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Ketamine and Complex Regional Pain Syndrome

Characterized as “having your pain system cranked up to ten,”[i] Complex Regional Pain Syndrome (CRPS) is frequently unknown and misunderstood—even in the medical community—and is easily misdiagnosed. Some patients with CRPS may even be told that it is “all in their head” (Conversion Disorder). However, the 1.5-7 million Americans who are estimated to suffer from CRPS know that what they are feeling is very, very real.

CRPS usually begins in an arm or leg that has been injured in some way. However, especially if mistreated or left untreated, the severe burning pain, swelling and skin redness associated with CRPS can progress and spread to other parts, or all, of the body. Sufferers become extremely sensitive to even the lightest touch. The condition does not respond well to typical pain therapies: physical and psychology therapy, or even pain killers. There is frustration, potentially desperation, and sometimes depression.

While antidepressants are frequently prescribed to individuals with CRPS, and they are helpful to some, research has shown that this condition is associated with an overstimulation of a nerve receptor complex (NMDA) in the experience of pain. The pain sensory feedback loop becomes dysregulated, pain receptors become chronically overexcited, and the brain gets overloaded.

In recent years, an increasing number of patients have found relief with medically-supervised Ketamine infusion therapy. NMDA receptors comprise about 50 per cent of nerve tissue in the body and brain, and Ketamine has been shown to block those receptors, preventing the neurotransmitter from initiating pain signals. There are also signs that Ketamine has a regenerative effect on nerve tissue, and researchers believe that Ketamine’s ability to interrupt pain perception, allows the body a break from the pain, somehow rebooting the system, and giving nerves a chance to heal.

Published results—including case studies, randomized trials and physicians’ observations from clinical treatments—indicate that 65 to 80 per cent of individuals with CRPS who undergo medically-supervised Ketamine treatment experience some to significant improvement in pain levels, for several weeks to even months.  Improved results are associated with larger doses and multiple treatments. Other research also shows that Ketamine can be very effective in treating depression, which often follows and exacerbates chronic pain syndromes such as CRPS and other types of chronic pain.

Medically-supervised Ketamine infusion is considered to be a much safer pain treatment option than the opiates often prescribed for chronic and severe pain. High-doses of opiates can depress the respiratory system, threaten the liver, and are associated with physical dependence, increased tolerance, and constipation. On the other hand, Ketamine is a dissociative sedative that was originally used as a surgical anaesthetic. Patients often experience nausea, headache and hallucinations. However those effects usually don’t last much beyond the duration of the treatment, and the use of additional drugs, such as benzodiazepine, can help prevent these psychotropic effects, as can starting with a low dose and gradually increasing it with the patient’s tolerance. Additionally, Ketamine has been shown to reduce opioid tolerance, allowing patients to decrease their doses.

Ketamine Infusion for Pain Relief Institute (KIPRI) offers medically-supervised Ketamine infusion therapy, according to scientific, evidence-based principles, using high standards of clinical practice and professional conduct. If you suffer from CRPS, KIPRI could help you regain control of your life and physical function. Call today.

[i] https://www.vice.com/sv/article/znw495/ketamine-therapy

 

“80 percent [of CRPS patients] see dramatic reduction in their pain with lasting improvement”
Dr. Glen Brooks, anesthesiologist, New York Ketamine Infusions Center, Manhattan

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