RSD/CRPS is a very painful condition and patients need to search out and try methods beneficial in relieving their painful condition.
Why should infusion pumps be used for the treatment of chronic pain ? There are two parts to this question that are addressed regarding the use of infusion pumps one is the fact that the patient has gone through the tedious trouble to detoxify and then a form of narcotic treatment is recommended on a permanent basis (infusion pump) .
The infusion pump is different from other forms of narcotic treatment due to the fact that:
(i). The use of the infusion pump provides a slow drip continuous small amount analgesic. This form of drip irrigation emulates the way that the endorphin’s work. On the other hand, other forms of long term narcotic administration such as patient controlled anesthesia (PCA ), Duragesic skin patch, IM subcutaneous IV, or oral narcotic administration exposes the patient to a flood irrigation of large doses of narcotic followed by a significant withdrawal after a few hours .
During such withdrawal, the central nervous system is devoid of both exorphins and endorphin’s with the resultant alarm panic agitation and the sensation of pain even in the absence of any lesion originating the pain.
(ii). Most importantly the patient is being given the equivalent of one and a half to two days of standard narcotic dose in the pump to be dripped in 30 days. As a result, the patient is given 1/15 to 1/20 of the standard dose of narcotic. This sharp reduction of the intake of narcotics will prevent the inhibitory and suppressive effect that large doses of narcotics have on other CNS hormones such as Estrogen, antidepressants, and hypothalami c hormonal secretions. As a result, the patient does not end up having the side effects of insomnia, depression, suicidal tendencies, a lack of desire for sex, and poor appetite .
Researchers from the Cleveland Clinic have reported that the use of intraspinal narcotic (usually intrathecal morphine) infusions with implanted pumps are increasingly used in patients with intractable chronic pain not caused by cancer.
The benefit of the infusion pump is not to provide the patient with narcotics but to make sure that the patient does not need narcotics in the future . When the patient gets to the stage that they are not responding to standard treatments for chronic pain and when their RSD/CRPS becomes so advanced that neither nerve blocks nor other forms of treatment can control the patient’s pain, and when the condition is so advanced that it goes beyond one to two years after the onset of the disease, the only thing that can be offered to relieve the patient from severe pain is the infusion pump .
This form of treatment provides a minimal amount of pain medication through a catheter to the spinal fluid. It is in the form of drip irrigation rather than flood irrigation. The flood irrigation would be when the patient takes narcotics by mouth or injection or by the use of a skin patch. On the other hand, the drip irrigation is in the form of infusion pump providing a slow drip of minimal amounts of pain medication.
As a result, the patient will be taking fa r less pain medication but will have more effective results from it because the analgesic will go directly into the spinal fluid as well as access to the brain. The end result is that the patient will not have withdrawal effect from oral or an intramuscular intake of pain medications. Each time the patient is given strong narcotics by mouth, or intramuscular or with the help of a skin patch, the patient gets a flood irrigation of the medication in the body and as a result after four hours of total relief of pain with strong narcotics the patient has a few hours of severe pain until the next narcotic dose is supplied. This problem gradually accelerates and picks up momentum until the patient has to take the narcotic every two to three hours, and becomes totally addicted to the larger and larger doses of medication. Then the patient will be sleeping all the time or screaming with pain.
The patient does not go through withdrawal every four hours from the pain medication and does not develop the severe withdrawal pain. The infusion pump stimulates the function of endorphin’s. The endorphin’s work in very small amounts but continuously. The infusion pump works the same way by giving proper analgesic coverage of a continuous nature without withdrawal and without addiction. It also guarantees that the patient would not take another strong medication because if the patient gets a hold of any strong pain medication it will cause such an extensive sleep and drowsiness that the patient will end up in the emergency room . This is the best safeguard in regard to the way the infusion pump works. It is true that the infusion pump has a 5 % to 10 % chance of complications, but it is much safer then any operation that has a much higher chance of complications and a much higher rate of failure.
The use of the infusion pump has been helpful in treating patients who suffer from cancer pain and noncancerous intractable pain for many decades. In 83% of advanced RSD/CRPS patients, that have been given this form of treatment to, the patients have been totally pain free and have become useful to themselves and to their families. They have also been able to return to work with the help of the infusion pump.
The use of an infusion pump should not be tried unless the patient is already detoxified for at least one week from other forms of narcotics. Most importantly the infusion pump prevents the expensive repeated visit to the neurologist and psychiatrist, and the necessity for expensive and seriously dangerous medications given by mouth or IM operation that has a much higher chance of complications and a much higher rate of failure.
For access to the full clinical report: THE INFUSION PUMP: CLINICAL OBSERVATION