Ketamine Infusion Therapy: A New Approach to Chronic Pain
For patients who have been told "there's nothing more we can do" for their chronic pain, ketamine infusion therapy can represent a breakthrough. I want to explain this treatment honestly — what it is, what the research shows, and why it works when other approaches fail.
What Makes Ketamine Different
Most pain medications — opioids, anti-inflammatories, neuropathic drugs — work on peripheral pain pathways or modulate neurotransmitters in a single way. Ketamine works through a fundamentally different mechanism: it's an NMDA receptor antagonist.
In chronic pain, the central nervous system often undergoes a process called central sensitization — essentially, the brain and spinal cord become "wound up" and amplify pain signals far beyond what the original injury would produce. This is why chronic pain can persist long after tissue has healed, and why it often doesn't respond well to conventional treatments.
Ketamine directly interrupts this central sensitization process, essentially resetting overactive pain pathways in the brain and spinal cord.
Who Benefits Most?
The strongest evidence for ketamine in chronic pain includes:
- CRPS (Complex Regional Pain Syndrome): Studies show 70–80% of patients with CRPS achieve significant pain reduction after a ketamine infusion series
- Fibromyalgia: Central sensitization is a core mechanism; ketamine addresses it directly
- Neuropathic pain: From nerve injury, post-herpetic neuralgia, diabetic neuropathy
- Failed back surgery syndrome: When surgery hasn't resolved the pain
- Migraine: Refractory cases, particularly status migrainosus
The Treatment Protocol
A standard course is typically 3–6 infusions given over 2–3 weeks. Each infusion lasts 40 minutes to 4 hours depending on the protocol. You are awake but may experience mild perceptual effects — a floating sensation, altered sense of time — that resolve when the infusion ends.
A driver is required. Most patients tolerate the infusions well and return home the same day.
Realistic Expectations
Ketamine is not a miracle cure. Response rates vary by condition. Some patients achieve months of meaningful relief; others need periodic maintenance infusions. And a minority of patients don't respond.
What's unique about ketamine relief when it works is its quality — patients often describe improvement in mood, sleep, and function alongside pain reduction, which differs from the numbing effect of opioids.
Currently, ketamine for chronic pain is not covered by most insurance. Our office can provide documentation for possible self-pay reimbursement requests.
Starting the Conversation
If you have treatment-resistant chronic pain and want to know whether ketamine infusion therapy is appropriate for you, call 516-492-3100 to schedule a consultation.