Medically reviewed by Zahida Samat, MSN, AGNP-C · Last updated October 19, 2026
You have tried the medications, the injections, the physical therapy. Some helped for a while. The pain is still there when you wake up, shaping your work, your sleep, and your mood. If that sounds familiar, you are not alone. Chronic pain affects about 1 in 5 U.S. adults, and many run out of standard options. Ketamine therapy is one of the few non-opioid treatments with clinical evidence for this kind of stubborn pain. At Z&Z Wellness, an integrative medicine clinic in Alexandria, VA, we offer medically supervised ketamine therapy for hard-to-treat pain. Here is what to know before deciding if it is right for you.
Quick answer: does ketamine help chronic pain?
Yes, for some people. Ketamine is a non-opioid medicine that blocks NMDA receptors, which helps "reset" pain signals that have become stuck on high. The strongest evidence is for complex regional pain syndrome (CRPS). It may also help neuropathic (nerve) pain and fibromyalgia. Relief often starts within hours to days, side effects are usually short-lived, and treatment must be medically supervised.
What is ketamine?
Ketamine is an anesthetic first developed in the 1960s and still used in hospitals and emergency care today. At lower doses, it relieves pain and lifts mood without putting you to sleep. Using ketamine for chronic pain is "off-label," meaning it is FDA-approved as an anesthetic and prescribed for pain based on clinical evidence and medical guidelines.
How does ketamine relieve chronic pain?
Ketamine blocks the NMDA receptor, a "volume knob" in the nervous system that turns pain signals up. In chronic pain, that knob can get stuck on high, a process called central sensitization. By blocking it, ketamine can calm overactive pain pathways. It also supports neuroplasticity, the brain's ability to form new, healthier connections, which may explain why relief can last after the medicine leaves your body.
What conditions can ketamine treat?
Complex regional pain syndrome (CRPS): The best-studied use. Randomized trials show meaningful pain reduction for weeks after an infusion series.
Neuropathic (nerve) pain: Neuropathic pain comes from damaged or overactive nerves and often feels burning, tingling, or electric. It includes diabetic neuropathy, post-shingles pain, and radiculopathy (pinched-nerve pain). Ketamine may help by calming nerve signals that are stuck on high, and studies show some patients get meaningful relief when other treatments have not worked.
Fibromyalgia: Causes widespread pain, fatigue, and poor sleep, and researchers believe central sensitization plays a key role. Some patients with fibromyalgia improve with ketamine, though results are more mixed than with CRPS and relief may be shorter. It works best as one part of a broader treatment plan.
Pain with depression or anxiety: Ketamine also has rapid antidepressant effects, which can help when pain and mood feed each other.
Is ketamine safer than opioids for pain?
Many people exploring ketamine also want to rely less on opioids. Ketamine works through a different pathway than opioids and does not slow breathing at therapeutic doses the way opioids can. For some patients, it can reduce the need for opioid pain medicine. Ketamine does have misuse potential, which is why it is given only under medical supervision with careful screening and monitoring. Here is what that looks like in practice.
What happens during ketamine therapy?
1. Medical evaluation
Your first visit is a conversation, not a procedure. Your provider reviews your diagnosis, medical history, current medications, and every pain treatment you have tried. Together, you talk through your goals, what relief would mean for your daily life, and whether ketamine is safe for you. A referral or records from your pain specialist or primary care provider help us plan your care.
2. Your treatment session
Ketamine is given by IV infusion, intramuscular (IM) injection, or by mouth, depending on your plan. During an IV session, your blood pressure, heart rate, and oxygen are monitored the whole time. Each pain infusion lasts 2 to 3 hours. Most people feel relaxed, floaty, or mildly "detached," which fades soon after the session ends.
3. Follow-up and maintenance
Pain treatment is given as a series of infusions over 3 to 5 days in a row, because relief builds with each session. After that, some patients come back for maintenance sessions when pain starts to return. Your plan is adjusted based on how you respond. Like any medical treatment, ketamine has side effects worth knowing about.
What are the side effects of ketamine?
Most side effects are mild and wear off within an hour or two:
Dizziness or blurred vision
Nausea
A temporary rise in blood pressure and heart rate
Dreamlike or "out of body" feelings during treatment
You will need someone to drive you home after each session.
Who should not get ketamine therapy?
Ketamine may not be safe if you have uncontrolled high blood pressure, serious heart disease, a history of psychosis, are pregnant, or have an active substance use disorder. Your provider will review these risks with you during your medical evaluation.
Frequently asked questions
How quickly does ketamine work for pain?
Many patients notice relief within hours to a few days of starting treatment. Results build over the initial series.
How long does pain relief from ketamine last?
It varies. In CRPS studies, relief lasted several weeks after an infusion series. Maintenance sessions can help extend results.
Is ketamine for chronic pain FDA-approved?
Ketamine is FDA-approved as an anesthetic. Its use for chronic pain is off-label but supported by published consensus guidelines.
Does insurance cover ketamine therapy for pain?
Most insurance plans do not cover ketamine infusions for chronic pain, so they are cash-pay at Z&Z Wellness. Contact us for current pricing.
Do I need a referral?
A diagnosis from your pain specialist or primary care provider helps us plan safe, effective care. Contact us and we will walk you through it.
Can ketamine help both my pain and my depression?
It may. Ketamine affects both pain pathways and mood, which is why many patients with chronic pain also notice improvements in mood. Learn how ketamine therapy works
Ketamine therapy for chronic pain in Alexandria, VA
If traditional pain treatments have not given you the relief you need, ketamine therapy may be worth exploring. Z&Z Wellness serves patients in Alexandria, Arlington, Fairfax, and across Northern Virginia, with care led by a nurse practitioner with 16+ years of critical care experience.
Book a Medical Evaluation · Learn more about ketamine therapy in Alexandria, VA
Sources
Cohen SP, et al. Consensus guidelines on the use of intravenous ketamine infusions for chronic pain. Regional Anesthesia & Pain Medicine. 2018;43(5):521–546.
Orhurhu V, et al. Ketamine infusions for chronic pain: a systematic review and meta-analysis of randomized controlled trials. Anesthesia & Analgesia. 2019;129(1):241–254.
Sigtermans MJ, et al. Ketamine produces effective and long-term pain relief in patients with complex regional pain syndrome type 1. Pain. 2009;145(3):304–311.
Schwartzman RJ, et al. Outpatient intravenous ketamine for the treatment of complex regional pain syndrome: a double-blind placebo controlled study. Pain. 2009;147(1–3):107–115.
This article is for education only and is not medical advice. Talk with a qualified provider about your situation.
