Old Drug Ketamine Offers New Hope for Chronic Pain Sufferers

Source: Leah Shaffer, Science History Institute 

Jennifer Ray was in constant pain. Sometimes it was a low-level burning sensation like lemon juice on a wound; sometimes it was far worse.

Ray has complex regional pain syndrome (CRPS), a little-understood disorder in which pain starts in one part of the body—usually at the site of an injury—and then spreads. In Ray’s case she was diagnosed following a knee operation at 16.

“I felt more pain as I progressively healed,” she remembers. Ray, now 31, was also diagnosed with rheumatoid arthritis and struggled with digestive problems. She often had to go to the hospital for a feeding tube because she couldn’t hold down food. Her constellation of problems all related to a central nervous system gone haywire.

She finally found relief from a surprising source: ketamine.

“It’s incredible what the life change has been,” she says.

Ketamine has been used as a surgical anesthetic for more than 50 years, but lately it’s finding uses outside the operating room. Doctors have discovered it’s surprisingly effective for treating depression and other mood disorders, so much so that in 2019 the FDA approved a nasal-spray version of the drug to help manage depression. But ketamine’s effect on difficult-to-treat chronic pain disorders, such as CRPS, fibromyalgia, and migraines, has remained under the radar.

“It is being used all the time for chronic pain,” says Steven Cohen, an anesthesiologist at John Hopkins Medical Center, who coauthored guidelines on the intravenous use of ketamine for chronic pain.

Ketamine works by blocking N-methyl-D-aspartate (NMDA) receptors, proteins in nerve cells that play a role in sensitizing the nervous system, says Cohen. The drug can halt that progression of pain sensitivity and even reverse it.

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