A 70-year-old woman suffering from chronic postherpetic neuralgia since 2015 stated that the pain is so intense that everyday activities such as caring for her grandchildren became almost impossible. She described the pain as a burning sensation throughout that gradually worsens with activity. The patient has tried the controlled substances Tramadol, Cymbalta and medicinal marijuana to treat myalgia, but was unable to experience a significant reduction in pain. The patient tried multiple combinations of medications and treatments as well, but to no avail.
Pending approval from the patient’s cardiologist, the experts in pain management at Premier Pain & Spine(PPS) recommended that the patient go through a series of intravenous ketamine infusions over 3 days, continue with Tramadol at 2 to 3 tabs per day and follow up within a month. It’s important to note that the patient has a history of depression as well, which can sometimes cause or prolong chronic pain. Another reason fo choosing ketamine infusion therapy for this case is that there’s significant evidence that ketamine infusions are effective in treating depression as well.
First follow up (1-week post infusion)
A follow up visit was scheduled where the patient reported a 50% reduction in pain. The patient also shared that she experienced days where she had no pain at all, which is a significant improvement from the constant pain experienced prior to ketamine infusion therapy. However, the patient still reported pain flares which required the usage of Tramadol, but she reported that she was able to scale back her usage to 1 to 2 tabs per day from 2 to 3.
Second follow up (1-month post infusion)
During the second post infusion office visit, the patient maintained a 50% reduction in pain, but added that she is completely pain free when she takes her Tramadol as well. As a result of the ketamine infusions, the patient is still able to take less than her prescribed dosage Tramadol. The patient also stated that she is overwhelmingly happy with the results of the infusions and treatment regimen provided by PPS.
Moving forward PPS will monitor the patient’s pain levels and provide ketamine boosters every 2 to 3 months as needed. The patient will also continue to use prescribed Tramadol sparingly for pain flares.