Multiple Sclerosis and Baclofen Therapy
Who Should Get ITB?
If baclofen pills haven’t helped your spasticity, you can try a pump system. It tends to work better for spasticity in the legs rather than the arms.
Before you get ITB, you will meet with a treatment team that may include a doctor who specializes in rehabilitation (a physiatrist or neurologist), a physical therapist, an occupational therapist, a nurse, and a social worker. All of these professionals work together to check your spasticity symptoms and to set a treatment plan that fits your personal needs. Many doctors who specialize in pain management, called anesthesiologists, also manage ITB pumps.
Know the Risks
Any surgery comes with risks, and implanting the baclofen pump is no exception. They include:
- A bad reaction to anesthesia
- Trouble with bladder control
- Pump malfunction: If the pump stops working (this is rare), it may give you too much medicine at once. That can cause symptoms such as drowsiness, dizziness, weakness, trouble sleeping, lightheadedness, nausea, constipation, vomiting, loose muscles, trouble with vision, coma, respiratory depression, seizures, dry mouth, double vision, poor concentration, or diarrhea. If this happens, go to the nearest emergency room right away. A doctor can give you a drug called physostigmine to counteract baclofen.
- Kinked catheter: If the catheter stops working well, you may need surgery to replace it.
How Do I Know if the Baclofen Pump System Is Right for Me?
If your treatment team recommends the baclofen pump system, you’ll try it out to see how well it works.
Your doctor will inject baclofen into your spine with a small needle. Then the team checks how well it works over 2 to 4 hours. If your muscles don't relax during the first try, you may get a larger dose to see if that makes a difference.
If it works, you can decide with your doctor and family members if you should have a baclofen pump system implanted.