Chronic pain is not a simple symptom—it is a condition that reshapes the nervous system itself, altering how the brain and spinal cord process sensory signals in ways that can persist long after the original injury has healed. For patients with complex regional pain syndrome (CRPS) and fibromyalgia, this neurological remodeling is at the heart of why standard pain treatments so often fall short. We work with chronic pain patients at Albany Ketamine Infusions who have tried multiple medications, physical therapy, nerve blocks, and other interventions, and who come to us because they have heard that ketamine approaches pain through a fundamentally different mechanism.
Why Chronic Pain Is a Neurological Problem
The classical view of pain—that it is a direct signal from an injury site to the brain—does not explain the experience of most chronic pain patients. In conditions like CRPS and fibromyalgia, the pain signal has become amplified within the central nervous system through a process called central sensitization. In central sensitization, NMDA receptors in the spinal cord and brain become overactive, lowering the threshold for pain signals and causing the nervous system to respond to stimuli that would not normally cause pain, or to respond disproportionately to those that do.
CRPS in particular is associated with severe, burning pain, often in a limb, following an injury or surgery—sometimes a minor one. The pain spreads beyond the original injury site and is accompanied by changes in skin temperature, color, and sweating. Fibromyalgia involves widespread musculoskeletal pain, fatigue, cognitive difficulties, and sleep disruption, and is now understood as a disorder of central pain processing rather than a disease of muscles or joints. Both conditions are notoriously difficult to treat with conventional analgesics. Understanding the stages of CRPS can help patients and caregivers better anticipate how the condition may progress and why early intervention matters.
How Ketamine Targets Central Sensitization
Ketamine’s primary mechanism of action is relevant here: it is an NMDA receptor antagonist, meaning it blocks the same receptors that are overactive in central sensitization. By dampening the activity of NMDA receptors in the pain-processing pathways of the spinal cord and brain, ketamine can interrupt the cycle of amplified pain signaling that sustains conditions like CRPS and fibromyalgia. This is not a sedative effect—it is a targeted intervention at the neurological level of pain processing.
The clinical literature on ketamine for CRPS is among the most established for any chronic pain condition. Studies have shown significant pain reduction in CRPS patients following infusion protocols, with some patients experiencing durable benefits over months. The evidence for fibromyalgia is more preliminary but encouraging, with research suggesting meaningful reductions in pain intensity and improved function for some patients. For a deeper look at how this therapy works, our guide on ketamine therapy and neuropathic pain treatment explores the science behind these mechanisms in detail. Results vary by individual, and we are careful to be honest with patients about what the evidence shows and what it does not yet confirm.
What the Infusion Protocol Looks Like for Pain
Ketamine protocols for chronic pain conditions are typically different from psychiatric protocols. Pain indications often involve longer infusion sessions—sometimes four to six hours—and higher dosing, particularly for conditions like CRPS that are among the most severe forms of chronic pain. The specific protocol we recommend is individualized based on your diagnosis, pain history, current medications, and overall medical status.
Dr. Hansen‘s background as a board-certified anesthesiologist is directly relevant here. Anesthesiologists are the physicians most experienced in ketamine administration, having used it in surgical and procedural contexts for decades. His training and expertise allows us to offer chronic pain infusion protocols with the same careful physician oversight that characterizes all of our work. Every session is monitored, vital signs are tracked, and the clinical team is present throughout.
The number of sessions needed for chronic pain varies. Some patients with CRPS require a more intensive initial series; others respond to a shorter course. We assess your progress after each infusion and adjust the plan accordingly. Many chronic pain patients also benefit from periodic maintenance infusions to sustain the benefit, particularly for conditions like fibromyalgia where the underlying central sensitization can reassert itself over time.
Chronic Pain and the Psychological Dimension
Living with chronic pain for months or years takes an enormous psychological toll. Depression, anxiety, disrupted sleep, and social withdrawal are nearly universal companions to long-term pain conditions, and they are not just secondary effects—they are part of the same neurobiological picture. The same NMDA receptor systems that are overactive in central sensitization are involved in the neurobiology of depression, which is one reason why ketamine’s antidepressant and analgesic effects are connected rather than coincidental.
We take the psychological dimension of chronic pain seriously at Albany Ketamine Infusions. Patients who are also managing significant depression or anxiety alongside their pain condition may benefit from a treatment plan that addresses both. Those dealing with co-occurring mood symptoms can learn more about our Albany depression treatment options. We discuss this during the consultation process and consider the full picture of a patient’s health, not just the primary pain diagnosis.
Addressing the Barriers: Access and Skepticism
One barrier we encounter with chronic pain patients is skepticism from their existing pain management physicians. Ketamine for chronic pain is not universally accepted in pain medicine, and some patients have been discouraged from pursuing it by providers who are unfamiliar with the research. We understand that this creates confusion and sometimes distress for patients who feel they have been denied options. We welcome open communication with your pain management team and are happy to share clinical literature and discuss our approach with any physician who has concerns.
A second barrier is cost. Chronic pain infusion protocols are often more time-intensive than psychiatric protocols and can represent a significant out-of-pocket expense. We are transparent about costs during the consultation and understand that financial constraints are real. Some patients with chronic pain conditions may have insurance options that cover certain components of their treatment, and we encourage patients to investigate this with their insurer before assuming no coverage applies.
FAQ
Is ketamine FDA-approved for chronic pain?
Ketamine is FDA-approved as an anesthetic, but its use for chronic pain conditions including CRPS and fibromyalgia is off-label. The clinical evidence base for CRPS in particular is well-established. We discuss the research during every consultation.
How is the pain protocol different from the depression protocol?
Pain protocols, especially for CRPS, typically involve longer sessions and may use higher doses than psychiatric protocols. The exact protocol is individualized based on your diagnosis and history. Please discuss the specifics with Dr. Hansen during your consultation.
How long do the benefits of ketamine last for chronic pain?
Duration of benefit varies significantly by individual and condition. Some patients with CRPS report months of meaningful pain reduction after an initial series; others benefit from periodic maintenance infusions. Results vary by individual, and we monitor your response throughout treatment.
Can I continue my other pain medications during ketamine treatment?
We conduct a thorough medication review during intake. Some medications may interact with ketamine or affect the response to treatment. We discuss all current medications and any adjustments needed before beginning your infusion series.
Does Albany Ketamine Infusions treat all types of chronic pain?
We treat a range of chronic pain conditions including CRPS, fibromyalgia, chronic regional pain, and migraines, among others. A consultation with Dr. Hansen determines whether your specific condition is appropriate for our protocols.
Key Takeaways
- Chronic pain conditions like CRPS and fibromyalgia involve central sensitization, a neurological amplification of pain signals driven by overactive NMDA receptors.
- IV ketamine acts on NMDA receptors and may interrupt central sensitization, producing meaningful pain relief for appropriate patients.
- Ketamine for chronic pain is used off-label; the clinical evidence is strongest for CRPS.
- Pain protocols at Albany Ketamine Infusions are individualized, with direct physician oversight from Dr. Hansen throughout every session.
- Results vary by individual; patients should discuss with their provider whether ketamine is appropriate for their specific pain condition.
Conclusion
For patients with CRPS, fibromyalgia, or other forms of central sensitization-driven chronic pain who have not found adequate relief through conventional approaches, IV ketamine therapy offers a mechanism-based alternative that addresses the neurology of pain directly. We approach chronic pain patients with the same rigor and care that we bring to every patient who walks through our doors, beginning with a thorough consultation and continuing through personalized treatment. If you are ready to explore whether ketamine may be right for your pain condition, we encourage you to schedule a consultation with Dr. Hansen. Please discuss with your provider whether this approach is appropriate given your full medical history.
About Dr. Philip Hansen
Dr. Philip Hansen is a board-certified anesthesiologist who trained at Albany Medical Center. He established Albany Ketamine Infusions in partnership with Dr. Brooks, building on his training at NY Ketamine Infusions. Dr. Hansen graduated from the University of Kansas School of Medicine and holds membership in the American Society of Anesthesia, the American Medical Association, and the New York State Society of Anesthesiologists. He provides medical oversight for both in-office IV ketamine infusions and at-home telehealth ketamine programs for patients across New York, New Jersey, Florida, and Texas.
References
American Chronic Pain Association — https://theacpa.org/condition/complex-regional-pain-syndrome/
National Institutes of Health — https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613167/
International Association for the Study of Pain — https://www.iasp-pain.org
Mayo Clinic — https://www.mayoclinic.org/diseases-conditions/complex-regional-pain-syndrome/symptoms-causes/syc-20371151
Medical Disclaimer
This content is provided by Albany Ketamine Infusions for educational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. Ketamine for chronic pain is used off-label for most indications. Individual results vary, and not all patients will respond to treatment. This information should not replace consultation with a qualified medical provider. If you are experiencing a medical emergency, please call 911 or go to your nearest emergency room.