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Ketamine Infusion Therapy for Complex Regional Pain Syndrome (CRPS)

Ketamine Infusion Therapy for Complex Regional Pain Syndrome (CRPS)

Imagine living with chronic pain with no apparent explanation, no readily available cure, and no sense of relief in sight. For nearly 200,000 Americans suffering from Complex Regional Pain Syndrome, that nightmare is an everyday, life-long reality, but it doesn’t have to be. 
For patients experiencing near-constant pain, a proven treatment solution is crucial. Thankfully, research has shown a glimmer of hope that ketamine infusion for CRPS symptom management is an effective first line of defense. 
Complex Regional Pain Syndrome is a chronic neuro-inflammatory disorder characterized by debilitating pain that is out-of-proportion to the original injury

What is CRPS?

Complex Regional Pain Syndrome is a chronic neuro-inflammatory disorder characterized by debilitating pain that is out-of-proportion to the original injury. CRPS occurs when there is trauma-related tissue damage that causes the nervous and immune systems to malfunction and send constant pain signals to the brain. Patients generally describe the pain as a “burning,” “tearing,” or “stinging” sensation felt deep inside the limbs. The condition is associated with pain levels among the most severe on the McGill University Pain Scale and is regarded as more painful than natural childbirth, amputation, and the physical effects of terminal cancer. 
Diagnosis of CRPS is based on medical history, physical evaluations, and lab results.

What Are the Symptoms of Complex Regional Pain Syndrome?

There is no single diagnostic tool for CRPS. Diagnosis is based on medical history, physical evaluations, and lab results. Still, doctors must rule out other disorders that would account for the level of pain the patient is experiencing before considering a CRPS diagnosis. 
Despite the difficulties many patients face when obtaining a diagnosis, there are several telltale symptoms of CRPS:

  • Constant, unprovoked burning or throbbing pain, usually in the arms, legs, hands, or feet
  • An initiating injury or traumatic event that should not cause as severe pain as being experienced or where the pain does not subside with healing
  • Increased sensitivity to external stimuli, particularly touch and cold
  • Swelling in the affected area
  • Changes in skin temperature—alternating between sweating and chills
  • Changes in skin color, ranging from white and blotchy to red or blue
  • Changes in skin texture, which may become thin, tender, or shiny in the affected area
  • Changes in hair and nail growth
  • Joint stiffness, swelling, and damage
  • Muscle spasms, tremors, weakness, or loss (atrophy)
  • Decreased ability to move the affected area
  • Insomnia and emotional disturbances

Symptoms will vary from person to person and may change over time, but if the pain worsens or is disproportionate to the original injury, it might be CRPS.
CRPS occurs when there is trauma-related tissue damage that causes the nervous and immune systems to malfunction

What Are the Treatment Options for CRPS?

The current approach suggests a combination of several treatment modalities, including physical, behavioral, and medicinal therapies. Despite the various angles from which doctors try to treat CRPS, the treatment’s efficacy is only as strong as its weakest link, and for patients suffering from Complex Regional Pain Syndrome, traditional pharmacological methods of achieving pain relief are neither practical nor effective. 
CRPS activates NMDA receptors in the brain, making its sufferers more sensitive to pain and less sensitive to the effects of opiates. This inverse relationship has the potential to be lethal, particularly in individuals experiencing chronic pain. As pain levels rise, it might be easy to assume that more opioid medication equals more pain relief, but that isn’t the case, especially when it comes to managing CRPS. Since the condition makes patients less susceptible to the pain-relieving effects of opioid drugs, the possibility of adverse side effects is exponentially increased with this treatment regimen. 
Negative side effects associated with opiate medications include respiratory depression, weakened immune system, and strangely enough, an increased pain response over time as the body builds a tolerance to the drug. Additionally, opiate medications are considered to be one of the most highly addictive classes of medications currently approved by the FDA, contributing to more than 45,000 deaths in 2018. 
Treating CRPS with Ketamine Infusion Therapy 

Treating CRPS with Ketamine Infusion Therapy 

Ketamine, on the other hand, is an NMDA receptor antagonist, which means that it inhibits the activity caused by CRPS activating NMDA receptors in the brain. By blocking certain neurotransmitters from binding to these receptor sites, patients are able to experience a decrease in CRPS-related pain. In addition to acting as an NMDA receptor antagonist, ketamine also produces a powerful analgesic effect when administered intravenously, mirroring the therapeutic benefits produced by opiate drugs in individuals who don’t have CRPS.
Ketamine is typically dosed at 1mg/kg/hr for the treatment of acute pain and may be adjusted according to each patient’s individual needs. The treatment protocol when receiving a ketamine infusion for CRPS symptom management is as follows: 

  • One 6-hour, high-dose ketamine infusion therapy session (4 hours of active infusion and 2 hours of active recovery before being released to go home)
  • A series of 5 additional ketamine infusions, either every day or every other day, following the initial dose
  • Maintenance infusions every 6 to 8 weeks, as necessary

Additionally, Ketamine has been established as a proven treatment method for major depression, a welcome fact for the high number of patients experiencing comorbidity between the two affiliations, especially since patients are able to experience symptom relief almost immediately with IV ketamine therapy.

Mindscape Ketamine & Infusion Therapy

Here at Mindscape Ketamine and Infusion Therapy, we know how severely chronic pain can negatively impact your day-to-day functioning, which is why we’re here to help! If you or someone you know is suffering from any of the aforementioned symptoms associated with Complex Regional Pain Syndrome, therapeutic ketamine infusion for CRPS could be the option that finally brings you relief. 
Contact our office to schedule a free consultation today to find out how therapeutic ketamine could work to improve your quality of life!

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