drummermikey wrote: ↑Thu Apr 02, 2026 12:01 am
I think an intrathecal pain pump, after failed surgery, or in my case, surgeries (1st with Dr. Hibner, 2nd with Dr. Aszmann) is a safe, reasonable, feasible approach to consider but I would not trust any doctor with the procedure, which first involves essentially a trial injection of typically a narcotic into the space holding the spinal fluid. My understanding is that pain pumps can and often are highly effective for neuropathic pain such as failed back syndrome, CRPS, and central sensitization; why not pudendal nerve disease? I don't think an intrathecacal pain pump is necessarily in Dr. Hibner's wheelhouse so to speak. But it is very much the domain of virtually all pain management doctors and these physicians custom tailor the drug (could be morphine, could be baclofen, dilaudid, or others) depending on patient need, response and tolerance. A plus for pain pumps is that they run continuously but only provide about 1/300th the amount of medication required to get the same relief with oral equivalents like percocet for example. Also, chance of addiction is virtually nil as is the chance of intoxication. It's a big step many people don't want to take because they're fearful but if it works, count me in. My trial is on April 24. Please please keep me in your prayers for a complete success!
I think there are some very interesting insights into some of the problems with pain pumps.
They should be viewed as the last resort, typically for failed surgery in the context of pudendal entrapment
Anxiety about decompression, should not make people go the pain pump route and if someone feels this way, they need to discuss the risks of surgery vs a pain pump with someone that is knowledgable about both. Pain specialists are not surgeons, so surgery should be discussed with a surgeon that ideally performs the procedure. Whatever your decision, you need to have considered the risks using statistics, not words, and think very carefuly. It is normal to be anxious but you must be rational.
Insertion of a pain pump is surgery and you can get all sorts of problems with them, infection, leads moving, battery issues, pump dysfunction (incorrect dose delivered) and the inconvenience of refills etc..
I would also seriously question anyone that is willing to insert these without having previously attempted decompression surgery assuming entrapment is suspected or there is some contraindication to surgery.