Phantom Limb Pain

• • Ketamine Therapy • •

Ketamine Treatment for Phantom Limb Pain in Southern California

Phantom limb pain is a neuropathic pain condition that develops following amputation in approximately 80% of patients. Treatment for phantom limb pain can be challenging, with fewer than 10% of patients achieving lasting relief. Emerging evidence has shown that IV ketamine is a highly effective treatment for many chronic mood and pain disorders including phantom limb pain (PLP).

What is Ketamine IV Therapy?

Ketamine is a dissociative anesthetic, meaning that it relieves pain without loss of consciousness. Ketamine is useful for both neuropathic pain and chronic mood conditions like depression. Ketamine is an NMDA receptor antagonist, it helps block receptors that play a key role in acute and chronic pain pathways. Ketamine is safe and effective in treating phantom limb pain and it also has rapid antidepressant effects. Randomized controlled trials suggest ketamine is also useful for complex regional pain syndrome, post herpetic neuralgia, migraine, burns, and fibromyalgia.

How is Phantom Limb Pain Treated with IV Ketamine Therapy?

Ketamine is an anesthetic that has been used safely and effectively since its approval by the FDA in 1970. Within the last twenty years, researchers have shown that ketamine has other potential treatment applications in addition to anesthesia for phantom limb pain.

By stimulating neuronal growth, IV ketamine can improve mood and relieve chronic pain rapidly. Most patients who have had IV ketamine feel a significant improvement after the first treatment session. This improvement wanes over the subsequent 24-48 hours, but as the IV ketamine protocol continues, the symptom relief becomes increasingly sustained.

Although there is still a lot unknown about phantom limb pain, it is clear that PLP involves both central and peripheral neural factors that activate N-methyl-D-aspartate (NMDA) receptors. Ketamine is known to block these NMDA receptors. Because of this, IV ketamine is considered to be a potentially effective treatment for many neuropathic disorders, including PLP.

Phantom limb pain can sometimes be opioid-resistant. Ketamine offers opiate-sparing effects. It can either be used as a primary analgesic (pain reliever) or analgesic adjuvant (used after initial treatment).

If IV ketamine is indicated, the dosage is decided based on the patient’s body weight (0.5mg/kg). Each ketamine infusion lasts about 40 minutes, after which patients should have someone available to accompany them home safely. During the infusion, patients recline in a treatment chair surrounded by a calm, quiet and experientially safe environment. Ketamine is delivered at a slow and controlled dose and a registered nurse accompanies each patient for the duration of the infusion to monitor blood pressure, pulse and oxygen saturation. Patients do not experience any respiratory effects during or after the treatment.

IV Ketamine Therapy is well-tolerated. During a ketamine infusion, patients remain aware of their surroundings and experience a deep relaxation. Your clinician may lower the lights, offer an eye mask or aromatherapy, or take other measures to make the setting more comfortable.

Some patients may experience dissociation, perceptual disturbances or nausea. Generally, any changes in perception or dissociation dissipate very quickly after the infusion. However, many patients report that feelings of dissociation experienced during the infusion can help them develop an objective perspective about past experiences.

Typically, patients receive 8-12 ketamine infusions over the course of 3-4 weeks. The combination, frequency, and order of each of your treatment sessions will be discussed with you and will be recommended based on your unique circumstances.

How Ketamine Treatment for Phantom Limb Pain Works

Phantom limb pain is a neuropathic condition that causes lasting painful sensations originating from the area of an amputated limb. Although the limb is gone, the pain caused by PLP is very real, caused by the brain sending mixed signals to the spinal cord.

PLP usually begins shortly after surgery. Sufferers say that it feels like twisting, burning, pressure, or itching, and it is commonly felt in fingers or toes. The duration and severity of the pain differs from person to person. Sometimes PLP can last only seconds, while for others, it may last several days.

Phantom limb pain flare-ups can be triggered by:

  • Urination
  • Sex
  • Smoking
  • Exposure to cold temperatures

Phantom Limb Pain Statistics

  • 60-85% of amputee population experiences PLP.
  • In 2005, 1.6 million Americans (1 in 190) had PLP. This number is expected to reach 3.6 million by 2050.
  • Phantom limb pain is thought to affect 20% of children born without a limb and half of children who have a limb amputated before the age of 6 years old.

Signs & Symptoms of Phantom Limb Pain

  • May begin within the first week after an amputation or may be delayed for months or even longer.
  • Pain flares up and subsides recurrently
  • The symptoms affect the portion of the amputated limb farthest from the body. For example, the foot of an amputated leg.
  • Stabbing, shooting, cramping, burning, itching, or twisting pain in the missing limb.

Phantom Limb Pain Treatment in Southern California

At Neuro Wellness Spa, we recognize that phantom limb pain can feel difficult to understand, but there are effective treatment options. We build relationships with all of our patients so they feel safe navigating their illness and understanding which options are best for them.

For more information about the services we offer or whether IV Ketamine Treatment is covered by your insurance provider, contact us today.

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