For many struggling with nerve pain or spasticity, intrathecal infusion therapy offers a more effective treatment with fewer downsides.
Stacy Wilson knows something about chronic pain; she’s been dealing with it her entire life. “I have cerebral palsy,” she says. “When I was in my late teens I had a surgical complication and I started suffering from nerve pain — burning in my legs, spasming. We tried a lot of oral medicine, we tried nerve blocks,” she says, but nothing really worked — until she was told about a new option: intrathecal therapy (IT).
IT, sometimes called the “pain pump,” involves a pump being surgically implanted into the patient’s body which then delivers pain medication directly into the cerebral spinal fluid (CSF). Studies have demonstrated that IT is extremely effective in pain management.
“Chronic pain is one of the most expensive chronic diseases to treat,” says Chuck Bell, PharmD, president and founder of AIS Healthcare. “There is an estimated $635 billion annual expenditure treating and managing chronic pain in the United States.”
“I’ve worked with it for over 20 years,” says Stacy’s doctor, Stuart Rosenblum, M.D., of the Oregon Interventional Pain Clinic. “It’s targeted therapy that is at least 100 times more potent than medicine that we give orally or even intravenously with a much smaller dose.”
Less pain, fewer downsides
Aside from a lower danger of addiction due to the lower dosage, IT typically offers other advantages. “Many patients have significant side effects from our commonly used medications,” says Dr. Rosenblum. “We can use this micro-dosing, very low doses of medication placed directly on target, which can provide excellent pain relief or control of spasticity without serious side effects.”
That’s been Stacy’s experience. “It has made it more manageable, and the thing I really like and I really notice is that everything I’ve tried in the past has made me very nauseous, so I would get relief but I would be sick to my stomach 90 percent of the time, and I have hardly any side effects from the medicine in my pump.”
Sterile and safe
“Because the drug is being infused directly into the patient’s cerebral spinal fluid bypassing all of the human body’s natural defense mechanisms, sterility is absolutely required,” explains Bell.
“I’ve looked widely at different suppliers in terms of who provides the best product and from a safety point of view,” says Rosenblum. “I selected AIS Healthcare to be the supplier of our spinal infusion pump service due to their ability to provide aseptic processing (preparing patient-specific medications from non-sterile pharmaceutical ingredients into sterile and preservative-free medications in a controlled and sterile environment) as well as their process of terminal sterilization (an additional step where the material is again sterilized while in its final container to ensure that no contamination is possible).”
“The pharmacists at AIS have over 400 years combined experience,” adds Bell, “and participate in continuous training on compounding of sterile products.”
For Stacy, the pain pump has improved her quality of life. “I can do more social things,” she says. “I can have a daily routine. I like to cook and I like to go out and about, and when I have a lot of pain I just can’t do that. The pump has made it a lot easier to do it.”
Both Stacy and Dr. Rosenblum view IT as an underutilized therapy. “I very often come across patients who clearly would benefit from this therapy who haven’t had this therapy even brought up by their health care providers,” Rosenblum says. “It’s well established, it’s not an investigational therapy. And I think the future possibilities for this therapy are almost boundless. When we think about some of these devastating diseases like Alzheimer’s disease, multiple sclerosis or ALS, the potential medications delivered directly into the CSF can have a profound impact on these diseases. I think it’s a very ripe area for research.”
Jeffrey Somers, [email protected]