Occasionally you may wake up with pain from an aching neck to a sore back; however, if you have chronic pain, you may wake up every morning and go to bed each night with extreme discomfort and agony. The pain can start to consume your life during each waking moment and, at times, while you sleep. There are new therapy techniques that may provide long-term relief to chronic pain with minimal side effects.
Aside from the more traditional method of pain relief — oral medications — chronic pain now can be treated through drug delivery therapy (also known as intrathecal therapy), This type of therapy allows the patient to receive long-term pain relief with minimal side effects that usually are experienced through oral medications such as oxycodone and Vicodin.
In intrathecal therapy, the medication is delivered directly to the fluid around the spinal cord so it can block the pain signals before it reaches the brain. By inserting the medication directly to the site, the medication is not circulating throughout the bloodstream like oral medication — which ends up causing side effects such as nausea, fatigue, sedation or headaches.
The pain medication is stored in a palm-sized pump that is connected to a catheter. The pump and catheter are surgically placed under the skin to provide the long-term relief. If needed, the system can be turned off or surgically removed.
The prescribed amounts of pain medication are dispersed through the pump. If needed, the dosage can be easily adjusted based on the patient’s pain level. Refills can be provided by one’s pain management specialist and are typically needed every 30 to 90 days depending on dosage.
A benefit of intrathecal therapy is the improved ability to function and participate in daily activities. These improvements are dependent on each person and their ability prior to using intrathecal therapy. Although most people experience increased quality of life, it’s important to have realistic expectations. Intrathecal therapy cannot eliminate the source of pain or cure a disease; it helps to manage the pain.
A screening test is preformed to allow would-be patients to try intrathecal therapy before committing to have a system implanted. One’s physician will monitor response to the medication to see if he or she is a candidate. The screening test will allow the patient and physician to:
• evaluate how well it works to relive the pain;
• feel what it is like to receive pain medications directly through the spinal cord;
• determine if there will be side effects;
• establish the dosage;
• find the pump size that is most effective for each person (if you decide to proceed with intrathecal therapy); and
• decide whether or not the patient wants to have the pump surgically implanted.
Those who experience chronic pain should talk with their physician to see if intrathecal therapy is a good fit. Intrathecal therapy can also be used with other medications to help relieve the pain associated with spasticity. The doctor can refer the patient to Mount Nittany Health Pain Management Center to schedule an appointment for an extensive evaluation to see if he or she is a candidate for this therapy.
Dr. Upendra Thaker is director of anesthesia and medical director of the Mount Nittany Health Pain Management Center, located in the new Mount Nittany Health Blue Course Drive facility in State College.