Complex Regional Pain Syndrome (CRPS) is sometimes called the “suicide disease” because the pain is intense, difficult to treat and disabling. It leaves in it’s wake few safe choices for relief. Ketamine offers treatment for CRPS.
CRPS is a condition that can affect anyone at any age and occur anywhere on the body. As many as 35 percent of those diagnosed with it feel pain throughout their whole body.
CRPS has frustrated medical science for decades because they can do little for the patient but attempt to manage the pain. Today, the world is in the midst of an opioid crisis which makes prescribing drugs that could help like oxycodone or morphine problematic for CRPS pain because of the risk of addiction. Surgical options come with their own risks, as well.
Recent studies may have proved that there is a more practical approach to the treatment of complex regional pain syndrome – multi-day low dose ketamine infusions.
About Complex Regional Pain Syndrome
Complex regional pain syndrome is a type of chronic pain that usually affects one arm or leg. The cause of this pain remains a mystery but it tends to occur after:
- Heart attack
The intense pain exceeds what is expected from the initial injury. There are two types of complex regional pain syndromes:
- Type 1 – Called reflex sympathetic dystrophy syndrome (RSD) occurs after illnesses or injuries that did not damage the nerves. RSD accounts for about 90 percent of all CRPS cases.
- Type 2 – Relates directly to a nerve injury and the pain follows the path of that nerve.
People who suffer from either type of CRPS can experience:
- Burning or throbbing pain
- Swelling in the area of the pain
- Changed in skin temperature, color and texture
- Decreased mobility
Without a proper diagnosis and treatment plan, individuals with CRPS can also develop tissue wasting and muscle contracture. How can ketamine infusions help, though?
Ketamine is anesthesia that is getting lots of attention these days. It can provide sedation along with pain relief and it even shows potential in the treatment for depression. Ketamine first came on the market in the 1960s working as a sedative in the Vietnam battlefields and it acts by taking control of certain brain receptors.
It is that sedative feeling that also makes ketamine a popular party drug. It is sold on the street under names like Special K and K2. When used as part of a therapeutic plan, though, ketamine is a miracle drug, according to John Abenstein, MD and president of the American Society of Anesthesiologists.
Ketamine to Relieve CRPS
A 2005 study published in Pain Physician found that multi-day low dose ketamine delivered via an infusion might be effective for chronic pain relief for those with CRPS. The study involved 36 women and four men, CRPS affects women more, who underwent ketamine infusions to determine how the drug affected their pain levels. For this study, researchers such as Robert Hirsh with Cooper University Hospital looked at three different pain statistics:
- Overall pain level
- Worst daily or punishing pain
- Least daily pain
The goal was to see how the infusions affected pain at each of these levels. The patients kept pain journals to record their discomfort throughout the day. Doctors looked at other factors, as well, such as mobility, tissue wasting and muscle spasms.
Results of the 2005 Study
On the first day of treatment, the study participants reported some pain reduction, especially in the worst daily or punishing pain category. The study administrators continued the four-hour ketamine infusions going from 40mg to 80mg over 10-days. On the tenth day of treatment, most of the patients stated there was an improvement in their pain levels and a significant reduction in their worst pain daily. They also experienced better mobility and decreased autonomic dysregulation.
Autonomic nervous system dysregulation refers to managing certain involuntary reflexive actions in the body. The nervous system controls most of the muscles and when it malfunctions, it can lead to misfiring of the nerves. Often people with CRPS suffer from muscle spasms and poor mobility. These symptoms would fit into the category of autonomic dysregulation.
The participants in the 2005 study found improvement in autonomic dysregulation which could mean fewer muscle spasms and better muscle movement with a multi-day ketamine infusion.
Ketamine Treatment for Chronic Pain
Complex regional pain syndrome is just one form of reoccurring and life-changing pain that might benefit from ketamine therapeutic treatments. For example, a 2016 study published in the Journal of Headache and Pain looked at how ketamine treatments might benefit those with refractive chronic migraines or migraine headaches that fail to respond to standard treatment protocols.
The study authors found that IV ketamine did have a positive result on six out of six patients who participated in the migraine research. Ketamine has been studied as a treatment for:
- Central pain
- Ischemic pain
- Nonspecific pain of neuropathic origin
- Phantom pain
- Post-therapeutic neuralgia
Most of these projects found that ketamine could work as a treatment option in certain patients with various chronic pain syndromes. Studies show that prolonged infusion may provide long-term relief, as well. As a potential treatment for depression, ketamine may offer rapid improvement and alleviating suicidal ideation long enough to allow for traditional treatments to take effect.
Ketamine does not come with the same risks of addiction as opiate drugs like morphine or hydrocodone. It overall has fewer side effects than strong prescription pain meds, although different drug treatments affect people in different ways.
Today, Ketamine may be the treatment that gives hope to those with chronic regional pain syndrome. The data is beginning to show that it is more than a street drug and provides benefits outside of the operating room. Ketamine for the management of chronic pain may bring relief to millions of suffers throughout the world.
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