Ketamine Therapy: An Alternative Approach to Block and Reverse Chronic Pain
Intravenous or IV ketamine therapy is an exciting non-opioid medical approach that can be administered by a trained physician in a pain clinic, and some pain doctors administer ketamine as it has shown usefulness in their practices for a variety of painful conditions.
How does ketamine work? In acute pain, or short term pain, a painful signal is transmitted from a point of injury via the nerve to the spinal cord. A signal from the spinal cord is then relayed to the brain, where we perceive and respond to the painful stimulus. In chronic pain, where there no longer is a painful stimulus, the spinal cord relay point unfortunately becomes accustomed to painful signals and has developed "frequently used shortcuts." These pathways may begin to signal spontaneously or overzealously to the brain, known as dysesthesia, hyperesthesia and hypersensitization, via a specific type of neurotransmitter known as glutaminergic neuronal signaling, also known as NMDA receptor upregulation. Ketamine is an NMDA blocker, or antagonist, and can block or reverse this type of disorderly neurotransmission.
Ketamine has been used in clinical practice by pain clinic physicians for conditions ranging from acute pain to chronic pain to pyschological disorders. In early 2019, the US Food and Drug Administration approved a brand name ketamine, Spravato, for refractory depression, also known as treatment resistant depression. While the on-label indication for Spravato is narrow, some doctors have used ketamine to treat complex regional pain syndrome, depression, bipolar disorder, and other various chronic pain disorders.
Stay tuned for upcoming blog postings on Spravato in the near future!
Pain management anesthesiologists and pain clinic doctors are in a unique position to administer IV ketamine infusion therapy in an outpatient setting, based on understanding of diagnosis of acute and chronic pain conditions, as well as an understanding of administration of intravenous medications, based on years of training and experience in operating rooms administering anesthetic medications.
IV ketamine infusion therapy is typically adminstered in a recurring series. Patients may elect for three to four day a week sessions of four hours each. An IV may be placed, vital signs can be monitored, and patients typically read, listen to music, or browse the internet while the infusion therapy is painlessly occcurring. During the initiation of therapy, dosing is typically started conservatively to avoid side effects. Monitoring is performed to avoid adverse effects of the therapy.
Also check out a couple other popular blog posts about low back pain and sciatica here:
Bellevue Pain and Wellness PLLC is a Seattle Bellevue area pain clinic helmed by pain doctor, Robert Bowers M.D., who is board certified in pain medicine and anesthesiology by the American Board of Anesthesiology.