CHRONIC PAIN DISORDERS
CHRONIC REGIONAL PAIN SYNDROME
What is Chronic Regional Pain Syndrome (CRPS)?
CRPS is a type of chronic pain that develops after an injury. It can also develop after a stroke or heart attack, but this is less common. The pain is usually located in an arm or leg and extends beyond the area of the initial injury. The pain lasts far beyond the time it typically takes for the injury to heal. The intensity of the pain is worse than the initial injury and can be accompanied by skin changes, swelling, and difficulty with movement.
Why do some people develop CRPS?
The cause of CRPS is unknown. It appears that neuropathways become dysfunctionally inflamed after the initial injury and create a significant increase in the perception of pain. CRPS most commonly affects postmenopausal women but can also affect men and younger people.
How is CRPS usually treated?
Physical and occupational therapy is the first line of treatment for CRPS. Medications can be prescribed to help with the pain and other symptoms. Psychosocial and behavioral therapy can also help with managing pain and other symptoms commonly associated with CRPS, such as depression and anxiety. If you are not achieving improvement with these typical treatment methods, ketamine may be beneficial for you.
How does ketamine help CRPS?
Ketamine is an anesthetic drug, typically used to sedate people for surgery or because of extreme agitation. The latest evidence suggests that ketamine may be effective in the treatment of Chromic Regional Pain Syndrome when used at low doses. Although the way ketamine works is unclear, it is believed that ketamine disrupts the ingrained nerve pathways that signal your brain to produce dysfunctional pain. It appears that ketamine can also assist in building new, functional nerve pathways in your brain.
How many treatments do I need?
The number of treatments needed varies by person. For CRPS, we recommend initially 6 treatments over 3 to 4 weeks. Most patients will start to see improvement at the end of 6 treatments. Some may see improvement sooner and some may require more treatments to see an initial improvement. It is possible to not respond to ketamine treatments. Your specific response cannot be guaranteed or predicted. Patients who are willing to combine their ketamine treatments with psychotherapy and lifestyle changes are generally more successful.
How long do results last?
The length of time improvement lasts also varies. Most patients will need booster treatments every four weeks, but some may not need boosters for much longer, while others may need boosters more frequently.
Does insurance pay for these treatments?
Unfortunately, most insurances do not yet cover IV ketamine treatments for CRPS. You can use your HSA or FSA accounts to pay for your ketamine treatments. We also accept all major credit cards, Venmo, PayPal, ApplePay. We can provide you with a claim to submit to your insurance to see if they will reimburse part or all of your treatments, but payment is due at the time of service.
How do I get started?
In order to provide the safest and most effective treatments for our patients, you must have a current primary care or pain management provider. We need to be able to coordinate your care. You must have an official diagnosis of CRPS. Additionally, we highly recommend you have a mental health therapist as treatment for CRPS requires work on your part to make lifestyle changes that may be difficult to do on your own. Call today to speak with our patient coordinator to see if you are appropriate for this treatment.
CHRONIC BACK OR NECK PAIN
What is chronic back or neck pain?
Chronic neck or back pain is pain that lasts longer than 3 months, that has no anatomical explanation, or that continues after the anatomical cause has been treated. Some patients who have back or neck surgery continue to have pain and may be considered "failed" surgical patients. However, the latest research supports that "failed surgery" pain may really have nothing to do with the surgery but with neural pathways in your brain. For some patients, once the anatomical issue is fixed, the brain continues to recognize the ingrained pain pathway and tells you you still have pain.
Why do some people develop chronic back or neck pain?
Most people with chronic back/neck pain have no anatomical reason for the pain. In fact, roughly 85% of people who see their primary care physician for back pain have no identifiable condition to explain the back pain. Certain factors seem to increase a person's risk of developing low back pain. These include smoking, obesity, older age, female gender, physically strenuous or sedentary work, job-related stress, job dissatisfaction, and mental health issues such as anxiety or depression.
How does ketamine help chronic back or neck pain?
The latest evidence suggests that ketamine may be effective in the treatment of chronic neck and back pain when used at low doses. Although the way ketamine works is unclear, it is believed that ketamine disrupts the ingrained nerve pathways that signal your brain to produce dysfunctional pain. It appears that ketamine can also assist in building new, functional nerve pathways in your brain.
How many treatments do I need and what does it cost?
CHRONIC MIGRAINE HEADACHES
What is a migraine?
Migraines are a common neurological disorder, the cause of which is unclear. Migraine sufferers typically have a one-sided headache that is made worse with movement, bright lights, loud sounds, and smells. Some people have additional symptoms, such as nausea, vomiting, numbness, tingling, slurred speech, visual changes, or ear ringing.
What causes a migraine?
It is unclear what causes migraines. There appears to be a genetic component to migraines in that approximately 80% of migraine sufferers have a first-degree relative with migraines. Women are more likely than men to have migraines which may be due to hormone fluctuation.
How are migraines treated?
There are medications and other therapies used to prevent and manage migraine headaches. Typically people with chronic migraines have been seen by several medical professionals including neurologists for help with their symptoms. Some people do really well with typical treatments. If you have not improved with typical treatments, ketamine may help.
How does ketamine help with migraines?
Ketamine is an anesthetic drug, typically used to sedate people for surgery or because of extreme agitation. The latest evidence supports the effectiveness of ketamine for chronic migraines when used at low doses. Although the exact way ketamine works is unclear, it is believed that ketamine disrupts the ingrained nerve pathways that signal your brain to produce pain. It appears that ketamine can also assist in retraining your brain to not stimulate these ingrained dysfunctional pathways that cause your headaches.
FIBROMYALGIA
What is fibromyalgia?
Fibromyalgia is the most common cause of widespread muscle and bone pain and is more common in women than men. It is commonly accompanied by fatigue, difficulty thinking, headaches, depression, anxiety, numbness, and tingling. It is considered a disorder of pain regulation in the central nervous system.
What causes fibromyalgia?
The cause of fibromyalgia is unknown. It is believed to be a dysfunction of the central nervous system that causes an increase in neural signaling resulting in pain. There is no specific test for fibromyalgia and the diagnosis is usually made after all other causes for the pain are ruled out.
How is fibromyalgia treated?
Treatment for fibromyalgia includes exercise, psycho-behavioral therapy, and multiple types of medication. If you have not improved with conventional treatments, ketamine may e beneficial for you.
How does ketamine help with fibromyalgia?
Ketamine is an anesthetic drug, typically used to sedate people for surgery or because of extreme agitation. The latest evidence supports the effectiveness of ketamine for chronic pain conditions when used at low doses, particularly those that are accompanied by depression or anxiety. Although the exact way ketamine works is unclear, it is believed that ketamine disrupts the ingrained nerve pathways that signal your brain to produce pain. It appears that ketamine can also assist in retraining your brain to not stimulate these ingrained dysfunctional pathways. There is also good evidence that ketamine helps with depression and anxiety.