Fibromyalgia is a leading cause of chronic pain affecting millions of Americans every day. Researchers hypothesize that central sensitization is the primary mechanism involved, but there are many other factors including genetics, immunological, psychological, and hormones that influence the development of fibromyalgia. Central sentization refers to a process called “wind-up” where the central nervous system gets regulated into a persistent state of high reactivity. This persistent or wound up state of reactivity lowers the threshold for what causes pain and can create extreme pain even with minimal stimulus. This phenomena is believed to be related to neuroplasticity which is mediated by the N-Methyl-D-aspartate (NMDA) receptors located in the spinal cord.
So how exactly do ketamine infusions help in fibromyalgia?
Ketamine’s most immediate mechanism of action is to block NMDA receptors. It is the most potent clinically available NMDA receptor antagonist today. By blocking the activity of the NMDA receptor, ketamine seems to reset the altered pain receptors that have become hypersensitized in patients with fibromyalgia.