Summary: Ketamine infusion can change the lives of people with chronic or intractable (hard-to-treat) pain. It gives long relief and can even change the course of the disease. Doctors believe it not only dulls pain but also helps rewire the brain. That is why relief lasts. Many painful, disabling conditions do not respond to regular painkillers or even opioids. People living with chronic pain keep suffering. Constant pain raises the risk of depression and causes other brain changes.
Millions are being treated for intractable or chronic pain. But for many, the results are far from good enough. Doctors keep changing drugs and treatments. For some people, nothing seems to help. Chronic pain often starts in unexpected ways, in people who were fairly healthy. So for them, constant pain is very depressing. Worse, doctors may not help enough. For many of these people, ketamine infusion offers hope. In many cases, it can change their lives.
Take Berkley Jones, a tough woman and a nurse in the US Air Force. She was the kind of person who never thought she could have intractable pain. She was active and worked hard. But her life changed after an allergic reaction put her in the hospital. After that, she was always tired and had body aches. Doctors diagnosed her with fibromyalgia.
Then things got worse. She was injured during a training exercise and badly hurt her arm. She needed surgery. When she woke up, her arm was far more swollen than expected, and she had unbearable pain. That was when doctors diagnosed her with Complex Regional Pain Syndrome (CRPS).
From then on, her life got worse. She had to leave her job, and she ended up in a wheelchair. She stayed in bed for long hours and became depressed. Then she heard about ketamine therapy and decided to try it. She stayed in the hospital for five days of ketamine infusions. The results changed her life. She was back on her feet, walking with a cane. As a medic, she was amazed by the results and even wrote a book, “Ketamine Infusion: A Patient’s Guide.”
Is Ketamine Approved for Chronic Pain, and How Does It Work?
Ketamine is a new trend in pain and depression treatment. But it is an old drug that has been around since the mid-20th century. For decades, it was used mainly as an anesthetic. It is a US FDA-approved anesthetic and works well for pain after surgery. Later, the US FDA also approved it to treat depression, where it may clearly change the course of the disease.
Ketamine is not an opioid, and that is a good thing. It does not cause the side effects opioids do, and it is safer. For example, it does not slow breathing or cause severe constipation.
Still, ketamine does change your state of mind. It can cause unpleasant feelings, a sense of detachment (dissociation), and even hallucinations. So its use is tightly regulated. Because it changes your state of mind, it is also used illegally at parties. What sets this drug apart is that it can reboot the brain. Researchers now think it can even help rewire the brain. That may explain how it helps with depression and chronic pain. And unlike other painkillers and antidepressants, its effects last a long time. After ketamine infusion therapy, a person does not need daily medicine, or needs much smaller doses. It seems to help manage the root cause of many of these disorders.
Hospitals use high-dose ketamine infusions. But doctors now also use low-dose ketamine in pain clinics. Lower doses have a milder effect, but they also cause fewer unpleasant effects. So the person can go home after the therapy. Low doses also make ketamine much safer.
Most clinics give low-dose infusions over a little more than an hour. A low dose does not cause psychosis, so it is safer in a clinic. Yet a low-dose infusion is enough to help with chronic or intractable pain. It can still help rewire the brain, dull pain, ease pain-related distress, and even lift mood.
Frequently asked questions
Is ketamine an opioid?
No. Ketamine is not an opioid, and that works in its favor. It does not cause the side effects typical of opioids. It does not slow breathing and does not cause severe constipation, so it is safer. It does change your state of mind. That is why its use is tightly regulated and why it is given under medical supervision.
How does ketamine help chronic pain?
Ketamine dulls pain, and researchers now think it helps rewire the brain. That may explain why it helps both chronic pain and depression. It may also explain why its effects last longer than regular painkillers and antidepressants. After ketamine infusion therapy, many people no longer need daily medicine, or need much smaller doses.
What are the side effects of a ketamine infusion for pain?
Ketamine changes your state of mind. So it can cause unpleasant feelings, dissociation (feeling detached from your body or surroundings) and even hallucinations. Low doses have a milder effect and cause fewer of these unpleasant effects. That is why pain clinics use low-dose infusions. They are safer, and the person can go home after the therapy.
How long does a ketamine infusion for chronic pain take?
In a pain clinic, a low-dose ketamine infusion usually runs a little over an hour, and you go home the same day. Hospitals use higher-dose infusions and may keep a patient for several days. In the story above, a nurse with CRPS stayed in the hospital for five days of ketamine infusions. She was back on her feet, walking with a cane.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
