Overview
In fibromyalgia and other wide spread pain patterns the nervous system can become over responsive. Pain can be triggered by light touch normal movement temperature changes stress or poor sleep. Over time the brain and spinal cord may amplify pain signals leading to persistent symptoms even without ongoing tissue damage.
Ketamine affects NMDA receptors which play a role in pain amplification and central sensitisation. At low doses under close monitoring ketamine infusion may help reduce neuropathic pain reduce sensitivity and improve overall coping in selected patients. It is generally considered when other treatments have provided limited benefit and when symptoms suggest nerve related or sensitisation driven pain mechanisms.
This treatment is not appropriate for everyone. Suitability depends on medical history current medications symptom pattern and clinical assessment.
Who This Treatment Helps
Ketamine infusion may be considered for people with:
• Wide spread pain with features of central sensitisation
• Neuropathic pain symptoms such as burning tingling electric shock sensations or marked sensitivity
• Fibromyalgia symptoms that significantly disrupt sleep and function
• Pain that has not improved with medication physiotherapy pacing and supportive treatments
• Severe flare ups that prevent progress with graded activity and rehabilitation
• Complex pain presentations where a consultant identifies pain amplification pathways as a major contributor
A consultation is required to confirm suitability and discuss realistic goals and expected outcomes.
What Is a Ketamine Infusion
A ketamine infusion involves delivering a carefully controlled low dose of ketamine through a drip into a vein. The infusion is performed in a clinical setting with monitoring of heart rate blood pressure and oxygen levels. The dose and duration are selected to influence pain pathways while maintaining safety and tolerability.
The aims of treatment may include:
• Reducing pain amplification within the nervous system
• Reducing neuropathic pain intensity in selected patients
• Improving sleep and activity tolerance when pain levels settle
• Supporting progress with pacing physiotherapy and rehabilitation
Some patients are offered a single infusion as a trial. Others may benefit from a series depending on response and clinical judgement.
What to Expect During the Procedure
Your visit typically includes:
• Review of symptoms medical history medications and suitability
• Explanation of the infusion plan and expected sensations
• Baseline observations including heart rate blood pressure and oxygen levels
• Placement of a small cannula into the arm or hand
• Continuous monitoring during the infusion
• Regular check ins by the clinical team
• A short observation period after completion before discharge
Infusion duration and protocol vary and your consultant will explain the plan clearly before treatment begins.
After the Procedure
After a ketamine infusion you may experience:
• Tiredness or fatigue
• Lightheadedness
• Nausea
• Mild changes in perception or feeling spaced out during or shortly after the infusion
Your consultant may advise:
• Rest for the remainder of the day
• Avoid driving for 24 hours or as advised by the team
• Keep a symptom diary tracking pain sleep mood and function
• Continue pacing and gentle activity rather than sudden increases
• Continue physiotherapy or graded activity plans when appropriate
Some people notice improvement within hours or days. Others notice gradual change over time. Response varies and not everyone benefits.
Benefits
Potential benefits may include:
• Reduced neuropathic or wide spread pain intensity in selected patients
• Reduced sensitivity to touch pressure or everyday movement
• Improved sleep when pain amplification settles
• Improved activity tolerance supporting rehabilitation
• Reduced flare up intensity or frequency in selected cases
• Improved overall quality of life when symptoms become less intrusive
Possible Risks and Side Effects
Ketamine infusions are delivered under monitoring to support safety. Possible side effects include:
• Nausea
• Dizziness or lightheadedness
• Temporary changes in blood pressure or heart rate
• Drowsiness or fatigue
• Mild dissociation or altered perception during infusion
• Headache
• Allergic reaction rare
Your consultant will screen carefully and explain individual risks based on your health profile.
When to Consider Other Options
If ketamine infusion is not suitable or does not provide meaningful benefit your consultant may discuss:
• IV lidocaine infusion where nerve sensitivity is prominent
• Trigger point injections for muscle based pain contributing to symptoms
• Medication optimisation for sleep and neuropathic pain
• Pelvic or general physiotherapy focused on pacing and graded activity
• Psychological support such as CBT and ACT approaches for chronic symptoms
• Multidisciplinary pain management strategies
Safety Note
Please inform your consultant if you have heart problems uncontrolled high blood pressure liver disease a history of severe mental health episodes are pregnant or take medicines that may interact with ketamine. You will usually need someone to accompany you home and you should not drive afterwards for the advised period.
Arrange a consultation to discuss whether ketamine infusion may be appropriate for your wide spread pain or fibromyalgia.