Ketamine Therapy for Chronic Pain

Beyond opioids. Ketamine targets the root mechanisms of chronic pain, offering relief for conditions that haven't responded to conventional treatments.

50M
Adults with Chronic Pain
Non-Opioid
Pain Mechanism
NMDA
Receptor Target
2-6 hrs
Duration of Relief

Why Ketamine for Chronic Pain?

Chronic pain affects over 50 million Americans and is one of the leading causes of disability. Many patients cycle through NSAIDs, opioids, nerve blocks, and other interventions without lasting relief. Ketamine works differently—it targets central sensitization, the process by which the nervous system amplifies pain signals.

  • Targets NMDA receptors involved in central sensitization (wind-up pain)
  • Non-opioid mechanism—no respiratory depression or classic opioid dependence
  • Can "reset" overactive pain signaling pathways
  • Effective for neuropathic pain, CRPS, fibromyalgia, and other chronic conditions
  • May reduce opioid requirements when used as part of a comprehensive plan

How Ketamine Addresses Chronic Pain

In chronic pain states, the nervous system becomes hypersensitized—normal signals are interpreted as painful (central sensitization). Ketamine blocks NMDA receptors that drive this amplification, essentially turning down the volume on overactive pain circuits.

  • Blocks NMDA receptor-mediated central sensitization
  • Reduces "wind-up" phenomenon in spinal cord pain processing
  • Anti-inflammatory effects at subanesthetic doses
  • Modulates descending pain inhibition pathways
  • Can help with the emotional component of chronic pain (depression, anxiety)

Conditions That May Benefit

Ketamine has shown promise for multiple chronic pain conditions, particularly those involving neuropathic or centralized pain mechanisms.

  • Complex regional pain syndrome (CRPS / RSD)
  • Fibromyalgia and central sensitization syndromes
  • Neuropathic pain (diabetic neuropathy, post-herpetic neuralgia)
  • Chronic migraine and cluster headaches
  • Chronic back and neck pain with central sensitization
  • Phantom limb pain

A Non-Opioid Alternative

In an era of opioid crisis, ketamine offers a fundamentally different approach to pain management. It addresses the underlying neural mechanisms of chronic pain rather than simply masking symptoms.

  • No opioid receptor activity—different mechanism entirely
  • No respiratory depression at prescribed subanesthetic doses
  • May reduce dependence on opioid medications over time
  • Can be used alongside other pain management strategies
  • Treatment from home—no repeated clinic visits
  • Board-certified physician oversight throughout

Clinical Evidence for Ketamine & Chronic Pain

Continuous low-dose ketamine infusion produced significant pain relief in CRPS patients, with effects lasting up to 12 weeks after treatment. (Sigtermans et al., 2009 (Pain))

Double-blind placebo-controlled trial showed outpatient IV ketamine infusions produced statistically significant reductions in multiple pain parameters in CRPS patients. (Schwartzman et al., 2009 (Pain))

Consensus guidelines confirmed ketamine's role in treating chronic pain, particularly neuropathic pain and CRPS, with evidence supporting both IV and oral routes. (Cohen et al., 2018 (Regional Anesthesia & Pain Medicine))

Frequently Asked Questions

Can ketamine replace my pain medications?

Ketamine is typically used alongside, not instead of, your current pain management plan. Over time, some patients are able to reduce other pain medications with physician guidance. Never stop or reduce any medication without consulting your doctor first.

How does oral ketamine compare to IV infusions for pain?

IV ketamine infusions are given in clinical settings and have more research behind them for chronic pain. Oral (sublingual) ketamine offers a more accessible, at-home option with lower but sustained blood levels. Your physician will determine if oral ketamine is appropriate for your specific pain condition.

How quickly will I notice pain relief?

Some patients notice pain reduction during or shortly after their first session. For others, it may take several sessions before meaningful improvement. Chronic pain treatment typically requires a longer course (8-12 sessions) compared to depression treatment.

Is ketamine safe for long-term pain management?

At the subanesthetic doses used for pain management, ketamine has a favorable safety profile. Regular monitoring by your physician ensures safe, appropriate use. Long-term use at prescribed doses has not been associated with the bladder issues seen with recreational abuse.

Will ketamine interact with my pain medications?

Ketamine can interact with certain medications, including opioids, benzodiazepines, and muscle relaxants. Your physician will carefully review all your medications during your consultation and adjust your treatment plan accordingly.

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What to Expect

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