Neuropathic Pain

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Ketamine Infusion Therapy for Neuropathic Pain

Neuropathic pain, also known as nerve pain, is a type of pain caused by nerve injury or damage. The damaged nerves send incorrect signals to other pain centers. The impact of nerve injury includes a change in nerve function both at the site of injury and areas around the injury. Symptoms of neuropathic pain are usually described as a shooting or burning pain, and are often accompanied by tingling and numbness. Peripheral neuropathy is a type of neuropathic pain that usually starts in the fingers and toes, spreading upwards into the arms and legs.

There are many potential causes of neuropathic pain. Causes include diabetic peripheral neuropathy, complex regional pain syndrome, amputation, alcoholism, spine problems, HIV infection, multiple sclerosis and shingles. Diabetic peripheral neuropathy is the most common cause of neuropathic pain, causing pain in 50% of the diabetic population.

Neuropathic pain treatment consists of two components. The first component is treating the underlying cause of the neuropathic pain (diabetes, spine problems, HIV, shingles, multiple sclerosis, alcoholism). The second component involves treating the symptoms of pain, numbness and tingling. Many different types of medications are used in the treatment of neuropathic pain. These medications include anti-inflammatories (ibuprofen), opioid pain medications (morphine), anti-seizure medications (gabapentin) and anti-depressants. Neuropathic pain is known to be unresponsive to opioid medications. Topical creams and patches are also used in neuropathic pain treatment. Some patients seek alternative medicine treatments including acupuncture, herbs and dietary supplements.

An exciting alternative to neuropathic pain treatment that has shown promise in many studies is ketamine infusions. Ketamine is an anesthesia drug that has been used for decades in the operating room. Low dose infusions of ketamine have been shown to give profound relief of neuropathic pain from diabetic peripheral neuropathy, shingles, phantom limb pain, complex regional pain syndrome and many other causes. Ketamine works by blocking a highly specialized receptor in the nervous system, the NMDA receptor. This receptor is overstimulated in neuropathic pain syndromes, and opioid medications have been shown to exaggerate this overstimulation. Ketamine is thought to “reset” this nerve pathway back to normal causing significant pain reduction much faster than traditional treatment options.

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