A small pump implanted just under the skin, typically in the abdomen, powers and controls the delivery.
Before permanent implant, a trial is performed to confirm meaningful benefit. If the trial confirms significant improvement, the permanent pump implant is performed as a same-day outpatient procedure. The pump reservoir is refilled periodically through a simple in-office procedure requiring no incision.
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Recovery & Results
What to Expect After the Procedure
Most patients go home the same day. Some soreness at the pump and catheter sites is expected for one to two weeks and resolves on its own. Most patients resume light daily activities within a few days and return to normal activity within two to four weeks. The pump is typically placed in the lower abdomen and is not visible under clothing.
Many patients notice meaningful improvement in pain control shortly after implant as the intrathecal dose is optimized. The pump reservoir is refilled periodically through a simple in-office needle injection — no incision required — typically every one to three months. Regular follow-up appointments are essential to monitor therapy and adjust dosing over time.
Frequently Asked Questions
Common Questions
Intrathecal drug delivery may be appropriate for patients with severe chronic pain from cancer, failed back or neck surgery syndrome, CRPS, degenerative scoliosis, severe degenerative disc disease, chronic pancreatitis, chronic pelvic pain, painful diabetic neuropathy, or peripheral neuropathy — particularly when oral medications have not provided adequate relief or are causing significant side effects. A trial is typically performed before permanent implant to confirm meaningful benefit.
When medication is taken orally, it must travel through the digestive system and bloodstream to reach the spinal fluid — requiring a much higher dose to achieve the same effect at the target site. Intrathecal drug delivery bypasses this process by delivering medication directly into the spinal fluid, where it can act on pain receptors with far less medication. This typically results in better pain control with significantly fewer systemic side effects.
Yes. Before permanent implant, a trial is typically performed to confirm that intrathecal medication provides meaningful benefit. The trial involves a single intrathecal injection or a short-term catheter trial that allows evaluation of the therapy before a pump is permanently placed. If the trial confirms significant benefit, the permanent implant procedure is performed as a same-day outpatient procedure.
Intrathecal drug delivery is used for a range of severe or refractory pain conditions including cancer pain, failed back surgery syndrome, failed neck surgery syndrome, CRPS, degenerative scoliosis, severe degenerative disc disease, chronic abdominal pain including chronic pancreatitis, chronic pelvic pain, painful diabetic neuropathy, and peripheral neuropathy. It is particularly valuable when high oral medication doses are required but produce intolerable side effects.
The implanted pump reservoir is refilled periodically through a simple in-office procedure — a small needle is used to inject medication through the skin into the pump’s reservoir without any incision. Refill intervals vary depending on the pump model, the medication used, and the dose — typically every one to three months. Our team will schedule refill appointments and monitor your therapy at regular intervals.
Most patients go home the same day. Some soreness at the pump site is expected for a week or two and resolves on its own. Most patients resume light daily activities within a few days and return to normal activity within two to four weeks. The pump itself is typically placed in the abdomen and is not visible under clothing. Regular follow-up appointments are an important part of long-term care with any implanted drug delivery system.
Schedule a Consultation
A consultation is the right starting point. Our clinical team will review your history and determine whether intrathecal drug delivery is an appropriate next step for your pain.
