Ketamine Infusion for Chronic Pain

Ketamine infusion for chronic pain is a treatment in which ketamine, an NMDA-receptor antagonist, is given through an IV at low, sub-anesthetic doses while you are monitored. It is used off-label for selected chronic pain conditions, most notably complex regional pain syndrome (CRPS) and some neuropathic pain, when other treatments have not provided enough relief.

What Is Ketamine Infusion?

Ketamine was developed in the 1960s as an anesthetic and is still used in operating rooms and emergency care. It is a Schedule III controlled substance in the United States. At much lower doses than those used for anesthesia, ketamine blocks NMDA receptors, which play a key role in central sensitization, a state in which nerve cells in the spinal cord and brain become more excitable and amplify pain signals.

By dampening this amplification, ketamine is thought to reduce pain intensity in some people with long-standing pain. Some people also search for this treatment as ketamine therapy; on this page we focus on its use for pain.

Which Pain Conditions Is Ketamine Infusion Considered For?

Consensus guidelines from the American Society of Regional Anesthesia and Pain Medicine (ASRA), the American Academy of Pain Medicine (AAPM) and the American Society of Anesthesiologists (ASA) reviewed IV ketamine for chronic pain. The evidence is strongest for complex regional pain syndrome, and ketamine infusion may be considered for:

• Complex regional pain syndrome (CRPS), where evidence for short-term pain relief is most consistent.
• Neuropathic pain, including some cases of peripheral neuropathy and other nerve pain that has not responded to standard treatment.
• Other refractory pain, such as mixed or widespread pain, where evidence is more limited and the decision is individualized.

A systematic review and meta-analysis of randomized trials found that ketamine infusions can reduce chronic pain in the short term, with benefit varying by condition and dose. Ketamine for pain management is usually one part of a broader plan, not a stand-alone cure.

Who Is a Candidate for Ketamine Infusion?

Ketamine infusion therapy is generally considered for people whose pain has not responded well enough to other treatments, such as medications, physical therapy, and interventional procedures. Candidacy is decided individually after a full evaluation of your diagnosis, medical history, current medications, and overall health. Your physician will review whether ketamine is safe and appropriate for you before any infusion is scheduled.

What to Expect During a Ketamine Infusion

Ketamine infusion is given in a monitored setting. A small IV line is placed, and ketamine is delivered slowly at a low dose while staff check your blood pressure, heart rate, oxygen level, and comfort. The dose and pace are adjusted to how you respond.

After the infusion, you rest until the effects wear off and you are cleared to leave. Plan for another adult to drive you home, and avoid driving, operating machinery, or making important decisions for the rest of the day. Your physician will explain the treatment plan that fits your condition.

Side Effects and Safety

Most side effects of ketamine infusion are short-lived and occur during or soon after treatment:

• Nausea or vomiting
• Dizziness or drowsiness
• Dissociation, dream-like feelings, or changes in vision and hearing
• Temporary increases in blood pressure and heart rate
• Headache

Ketamine is a controlled substance with misuse potential. Long-term or repeated use has been linked to bladder problems (ketamine-related cystitis), mainly in people who misuse it, and to liver and bile-duct problems, which have also been reported with repeated medical infusions. For this reason it should be given only under medical supervision, at sub-anesthetic doses. Tell your physician about your full medical history, including heart, blood pressure, and substance use history, so the team can judge whether it is safe for you.

Ketamine Infusion vs. Other Pain Treatments

Ketamine infusion is one option among several. Depending on your diagnosis, your plan may also include:

• Sympathetic nerve blocks, often used for CRPS
• Spinal cord stimulation or DRG stimulation for persistent nerve-related pain
• Medications such as nerve-pain agents, along with physical and occupational therapy

These treatments can be combined. The goal is better function and more manageable pain, not just a lower pain score for a few days.

Cost and Insurance

Insurance coverage for ketamine infusion varies. Because using ketamine for chronic pain is often off-label, many plans do not cover it. Please contact our office at 631-310-0000 to discuss coverage and options before you begin.

A Note on Mental Health

Ketamine is also being studied and used for depression. This page focuses on pain care; if you are interested in ketamine for mood symptoms, talk with your psychiatrist or mental health provider.

Ketamine Infusion at SpinePain Solutions

At SpinePain Solutions, Amit Sharma, MD, Chief, Division of Pain Medicine, Good Samaritan University Hospital, and our team evaluate whether ketamine infusion fits your pain plan. If you are looking for ketamine infusion on Long Island, you can book at any of our offices in Bay Shore, Commack or Farmingdale (see all office locations), or call 631-310-0000.

Frequently Asked Questions

Medical References

1. Cohen SP, et al. Consensus guidelines on the use of intravenous ketamine infusions for chronic pain from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists. Reg Anesth Pain Med. 2018;43(5):521-546. PubMed.
2. Orhurhu V, et al. Ketamine infusions for chronic pain: a systematic review and meta-analysis of randomized controlled trials. Anesth Analg. 2019;129(1):241-254. PubMed.
3. Ma X, Yan J, et al. Application of ketamine in pain management and the underlying mechanism. Pain Res Manag. 2023. PubMed.
4. KETALAR (ketamine hydrochloride) injection, prescribing information. Par Health USA, LLC; revised 03/2026. DailyMed.
5. Orhurhu VJ, Vashisht R, Claus LE, Cohen SP. Ketamine Toxicity. StatPearls [Internet]. StatPearls Publishing; 2023. NCBI Bookshelf.
6. Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152(3 Suppl):S2-S15. PubMed.