Overview
IV lidocaine infusion is a specialist treatment used in selected cases of fibromyalgia and wide spread pain, particularly when symptoms suggest increased nerve sensitivity and pain amplification. It is delivered in a monitored clinical setting under consultant supervision and aims to calm overactive pain signalling so that daily movement, sleep, and rehabilitation become more manageable.
Wide spread pain and fibromyalgia can involve heightened sensitivity within the nervous system. This can lead to pain signals becoming amplified, with normal sensations such as touch, pressure, temperature change, or gentle activity feeling uncomfortable. Many people also experience fatigue, sleep disruption, brain fog, and flare ups that can be difficult to predict.
Lidocaine is widely known as a local anaesthetic. When given intravenously at carefully controlled doses, IV lidocaine infusion can act on pain signalling pathways involved in sensitisation. The aim is to reduce nerve excitability and dampen pain amplification. For some patients this may reduce pain intensity, improve sleep, and increase tolerance for pacing, physiotherapy, and graded activity.
Who this treatment helps
IV lidocaine infusion may be considered for people with:
- Wide spread pain consistent with fibromyalgia or central sensitisation
- Neuropathic features such as burning, tingling, shooting pain, or abnormal sensitivity
- Pain that remains high despite medication, physiotherapy, pacing, and lifestyle measures
- Symptoms that significantly disrupt sleep, daily function, or activity tolerance
- Frequent flare ups that limit progress with rehabilitation
- Complex pain presentations where nerve sensitivity appears to be a major driver
A consultation is required to confirm suitability and ensure that IV lidocaine infusion matches your medical history, medications, and symptom pattern.
What is IV lidocaine infusion
IV lidocaine infusion involves administering lidocaine through a drip into a vein over a set period while monitoring heart rate, blood pressure, and overall response. The dose is chosen to influence pain processing pathways without producing the full numbing effect associated with local anaesthetic injections.
The aims of treatment may include:
- Reducing nerve sensitivity and pain amplification
- Improving comfort to support movement and rehabilitation
- Reducing the intensity or frequency of flare ups in selected patients
- Improving sleep and daily coping when pain levels settle
Your consultant will explain whether a single infusion or a planned series is more appropriate based on your response and wider care plan.
What to expect during the procedure
Your visit typically includes:
- Review of symptoms, medications, and medical history
- Confirmation of suitability and discussion of realistic outcomes
- Baseline observations such as heart rate and blood pressure
- Placement of a small cannula into the arm or hand
- Continuous monitoring throughout the infusion
- Regular checks to assess comfort and any side effects
- A short observation period after completion before discharge
The infusion duration varies depending on the clinical protocol and your individual tolerance.
After the procedure
After an IV lidocaine infusion it is common to experience:
- Mild tiredness or fatigue for the rest of the day
- Temporary lightheadedness
- A gradual change in pain levels over hours to days
Your consultant may advise:
- Rest for the remainder of the day
- Avoid driving for a period if advised or if you feel lightheaded
- Continue pacing and gentle activity rather than sudden increases
- Keep a simple symptom diary tracking pain, sleep, and function
- Continue physiotherapy or graded activity if already in progress
Some patients notice improvement quickly, while others need more time to judge the effect. Response varies and not everyone benefits.
Benefits
- May reduce wide spread pain intensity in selected patients
- May reduce nerve sensitivity and abnormal pain responses
- Can improve sleep when pain levels settle
- May improve ability to participate in physiotherapy and graded exercise
- May reduce reliance on some medications in selected cases
- Can support better daily function and coping when symptoms are less intense
Possible risks and side effects
IV lidocaine infusion is delivered in a monitored setting to support safety, but side effects can occur.
- Lightheadedness or dizziness
- Nausea
- Tingling sensations or metallic taste
- Temporary blurred vision
- Drowsiness or fatigue
- Changes in blood pressure or heart rate
- Allergic reaction, which is rare
Your consultant will screen for risk factors and adjust the plan if there are any concerns.
When to consider other options
If IV lidocaine infusion is not suitable or does not provide meaningful benefit, your consultant may discuss ketamine infusion for selected sensitisation patterns, trigger point injection for muscle driven pain, medication review to improve pain or sleep support, structured pacing plans, or multidisciplinary care.
Safety note
Please inform your consultant if you have heart rhythm problems, liver disease, allergies to local anaesthetics, are pregnant, or take medicines that may interact with lidocaine. You may be advised to arrange transport home depending on the protocol and how you feel afterwards.
Arrange a consultation to discuss whether IV lidocaine infusion may be appropriate for your fibromyalgia or wide spread pain.
You can also explore our wide spread body pain and fibromyalgia treatments, view all pain treatments, or learn more about our pain management services.