Chronic pain affects about 20 percent of U.S. adults, but treating it isn’t a losing proposition. A combination of ketamine and other chronic pain management techniques may offer the relief you’re looking for.
What is Chronic Pain?
According to the experts at Johns Hopkins, “Chronic pain is long-standing pain that persists beyond the usual recovery period or occurs along with a chronic health condition, such as arthritis. Chronic pain may be ‘on’ and ‘off’ or continuous. It may affect people to the point that they can’t work, eat properly, take part in physical activity, or enjoy life.”
What is Ketamine?
Ketamine has risen from humble beginnings in the 1960s as an anesthetic used during the Vietnam conflict to medicine with curative powers in mental illness and chronic pain. Ketamine defends against pain by counteracting a specific chemical receptor (N-methyl-D-aspartate), NMDA, which is found in the nervous system and helps to modulate pain. But because it intermingles with other receptors, ketamine has broader clinical uses.
What Causes Chronic Pain?
Sometimes chronic pain has an apparent cause, like arthritis or cancer. Injuries and diseases can also trigger bodily changes, which leave you more susceptible to pain. Some changes are constant even after the original injury or disease has healed. A sprain, broken bone, or a short-term infection are also chronic pain sources.
But you also can have chronic pain not directly related to an injury or physical illness.
Who’s Part of your Chronic Pain Management Team?
To effectively manage chronic pain, you not only need to be committed to improving, but a team of mental and medical healthcare professionals must work as a cohesive unit to diagnose your condition and create a treatment plan. People on the team may include: a primary healthcare provider, addiction specialist, pain clinician, nurse, pharmacist, psychiatrist, psychologist, additional behavioral specialists (like a social worker, marriage and family therapist, and a counselor), and physical or occupational therapists.
Ketamine in Chronic Pain Management
Generally, two types of patients undergoing chronic pain management may benefit from ketamine: patients experiencing chronic pain who haven’t had the positive outcomes they expected with another medication or treatment, or someone with chronic pain expecting to undergo surgery.
Ketamine has been used in chronic pain management when dealing with conditions like cancer, neuropathic pain, phantom pain, complex regional pain syndrome, fibromyalgia, postherpetic neuralgia, sickle cell disease, and spinal injury degree of varying success.
According to a report by the U.S. National Library of Medicine, researchers have found evidence of some of ketamine’s benefits when treating chronic pain: “The anesthetic ketamine is used to treat various chronic pain syndromes, especially those that have a neuropathic component. Low-dose ketamine produces strong analgesia in neuropathic pain states, presumably by inhibiting the N-methyl-D-aspartate receptor. However, other mechanisms are possibly involved, including enhancement of descending inhibition and anti-inflammatory effects at central sites. Current data on short-term infusions indicate that ketamine produces potent analgesia during administration only. In contrast, three studies on the effect of prolonged infusion (4-14 days) show long-term analgesic effects up to 3 months following infusion.”
The same report said further testing is required to determine ketamine’s efficacy.
One report by the U.S. National Institutes of Health concluded: “There is good evidence that ketamine in the perioperative setting reduces pain scores and opioid requirements. Adverse effects are mild or absent, and perioperative ketamine may decrease postoperative nausea and vomiting. It seems most beneficial for surgery associated with high levels of postoperative pain.”
Diagnosis & Treatment
Your healthcare provider may perform a physical examination and recommend tests to uncover the cause of your pain. You may undergo the following tests:
- Blood tests.
- Electromyography to test muscle activity.
- Imaging tests, such as X-rays and MRI.
- Nerve conduction studies to see if your nerves are reacting properly.
- Reflex and balance tests.
- Spinal fluid tests.
- Urine tests.
Depending on your symptoms, health, and medical history, you also may be referred to a mental healthcare specialist for further diagnosis. Sometimes there’s a psychological component to physical pain, which can help inform treatment options.
Treatment may involve different therapy, medicine, or ketamine therapy.
If you think you suffer from chronic pain, it’s essential to see your healthcare specialist for diagnosis and to begin treatment. An integrative approach may be your first step in managing pain symptoms, and ketamine could be part of that treatment plan.