Bryn Mawr Hospital
Innovative Pumps Help Control Chronic Pain

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Pain Science is a growing specialty for Bryn Mawr anesthesiologist.

(BRYN MAWR, PA, June 2008) – Laurie Hine is finally free of uncontrollable leg jerking caused by multiple sclerosis, thanks to a pain-blocking device implanted by a Bryn Mawr Hospital anesthesiologist.

The device, a pump about the size of a hockey puck, delivers a continuous flow of medication to her spine, shutting down the pathways of pain to her legs. For Ms. Hine, the difference in her life was like night and day.

“I would feel the sensation coming, a stiffness, and then my right leg, mostly, would jerk uncontrollably. I couldn’t do anything about it,” said Ms. Hine. “I started taking large doses of drugs but they didn’t help, and my neurologist eventually pointed me to Bryn Mawr and Dr. Kim.”

Philip S. Kim, M.D., an anesthesiologist specializing in pain medicine, thought Ms. Hine would benefit from an intrathecal pump, a drug delivery system that releases a prescribed dose of medication to the intrathecal space, the area surrounding the spinal cord. “We can successfully apply medications directly to the spine where they’re more effective in patients whose pain has not improved with traditional therapies,” said Dr. Kim.

The intrathecal pump is one of many options available today for patients in acute or chronic pain, regardless of its source, according to Dr. Kim. There are developments on many fronts, from new medications to rechargeable devices that use electrical pulses to block pain signals from the spine. Successful treatments can be prescribed for low back pain, headache, neck and facial pain, and neuropathies arising from injury, illness, cancer, or conditions like multiple sclerosis and diabetes.

“Pain can be difficult to control, but people do not have to live it,” Dr. Kim said. “We work with the patient and their doctor to determine the best treatment for the individual; whether it be physical therapy, an oral medication, or a more sophisticated pain system. Managing pain is not a one-size-fits-all prescription.”

Dr. Kim and Matthew T. Kline, MD, his partner in the Center for Pain Medicine in Bryn Mawr, are leaders in pain therapy. (Dr. Kim was nominated and selected for ‘America’s Top Anesthesiologists 2006’ by the Consumer’s Research Council of America, Washington, DC; and named ‘Outstanding Physician in Pain Medicine’ in the Delaware Valley Consumers’ Checkbook, Volume 2, No.4 Spring/Summer 2007.)

Dr. Kim was among the first in the area to implant RestoreULTRA™, a recently FDA approved neurostimulation device that treats pain related to neurological damage.

The system is typically placed under the abdominal skin and connected to flexible wires or leads that transmit pulses to the spine. It has a unique remote-control programmer that allows patients to customize their pain therapy. “If you can control a TV remote, you can control this device,” said Dr. Kim.

Dr. Kline has expertise in another new technique, disc biacuplasty, a minimally invasive solution to treat chronic lower back pain using radiofrequency technology.

Whether a patient needs a long-term solution, such as the implantable medication pumps and neurostimulators, or a short course of physical therapy, Dr. Kim says the aim is to restore the quality of life that chronic pain has taken away. “Pain is subjective,” Dr. Kim said. “The patient is the only one who knows if his or her therapy is controlling the pain well enough or needs to be changed because it is causing uncomfortable side effects.”

Ms. Hine, of North Coventry, Chester County, who had once broken an ankle as a result of a spasm, said of all the symptoms from multiple sclerosis, the leg spasticity was so severe that she had to seek a pain specialist.

“I can’t say that I don’t have any leg jerking, but the difference is like night and day,” she said. “If the pump wasn’t doing its job, I’d be the first one to say ‘take it out.’ But it’s been amazing. Now I can’t imagine living without it.”

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Editor’s Note: A recent study in the journal Lancet detailed the physical and financial toll that pain takes on Americans. It found that a quarter of Americans are in pain at any one point in time, at a cost of more than $60 billion a year in lost productivity. And yet, says Dr. Kim, patients—and many of their physicians—are unaware of the therapies that could put an end to their suffering and restore their quality of life.
According to a survey conducted for the National Pain Foundation, 45% of people with recurrent pain and 20% of people with chronic pain in the previous 12 months did not see a health care professional. One-third of these respondents didn’t think their doctor could help them.

Contact: Frieda Schmidt, 610-526-8298

Published:6-30-2008