Nura Pain Clinic
The One-Stop Clinic for Precision Pain Management

According to recent studies, approximately 25 percent of patients prescribed opioids for chronic pain misuse them, leading to many deaths from overdoses every year in the U.S. The usual routes of opioid administration—pills, skin patches, intravenous, injection, under the tongue—deliver the medication into the bloodstream distributing it to the highest blood flow organ, the brain. Systemic delivery of opioids may relieve pain but at the price of serious mental side effects, including mental clouding, somnolence, and euphoria leading to addiction.

One way to preserve the effectiveness of opioids while reducing abuse and diversion is to deliver these powerful medications directly to spinal cord pain receptors. Targeted drug delivery avoids the bloodstream by delivering medication directly to the spine—keeping the brain free of unwanted mental side effects. Specialized physicians are increasingly using intrathecal pain pumps to relieve even the most complex chronic pain for patients who have failed all other attempts at pain management.

“Pain pumps provide significant pain control with a fraction of the opioid dose required by pills or skin patches, but are not yet considered main stream,” states Dr. David Schultz, a renowned pain management specialist. Dr. Schultz has focused his practice, Nura Pain Clinics, on treating complex chronic and cancer pain using the most advanced technologies available anywhere. Nura physicians have been implanting pain pumps for the past 25 years and are at the forefront of advancing pain pump science, having published multiple studies on the safety and effectiveness in peer-reviewed medical journals.

Intrathecal pain pumps have evolved since they were introduced clinically 40 years ago. The device is now comprised of three components: a pump to deliver medication continuously 24/7, a reservoir to hold up to 3 months of medication delivered slowly over time, and a computer that can be programmed to deliver the medication any way the patient wants— continuous infusion, self-administered mini-doses, or some combination of both.

At Nura, the team starts with simple treatments and progresses to more advanced therapies, as needed, to control pain. For those patients who fail to respond to injection procedures, medications, and physical therapy, Nura’s pain specialists may recommend a neuromodulation trial—either electrical stimulation of the nervous system or targeted drug delivery with a pain pump. “We consider pain pumps to be the last resort but believe that targeted spinal drug delivery is often the best therapy for the worst pain. The success rate of our pain pumps can be attributed to our use of specially compounded mixtures of opioids and local anesthetics. Our pumps continuously deliver the local anesthetic bupivacaine, which creates a lighter version of spinal anesthesia. An opioid such as morphine, hydromorphone, or fentanyl is mixed with bupivacaine and blocks pain through a different pathway by binding to spinal cord opioid receptors. Together, these medications are synergistic and block just about any kind of pain very effectively,” adds Dr. Schultz. Since pain nerve fibers are very small and easily blocked, a low dose of bupivacaine will relieve pain without hindering the big sensory motor nerves that are required for body function. Consequently, the pain pump finds “a happy medium” and relieves pain at the spine without affecting the function of any other part of the nervous system. Nura patients with implanted pain pumps concur that their pain has been relieved, and function restored, while hospitalizations, doctor visits, surgeries, and drug intake have all been reduced.

Today, Nura is one of the largest practices in the world implanting and managing pain pumps for chronic and cancer pain. Nura’s multi-disciplinary approach brings together specialists from around the care spectrum for precision pain management, making it one of the go-to centers for treating complex chronic pain. As a center of excellence for implantable pain control, Nura is indeed a ray of hope for patients with debilitating chronic pain.