Kenneth J. Eaddy, MDInterventional Pain Management
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Targeted Drug Delivery (Pain Pump)

An implanted pump that delivers medication directly to the spinal fluid — strong relief at a fraction of the oral dose.

In short — Targeted drug delivery uses an implanted pump and catheter to deliver pain medication directly into the spinal fluid, so effective doses are a small fraction of the equivalent oral dose. Candidates are typically patients with severe chronic pain who need relief oral medication can't safely provide; a trial dose confirms the therapy works before any implant.

What is targeted drug delivery?

Targeted drug delivery — commonly called a pain pump — uses a small implanted pump and a thin catheter to deliver pain medication directly into the cerebrospinal fluid surrounding the spinal cord. Because medication reaches its target directly instead of circulating through the whole body, effective doses are a small fraction of equivalent oral doses, which can mean better relief with fewer systemic side effects like sedation and constipation.

Who benefits from a pain pump?

Candidates are typically patients with severe chronic pain — often cancer-related pain or persistent pain after spine surgery — who get meaningful relief from oral medication but can't tolerate the doses required, or whose pain remains uncontrolled despite comprehensive treatment. As with spinal cord stimulation, a trial dose is given first so you and Dr. Eaddy can confirm the therapy works for you before any implant.

What is living with a pump like?

The pump sits under the skin of the abdomen and holds a reservoir of medication that is refilled in the office every few months through a simple needle access — a short routine visit. Dosing is programmed wirelessly and fine-tuned over time. The system is fully reversible and is managed entirely by the practice, so your pain control no longer depends on pharmacy schedules or pill counts.

How often does a pain pump need to be refilled?

Refill intervals depend on your dose, medication concentration, and reservoir size — commonly every one to six months. Refills are short office visits in which the pump is accessed with a small needle through the skin. Keeping refill appointments is important, since letting a pump run empty can cause withdrawal symptoms and loss of pain control.

What are the risks?

Serious complications are uncommon, and the trial dose confirms benefit before anything is implanted. Risks include:

  • Infection or bleeding around the pump or catheter
  • Spinal-fluid leak causing a temporary headache
  • Catheter kinking, movement, or malfunction requiring revision
  • Medication side effects, monitored closely at every refill
  • Inflammatory tissue at the catheter tip (granuloma) — rare, and checked for at follow-up
  • Withdrawal symptoms if a refill is missed and the pump runs empty

Can Dr. Eaddy take over an existing pain pump?

Yes — the practice accepts patients whose pump was implanted elsewhere and provides refills, dose adjustments, troubleshooting, and revision when needed. See device troubleshooting & revision for what the practice manages, and bring your device card and prior records to the first visit.

What does the pain pump trial involve?

Before implantation, a carefully selected test dose is delivered into the spinal fluid in a monitored setting. You and Dr. Eaddy assess pain relief, function, and side effects. A helpful trial supports consideration of an implant, but the final decision also depends on diagnosis, medical risk, medication history, and ability to keep refill appointments.

What is recovery like after a pain pump implant?

The pump and catheter are placed during a procedure, followed by a short period of incision care and activity limits while tissues heal. Light activity often resumes first; lifting, bending, and strenuous activity remain limited until cleared. The office provides device-specific wound care, medication, and follow-up instructions.

Does insurance or Medicare cover pain pump therapy?

Medicare and many commercial insurers cover intrathecal drug delivery for selected diagnoses when medical-necessity, prior-treatment, and trial requirements are met. Coverage of the implant, medication, and ongoing refills can differ. The office verifies benefits, authorization, and known cost-sharing requirements before treatment.

Before your visit

The questions above cover candidacy, the trial, implantation, recovery, refills, risks, insurance, and management of an existing pump. The medication and refill schedule are individualized and require reliable follow-up.

Reducing the risk of infection before your procedure

Because the pump is implanted, Dr. Eaddy uses a skin-preparation protocol in the days before your procedure to lower the already-small risk of infection. Follow the exact instructions the office gives you — in general it involves:

  • Mupirocin antibiotic ointment — applied twice daily for the five days leading up to your procedure.
  • Hibiclens (chlorhexidine gluconate) antiseptic wash — used each day for the four days before your procedure, and once more on the morning of the procedure.

This reflects published evidence that decolonizing the skin and nose with mupirocin and chlorhexidine (Hibiclens) lowers the rate of surgical-site infection. See preparing for an interventional pain procedure for the rest of your pre-procedure checklist.

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Medically reviewed by Kenneth J. Eaddy, MD · Last reviewed: July 29, 2026