P-094 - (Poster #94) Impact of Intrathecal Pain Pumps on Pain Severity and Quality of Life in a Diverse Chronic Pain Population: A Patient-Reported Outcomes Study

Background: Chronic pain is a widespread condition affecting 1 in 5 adults in the United States, often leading to physical disability, emotional distress, and dependence on opioid medications. Traditional oral therapies and interventional procedures like nerve blocks may offer limited or short-term relief and frequently fail in patients with complex or refractory pain syndromes. Intrathecal pain pumps (ITPs), which deliver medication directly into the spinal fluid, present a targeted alternative with reduced systemic exposure. However, despite increasing use in pain management settings, there is limited data on how these devices impact daily functioning and quality of life across varied pain conditions. Understanding the lived experience of patients using ITPs is crucial to refining clinical guidelines and optimizing patient selection.

Purpose/Objectives: This study aims to assess patient-reported outcomes related to intrathecal pain pumps, with a specific focus on their effect on pain severity, quality of life, and overall satisfaction with care. We evaluated how different types of chronic pain—such as spine-related, neuropathic, visceral, or autoimmune pain—respond to ITP therapy. A key objective was to identify which patient populations benefit most, and to determine whether patients prefer ITPs over oral pharmacologic treatment. Given the current need for opioid-sparing, long-term pain management solutions, this research seeks to support future advancements in precision-based, interventional pain care.

Methods:

A cross-sectional survey study was conducted at a multidisciplinary pain management clinic involving  248 adult patients currently receiving intrathecal pain pump (ITP) therapy. A structured, anonymized questionnaire was developed to evaluate patient-reported outcomes across multiple domains, including previous pain treatments, pain severity before and after ITP implantation, impact on quality of life, ease of device use, and patient preference for continued therapy. The survey also stratified responses by underlying pain etiology (e.g., chronic back pain, nerve injury, visceral pain, autoimmune-related pain). Data were collected in a secure, de-identified manner to encourage honest feedback. Descriptive statistics were used to analyze response trends, and results were visualized using categorical breakdowns and pie chart representations to identify patterns in treatment efficacy and patient satisfaction.

Results:

Among the 248 patients surveyed, 134 patients (54%) reported significant improvement in pain levels following intrathecal pain pump (ITP) therapy, while 55 patients (22%) experienced moderate improvement. In total, 189 patients (76%) reported some degree of pain relief, whereas 35 patients (14%) noted no change, and 15 patients (6%) experienced worsened pain. An additional 9 patients (4%) were unsure of the impact.

Quality of life improved for 188 patients (76%), with 119 patients (48%) describing a substantial improvement and 70 patients (28%) noting some improvement. Patients with chronic back pain comprised 112 individuals (45%), and of these, 99 patients (88%) reported improved pain control. By comparison, among the 50 patients (20%) with nerve injury-related pain, only 18 (36%) reported improvement. Improvement was also lower among patients with visceral pain (25 patients, 10%; 10 patients, 40% reported improvement) and autoimmune-related pain (25 patients, 10%; 8 patients, 32% reported improvement).

When asked about treatment preference, 208 patients (84%) indicated they preferred to remain on ITP therapy rather than return to oral pain medications. Usability satisfaction was high, with 145 patients (58%) reporting the pump as very easy to use, and 75 patients (30%) describing it as somewhat easy. Use of the rescue bolus feature was common, with 105 patients (42%) using it regularly, 65 patients (26%) using it occasionally, and 44 patients (18%) rarely using it.

 

Conclusions/Implications for future research and/or clinical care:

This study demonstrates that intrathecal pain pumps (ITPs) significantly improve pain control and quality of life in a majority of patients with chronic, treatment-resistant pain, particularly those with axial spine-related conditions. Patient satisfaction and preference for ITPs over oral pharmacotherapy were notably high, indicating their potential as a long-term, opioid-sparing intervention in chronic pain management. However, outcomes were more variable among patients with nerve-related, visceral, or autoimmune pain, highlighting the need for more precise patient selection and individualized treatment protocols.

A key limitation of this study is its reliance on self-reported outcomes from a single clinical site, which may introduce bias or limit generalizability. The cross-sectional design also prevents longitudinal assessment of outcomes over time.

Future research should include multi-center, prospective studies to evaluate long-term efficacy, functional outcomes, and cost-effectiveness of ITPs across various pain subtypes. Clinically, these findings support broader integration of ITPs into multimodal pain management strategies, with a focus on refining selection criteria to optimize patient benefit.