Patient Information Resources

Centre for Orthopaedics
Suite 10-33/34/35 Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road
Singapore, 329563, Singapore
Ph: (65) 6684 5828
Fax: (65) 6684 5829

Child Orthopedics
Pain Management
Spine - Cervical
Spine - General
Spine - Lumbar
Spine - Thoracic

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I am sick and tired of being sick and tired. Ever since my car accident, I've had back pain that won't quit. I'm taking narcotics like candy and they don't help -- they just make me sick. Somebody mentioned a pain pump. Would something like that be worth trying?

Patients with severe, constant pain that has not responded to any other treatment may be candidates for pain pumps such as you are considering. There are various systems to provide long-term delivery of drugs into the spinal canal for fast action. The drug is delivered directly to the nervous system overriding pain messages to the brain. It's really a last resort effort to gain control of pain when everything else has been tried and failed. You would have to be evaluated as a possible candidate for this kind of pain management. A team of pain specialists will review what steps have already been taken and what pain control measures have been tried. Even these implantable pumps aren't used without a trial first. Electrodes are placed on the outside of the spine first to see if the patient can get good pain relief this way. The external (outside) unit is left on for one to two weeks before considering implantation. There can be a trial and error period when different drugs (or combination of drugs) are used to get the desired results (pain relief) with the fewest side effects. Common side effects with any of the opioid medications include nausea, dizziness, confusion, difficulty walking, and problems with memory. Patients considering a pain pump should be told that complete pain relief is rare. They can expect some improvement (up to 50 per cent reduction in pain) -- enough that they can function better. They may be able to tolerate their pain enough to complete daily activities and participate in life more comfortably. Besides the side effects mentioned, there can be problems with low blood pressure that can suddenly switch to dangerous high blood pressure. It's possible to develop a tolerance to the drug. This means the patient no longer gets the same pain relief with the standard prescribed dosage and must start taking more of the medication -- and that can lead to even more problems. Too strong of a reaction to a medication may require a switch to another drug. Even the process of withdrawing from one drug to try another can cause problems. Then the catheter used to deliver the drug can get blocked or kinked. And patients run out of their drugs. That's just the short list of things that can go wrong with this type of drug therapy. Pain pumps can be a very helpful tool for the right person. Talk to your doctor about your need for better pain control. There may be a far simpler solution to your problem than a pain pump. But if you have indeed explored all other options with no success, then this may be the next step to consider.


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