Ketamine for CRPS - What You Need to Know

Complex regional pain syndrome (CRPS) can be a serious condition without adequate relief from traditional medications. Ketamine can be a powerful tool to treat CRPS with long term benefit. Learn from Dr. Kaveh how IV ketamine infusion therapy can be used to treat CRPS.

What is Complex Regional Pain Syndrome (CRPS)?

CRPS is a poorly understood pain condition involving nerve irritation and inflammation. Pain often starts in the arms or legs. Some cases result after sports injuries or sprains, fractures, surgeries, or other tissue damage. Because of the nerve irritation, some unique characteristics distinguish CRPS from other pain syndromes:

• Changes in skin color, temperature
• Sweating
• Swelling
• Changes in hair distribution or nails growth
• Reduced strength, tremors, spasms

Ketamine for CRPS

Ketamine and CRPS both affect nerve function throughout the brain, spinal cord, and body. Several studies have shown lasting pain relief with IV ketamine infusion therapy for CRPS. Significant pain relief persisted even at 3 months post infusion. Severe CRPS type I has also shown pain relief from IV ketamine infusions.

We don't yet know how ketamine is so effective for CRPS. We believe ketamine's action on the NMDA receptor is responsible for some of its neuropathic pain relieving properties.

Ketamine may help CRPS through NMDA receptor modulation to relieve nerve irritation, depression, and anxiety

Why Ketamine for CRPS?

We believe nerves become more sensitive in patients with CRPS. This is called central sensitization and refers to nerves that conduct pain signals to the brain in the absence of tissue destruction. For example, lightly touching the skin can cause a pain sensation, called allodynia.

This central sensitization is affected by the NMDA receptor.

Furthermore, CRPS is associated with depression and anxiety. Given ketamine's role in treating depression and anxiety, this offers additional benefit in treating CRPS with ketamine. Ketamine is also effective in treating chronic pain that may be in addition to CRPS.

Ketamine can be a powerful tool for CRPS because other treatments are rarely successful

Ketamine treatment for CRPS is different than for depression

IV ketamine infusion can provide relief for multiple conditions, including depression, anxiety, and other forms of pain. However, the timing of ketamine therapy for CRPS is different than typical ketamine infusions. Ketamine is infused at higher doses over consecutive days instead of the more traditional weekly or bi-weekly infusion protocols. Treatment dosing is always determined by a board-certified physician to ensure patient safety and to minimize the risk of side effects.

Furthermore, depending on what part of your body is most affected by CRPS, your treatment protocol may vary.

Who may not be a candidate for ketamine for CRPS

Ketamine may not be the right treatment for some patients with:

• Pregnancy
• Uncontrolled hyperthyroidism
• Taking certain blood pressure medications (calcium channel blockers or beta blockers)
• Heart, liver, or kidney problems
• Schizophrenia, bipolar disorder, or history of psychotic episodes

Certain psychiatric risks are minimized by having a guide present for the infusion. It is also important to not fall asleep during infusions, as sleeping may increase the risk of undesirable hallucinations.

You can learn from Dr. Kaveh if ketamine infusion therapy is right for you by contacting Harmony Infusion Therapy Clinic.