Complex Regional Pain Syndrome (CRPS)

“After years of traveling to world renown ketamine clinics every 2 months for nerve pain from CRPS, I’m still relatively pain free months after my infusions at Ascend.” -Lisa F.

CRPS is one of the most painful conditions possible and doesn’t always respond to opioids and conventional pain management. Chronic, burning pain characterizes the syndrome, usually of one or more extremities that typically occurs following an injury. It is often accompanied by swelling, skin discoloration, abnormal sweating, and impaired function in the affected area. CRPS is also called Reflex Sympathetic Dystrophy (RSD). 

How We Help

Our integrated approach to healing CRPS combines ketamine infusion therapy and psychiatric medication management. We communicate closely with the patient’s pain management and other providers before treatment. Because there is no cure for CRPS, once we decrease symptoms substantially (often with the first infusion), we continue holistic, evidence-based protocols. “Holistic” does not mean we are limited to supplements, dietary changes, and natural medicine; rather, at Ascend we consider a variety of treatment options from the latest scientific research in intravenous infusions to lifestyle changes to everything in between.

Ketamine infusion therapy works in a variety of ways, because it works on multiple complex receptor systems to decrease pain and inflammation. Ketamine regulates glutamate in the nervous system to prevent central sensitization and increase nerve growth and communication. In the case of CRPS, many patients require several hours worth of ketamine infusions over consecutive days rather than the hour long infusions needed for mental health.

“Ketamine acts both centrally and peripherally. Its action is mediated by multiple receptor subtypes including opioid, NMDA, alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionate, kainite, and gamma-amino butyric acid A receptors. In chronic pain, ketamine appears to interact with the NMDA receptor. When stimulated, primarily by the excitatory neurotransmitter glutamate, the NMDA receptor leads to central sensitization via an upregulating feedback mechanism, a potential pathway for chronic pain. Reversal of central sensitization by NMDA-receptor antagonists such as ketamine is believed to reduce pain and may reduce the amount of opioid analgesics patients need as well” (Patil & Antiescu, 2012).

Central sensitization is a state in which the nervous system is always in a state of high reactivity. This results in heightened feelings of pain to non-pain provoking stimuli. The nerves affected by central sensitization have a much lower activation threshold than ‘healthy’ nerves. Central sensitization is thought to occur as a result of decreased pain thresholds, previous injury, and the stress response. Chronic stress is a known causative factor in lowered pain thresholds which may lead to chronic pain conditions. Allodynia and hyperalgesia are the result of central sensitization.

Allodynia is a disorder in which pain is felt by things that are not painful. Example – if you have central sensitization in your leg, you may be extremely sensitive to bed sheets, light touch, or hot or cold temperatures. These normally non-painful stimuli can evoke massive amounts of pain.

Hyperalgesia is a heightened response to a mildly painful event resulting in an excessive and exaggerated response to pain.