The Role of Ketamine for Chronic Pain in Modern Medicine

According to the CDC, approximately 20.9% of adults in the US suffer from chronic pain. The traditional pain management strategy includes the use of painkillers and physical therapy, which often come with limitations, especially when the pain persists despite conventional treatments. As a result, patients and doctors are turning to alternative therapies. One such option gaining attention is ketamine, a dissociative anesthetic that has the potential to manage chronic pain effectively.

In this blog, we will explain the role of ketamine for chronic pain, its advantages, risks, and safe dosage for pain management.

What is Ketamine?

The use of ketamine started in the 1960s as an anaesthetic. It was used as a dissociative anesthetic, which detaches the brain function from the body. Nowadays, ketamine is known for its potential beyond anesthesia, especially in the treatment of chronic pain, depression, and other mood disorders.

Ketamine is typically administered through intravenous (IV) infusions. However, it can also be delivered via nasal sprays, oral tablets, or intramuscular injections, depending on the condition being treated and the method of care prescribed by healthcare providers.

How Does Ketamine Treat Chronic Pain?

The mechanism of action of ketamine for chronic pain involves the NMDA receptor antagonism. This process blocks NMDA receptors in the CNS and causes disruption in several ways:

• NMDA receptors activate the nervous system toward pain, and by blocking these receptors, ketamine reduces the perception of pain.

• Ketamine reset the brain’s response to pain. In chronic pain sufferers, the brain may become "rewired" to amplify pain signals. Ketamine can help reduce this maladaptive pain processing.

• Chronic pain also causes inflammation, and ketamine may help reduce the inflammation contributing to pain.
  

Benefits of Ketamine for Chronic Pain

The following are the benefits of taking ketamine dose for chronic pain:

1. Reduces Neuropathic Pain

It is very effective for neuropathic pain, which occurs in conditions like diabetic neuropathy, post-surgical pain, and spinal cord injury. These kinds of conditions are very difficult to treat, and ketamine has the ability to provide relief in these cases when other treatments have failed.

2. Rapid Pain Relief

Many patients report experiencing pain relief within hours of a ketamine infusion, which is an advantage over traditional pain management options that may take longer to show results.

3. Reduced Opioid Dependence

Ketamine can eliminate the dependence on opioids, which is another painkiller, but has the risk of addiction, overdosage, and multiple side effects. Ketamine can serve as a great alternative in this regard.

4. Psychological Benefits

Beyond pain management, ketamine has the potential to improve mood and reduce anxiety, which makes it beneficial for individuals suffering from both chronic pain and co-occurring mental health issues.

5. Minimal Side Effects

Compared to opioids, ketamine has fewer long-term side effects when used under proper medical supervision. It doesn’t carry the same risk of tolerance, addiction, or withdrawal symptoms that opioids do.

Safe Dosage of Ketamine for Chronic Pain

The appropriate dosage of ketamine depends on the severity of the condition being treated. For safety purposes, it is administered by medical personnel in a clinical setting.

Doses are generally lower for chronic pain management than those used for anesthesia. IV ketamine infusions for pain usually start at a dose of around 0.1-0.3 mg/kg and are adjusted based on patient response. The infusions are given for 40-60 minutes.

Risks of Using Ketamine for Chronic Pain

Like any medication, ketamine comes with risks, particularly when misused or for prolonged periods:

• Ketamine can cause confusion and hallucinations.

• Long-term use can cause bladder dysfunction and other urinary tract problems.

• While ketamine does not carry the same addiction risks as opioids, there is still the potential for psychological dependency.

• Ketamine can elevate the heart rate and BP.

• Prolonged use of ketamine can cause liver issues.
  

Is Ketamine Right for You?

Ketamine is not suitable for everyone. It is primarily considered for patients with chronic pain that has not responded to other treatments, particularly for neuropathic pain or complex pain syndromes. If you are considering ketamine as a treatment option, consult with a doctor who has a specialization in pain management to know if it is appropriate for your condition.

Conclusion

Chronic pain and ketamine have a very odd relationship, but the benefits of ketamine in pain management have become a great alternative for those suffering from conditions that are resistant to conventional treatments. While ketamine shows great promise, it must be approved by healthcare providers. If you are dealing with unmanageable chronic pain, ketamine might be a viable option to consider.

FAQs

Does Medicare cover ketamine for chronic pain?

Medicare does not typically cover ketamine treatments for chronic pain unless the patient is enrolled in a clinical trial.

How long does ketamine last for pain relief?

The effects of ketamine can last for a few days to a few weeks, based on the severity of the pain.

Can ketamine cure neuropathic pain?

Ketamine can manage neuropathic pain effectively, but it is not a cure. It will just provide relief from symptoms for the time being.

Can we use ketamine for depression?

Yes, ketamine has shown promising results in treating treatment-resistant depression.

What is it like to get a ketamine infusion?

An IV will be placed in your arm, and the ketamine will be infused slowly over 40-60 minutes. Some patients experience mild dissociative effects, but these usually wear off after infusion.