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Baclofen Pumps: A permanent way to treat spasticity

Two older men displaying how an implanted Baclofen pump doesn't need to limit daily activities like playing tennis or socializing with friends.
An implanted Baclofen pump may be a way around the shortcomings of oral medications to treat spasticity.

For patients who experience spasticity problems, managing medications and their side effects can be just as taxing as the medical problem they are trying to treat. An implanted Baclofen pump may be a way around the shortcomings of oral medications.

What is spasticity?

“Spasticity is a condition where muscles contract and become tight due to a nerve injury to the brain or spinal cord,” said Dr. Mark Schuler, a physical medicine and rehabilitation physician at Marshfield Clinic Health System.

Conditions that can cause spasticity include cerebral palsy, spinal cord injury and multiple sclerosis (MS), among others. Spasticity can occur in specific areas of the body or over large areas.

Baclofen pumps

Baclofen is a medication that treats spasticity and tight muscles. It has been around for decades, but prior to the early1990s it was used primarily as an oral medication. This medication is very effective but has one main problem: it often causes drowsiness as a side effect. A pump was created to act as a delivery mechanism to administer Baclofen. It helps to bypass the drowsiness side effect by delivering a small fraction of the oral dose directly to the central nervous system. This can achieve even better results for the patient.

Surgeons implant the pumps under the skin of the abdomen. They run continuously to deliver the Baclofen medication straight into the spinal fluid. It requires a surgery to implant the device, which is about the size of a hockey puck. However, once implanted, the pump requires very little maintenance. Patients will need to visit their provider two to six times per year to refill the pump. Additionally, the pump needs to be surgically replaced every six to seven years.

There are very few limitations to living with a Baclofen pump. Dr. Schuler explained that because the pump is implanted below the skin, there are no activity restrictions. The pumps are quite compatible with most people’s life and leisure activities.

Who can get a Baclofen pump?

If you or a loved one are suffering from spasticity to a condition that affects the brain or spinal cord, a Baclofen pump may be a solution. The pumps work best for people with spasticity over a large region of the body such as the lower limbs. In addition, the pump treats spasticity in the legs better than in upper limbs.

“The pumps are not for everyone, though,” Dr. Schuler explained. “Depending on the social situation or geographic location, the pump may not be the best choice.” The pumps must be refilled several times per year. Therefore, it is important that patients have reliable transportation to their pump provider and can come in for appointments as needed. Additionally, a pump is not needed if oral Baclofen medication works.

If you and your doctor decide that a Baclofen pump is an appropriate solution for your spasticity problems, you will likely continue to use it for the rest of your life. “Since many nerve injuries are permanent and lead to ongoing problems, the need for treatment is ongoing as well,” Dr. Schuler said. “But patients are often quite happy with their pumps. Reduced spasticity can not only lead to improved quality of life for the patient, but can ease the caregiver’s burden as well.”

If you believe that you or a loved one would benefit from an implanted Baclofen pump, talk to your provider.

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