Our goal at Resolve Pain is to allow rehabilitation and repair of injured nerves, muscles, and body structures to reduce your pain to allow you to enjoy your life activities. At times, despite our best therapies and treatments and your best efforts, pain can persist.
Scientific research in pain medicine has begun to help us understand complex changes that occur inthe nerves in your body, spine and brain when you experience chronic pain (pain that lasts more than three months).
Changes to cells called ‘glia’ and alterations to electrical channels on cells, such as the NMDA receptor changes, seem to ‘turn on’ pain processes and can continue to give you pain sensations even after any tissue damage has been healed.
It is like a light switch that was turned on but as much as you try and try to turn that switch off, the light (or pain) stays on.
One option your health team may suggest is an infusion medication. The most used infusion medications are ketamine and lignocaine (though there are others). These medications are used to attempt to reduce the body changes in chronic pain and attempt to ‘turn off’ the light switch NMDA receptors.
Unfortunately, we can’t give you these medications as tablets by mouth because they don’t absorb well into your body through your stomach and gastrointestinal system.
So, we can usually provide these medications through a small cannula through your skin usually over a period of five to seven days in hospital.
Side effects are usually mild but can include short term sleepiness, cloudy thinking, and rarely, particularly ketamine, can cause mild hallucinations (which settle when we lower the dose). Specific information for each medication, including rare more significant side effects, will be discussed before starting any therapy.
It is important to know that these medications may not work, or be appropriate, for all types of pain. But for some people these medications can be very effective and often allow your body to complete the last steps of healing required to significantly reduce your pain.
All treatment options are considered at Resolve Pain, and it is often a combination of several therapies, rather than one on its own, which helps to manage your pain.
Ketamine has cloudiness, sometimes mildly blurred vision, and sedation as more common side-effects.
Very rare side effects but ones you need to know are possible include allergic reactions, headaches from increased intracranial pressure, psychosis, liver injury and bladder difficulties. If these occur infusions may need to be ceased and treatment of these side effects.
Lignocaine may cause allergic reactions, mild sedation and confusion - these resolve with cessation of medication.
Exceedingly rare but serious side affects you need to be informed about include toxicity from overdose which can range from tingling in the mouth through to seizures and cardiac death.