Chronic Regional Pain Syndrome (CRPS)

We specifically treat complex regional pain syndrome (CRPS) as studies have shown robust data that ketamine can truly benefit patients who have this condition. Ketamine can be used when more traditional therapeutic options have been tried but not yielded any beneficial results.

Complex regional pain syndrome (CRPS) is an uncommon condition that causes pain, usually in your upper and lower extremities. CRPS typically develops after an injury, surgery, stroke or heart attack. The pain is out of proportion to the severity of the initial injury.

It is believed that CRPS occurs as a result of dysfunction in your central or peripheral nervous systems. Your central nervous system consists of your brain and spinal cord whereas your peripheral nervous system sends information from your brain and spinal cord to your arms, legs, fingers and toes. The abnormal functioning results in an overreaction to pain signals that your nervous system can’t shut off. Symptoms of CRPS include burning or throbbing pain, sensitivity to touch or cold, changes in skin color (from white and blotchy to red or blue. Ketamine can be considered when more traditional forms of treatment have been tried and failed to produce relief from symptoms.

Ketamine is a very complex medication with a wide range of effects on the body. Although researchers have not definitively determined how ketamine works in chronic nerve pain, the following are a few of their leading theories:

1. Ketamine may decrease central sensitization – Researchers believe that the main way that ketamine treats chronic nerve pain, especially nerve pain, is by reducing central sensitization. It accomplishes this by altering the main cause of central sensitization, the NMDA receptor. This receptor is like a button on our nerves. When it is triggered, it sends a pain signal to our brain. Ketamine is actually able to block this button and prevent it from being triggered. Ketamine also reduces the number of these buttons on our nerves. As a result, central sensitization, and thus our pain levels, decreases. As everyone living with chronic nerve pain knows, any reduction in pain is a welcomed relief!

2. Ketamine may decrease inflammation – Inflammation has long been considered a major contributing factor to pain production. In the case of chronic nerve pain, our nerves and the tissues surrounding them, may become inflamed. This chronic inflammation could be a contributing factor to central sensitization. Researchers have found that ketamine can significantly decrease chronic inflammation throughout the body, as well as in the brain.

3. Ketamine may enhance natural pain relievers – Within our bodies, there are innate mechanisms that minimize pain. The scientific term for this process is called “conditioned pain modulation”. These are the brake pedals mentioned previously. In some circumstances, these pathways may be impaired, leading to the development of chronic nerve pain. Ketamine may have the ability to mend these broken mechanisms, restoring our bodies' natural ability to moderate its own pain.

4. Ketamine decreases opioid-induced hyperalgesia (OIH) and increase our bodies' sensitivity to opioids – Although opioids (i.e. hydrocodone, oxycodone, heroin, etc.) can reduce pain initially, if taken for longer than a few weeks, they can actually aggravate our pain. Therefore, instead of making pain better, they actually make it worse. Studies have shown that ketamine has the ability to reverse this increase in pain sensitivity due to chronic opioid use. This is partly due to a decrease in central sensitization. In addition, ketamine increases our bodies’ natural sensitivity to opioid medications, thereby reducing opioid tolerance. This can have profound effects for chronic opioid users. Ketamine may help reduce the number of opioid pills required and, hopefully, make it possible to eliminate them all together.

In order to receive ketamine for complex regional pain syndrome, we recommend

that you be referred by your primary care provider/pain specialist to us.

After you have been referred to us by your primary care physician/pain specialist. We will reach out to you and set up your initial screening evaluation. During your screening, we will discuss your medical history to determine whether ketamine is an appropriate treatment option for you. We will then walk you through the treatment process and answer any questions that you may have. We’ll also give you a tour of the facility so that you know what to expect on your first day of treatment. Once that is complete, we will set up an appointment for you to begin your own ketamine journey