Managing Chronic Pain with Ketamine Therapy

Living with chronic pain affects every aspect of life—physical health, mental wellbeing, relationships, and quality of life. When traditional pain treatments fall short, ketamine therapy offers a proven alternative that addresses pain at its neurological source.

Understanding Chronic Pain

What Makes Pain “Chronic”?

Chronic pain is defined as pain lasting longer than 3-6 months, or pain that persists beyond normal tissue healing time. Unlike acute pain (which warns of injury), chronic pain serves no protective function and becomes a disease state itself.

Types of Chronic Pain Ketamine Can Treat

Neuropathic Pain (nerve damage)

• Diabetic neuropathy
• Post-herpetic neuralgia (shingles pain)
• Peripheral neuropathy
• Nerve injury or damage

Complex Regional Pain Syndrome (CRPS)

• Type I (without confirmed nerve damage)
• Type II (with confirmed nerve damage)
• Previously called “reflex sympathetic dystrophy”

Fibromyalgia

• Widespread musculoskeletal pain
• Chronic fatigue and sleep issues
• Often accompanied by mood disorders

Central Pain Syndromes

• Post-stroke pain
• Spinal cord injury pain
• Multiple sclerosis pain

Chronic Headache/Migraine

• Treatment-refractory migraines
• Chronic daily headaches
• Cluster headaches

Failed Back Surgery Syndrome

• Persistent pain after spine surgery
• Often includes neuropathic components

Why Ketamine Works for Chronic Pain

The Problem: Central Sensitization

Chronic pain involves “wind-up” or central sensitization:

1. Overactive pain signals: Nervous system becomes hypersensitive
2. NMDA receptor upregulation: More pain receptors form
3. Neuroinflammation: Chronic inflammation in nervous system
4. Altered pain processing: Brain amplifies pain signals
5. Persistent pain cycles: Pain maintains itself even when original injury heals

Traditional pain medications don’t address these underlying mechanisms.

How Ketamine Addresses Root Causes

NMDA Receptor Antagonism

• Blocks overactive glutamate receptors
• Interrupts pain signal amplification
• Prevents central sensitization

Anti-Inflammatory Effects

• Reduces neuroinflammation
• Decreases inflammatory cytokines
• Calms overactive immune response in nervous system

Neuroplasticity

• Promotes growth of new neural pathways
• Helps brain “unlearn” chronic pain patterns
• Restores normal pain processing

Modulation of Pain Pathways

• Affects multiple neurotransmitter systems
• Reduces opioid receptor tolerance
• Enhances natural pain control mechanisms

Evidence and Clinical Results

Research Findings:

• 70-85% of CRPS patients experience significant pain reduction
• Fibromyalgia patients report 40-60% pain decrease on average
• Neuropathic pain responds in 60-75% of cases
• Effects often last weeks to months per treatment series

Our Chronic Pain Treatment Protocol

Initial Assessment

Comprehensive evaluation includes:

Pain History

• Onset and duration
• Previous diagnoses and treatments tried
• Impact on daily functioning
• Quality and location of pain

Medical Evaluation

• Physical examination
• Review of imaging and diagnostic tests
• Medication history and effectiveness
• Co-occurring conditions assessment

Treatment Planning

• Customized ketamine protocol
• Integration with existing pain management
• Goal setting and outcome measures
• Frequency and dose optimization

Ketamine Infusion Options for Pain

Standard Infusion Protocol

• 45-60 minute sessions
• Sub-anesthetic doses
• Initial series: 6 infusions over 2-3 weeks
• Comfortable private treatment room
• Continuous medical monitoring

High-Dose Protocol (for CRPS)

• 4-hour infusions
• Higher doses under deep sedation
• Hospital or specialized clinic setting
• Reserved for severe, refractory cases
• Intensive medical monitoring

Maintenance Therapy

• Frequency based on individual response
• Monthly to quarterly boosters common
• Prevents pain recurrence
• Adjustable based on pain levels

Integrated Pain Management

Ketamine works best as part of comprehensive care:

Physical Therapies

• Physical therapy and rehabilitation
• Occupational therapy
• Gentle exercise programs
• Mind-body practices (yoga, tai chi)

Psychological Support

• Cognitive-behavioral therapy for pain
• Mindfulness and meditation
• Stress management
• Pain psychology counseling

Medication Optimization

• Coordinating with pain management physician
• Often allows reduction in opioids
• Optimizing other pain medications
• Treating co-occurring conditions

Lifestyle Modifications

• Sleep hygiene
• Anti-inflammatory nutrition
• Pacing and activity management
• Stress reduction

What to Expect During Treatment

First Infusion

Preparation:

• Arrive with comfortable clothing
• No food 2-3 hours before (small snacks okay)
• Arrange ride home (cannot drive)
• Bring music or entertainment if desired

During Treatment:

• Relaxed, supervised environment
• May experience mild dissociation
• Some patients feel pain relief during infusion
• Time passes quickly for most

After Treatment:

• Rest in recovery area 15-30 minutes
• Side effects typically resolve quickly
• Can usually return to normal activities next day
• Some patients notice immediate improvement

Treatment Series Progress

Week 1-2:

• Building therapeutic levels
• Some patients notice early improvement
• Others see gradual changes
• Continue scheduled infusions

Week 3-4:

• Cumulative effects become apparent
• Pain levels often decrease noticeably
• Improved function and activity tolerance
• Better sleep quality

Ongoing:

• Sustained pain relief
• Periodic maintenance infusions
• Continued improvement in function
• Enhanced quality of life

Real Patient Experiences

“I’ve had CRPS for 8 years. Nothing helped—not nerve blocks, not pain medications, not anything. After my ketamine infusion series, my pain decreased from 9/10 to 3/10. I can finally live again.” — Sarah M., Las Vegas

“Fibromyalgia made everything hurt, all the time. Ketamine therapy gave me my life back. I can work, exercise, and enjoy time with my family without constant pain.” — Tom R., Upland

“Diabetic neuropathy pain in my feet was unbearable. After trying everything, ketamine was the only treatment that actually worked. The burning pain is 80% better.” — Linda K., Las Vegas

Advantages Over Traditional Pain Management

Compared to Opioids

Ketamine:

• Not addictive in clinical use
• No tolerance development
• Addresses root causes
• Can reduce opioid requirements
• No respiratory depression
• Enhances quality of life

Opioids:

• High addiction risk
• Tolerance requires increasing doses
• Only masks symptoms
• Many side effects
• Respiratory risks
• Quality of life often decreases

Compared to Other Treatments

Nerve Blocks/Injections:

• Temporary relief (days to weeks)
• Require repeated procedures
• Some risk of complications

Ketamine:

• Longer-lasting relief (weeks to months)
• Non-invasive
• Addresses systemic sensitization

NSAIDs/Other Pain Medications:

• Limited effectiveness for neuropathic pain
• Significant side effects with long-term use
• Don’t address underlying mechanisms

Ketamine:

• Effective for neuropathic pain
• Minimal side effects
• Targets pain at neurological level

Safety and Side Effects

During Infusion

Temporary effects may include:

• Mild dissociation (dreamlike state)
• Changes in perception
• Relaxation or drowsiness
• Slight increase in blood pressure
• Rare: nausea or dizziness

These effects typically resolve within 30 minutes after infusion ends.

After Treatment

• Most patients experience no lingering effects
• Can return to normal activities the next day
• No “hangover” feeling
• Rarely, mild fatigue or headache

Long-term Safety

• Extensive safety record in medical use
• No organ damage at therapeutic doses
• Can be used long-term with appropriate monitoring
• Regular follow-up ensures optimal safety

Insurance and Cost Considerations

Coverage

• Insurance coverage growing for chronic pain conditions
• CRPS often has better coverage
• Prior authorization usually required
• We provide documentation for reimbursement

Value Proposition

Consider the cost of chronic pain:

• Lost work productivity
• Multiple specialist visits
• Ongoing medications
• Reduced quality of life
• Other treatments that didn’t work

Many patients find ketamine therapy cost-effective compared to years of ineffective treatments.

Is Ketamine Therapy Right for Your Pain?

Good Candidates

You may benefit from ketamine therapy if you:

• Have chronic pain lasting 3+ months
• Haven’t found adequate relief with conventional treatments
• Want to reduce opioid medications
• Are motivated to engage in comprehensive pain management
• Have CRPS, fibromyalgia, or neuropathic pain
• Are under care of a pain management physician

Not Appropriate For

Ketamine may not be suitable with:

• Uncontrolled high blood pressure
• Certain heart conditions
• Active psychosis
• Pregnancy or breastfeeding
• Active substance abuse

Take Control of Your Pain

Chronic pain doesn’t have to define your life. Ketamine therapy offers real, lasting relief by addressing the neurological mechanisms that maintain chronic pain states.

You deserve to live without constant pain.

Schedule Free Consultation → | Call 844-552-7489

Our experienced pain management team is ready to help you find relief.

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Related Resources

• Chronic Pain Treatment Overview
• Ketamine Therapy Services
• About Our Medical Team
• Anxiety and Pain

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About the Author: Dr. Henry Liang, DO, Medical Director at Klarity Clinic, specializes in chronic pain management and has helped hundreds of patients find relief from debilitating pain conditions using ketamine therapy and comprehensive pain management approaches.