Ketamine & Fibromyalgia
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Fibromyalgia is a complex chronic pain condition that can affect nearly every aspect of daily life. In addition to widespread muscle and body pain, people may experience fatigue, disrupted sleep, brain fog, headaches, anxiety, and depression. Unfortunately, finding treatments that provide meaningful relief can be challenging.
Ketamine has gained increasing attention as a treatment for depression and certain chronic pain conditions—but what does the research actually tell us about ketamine for fibromyalgia?
Fibromyalgia and the Nervous System
Fibromyalgia is increasingly understood as involving changes in the way the brain and nervous system process pain. One important concept is central sensitization, where the nervous system becomes unusually sensitive to sensory and pain signals.
Think of it like the brain's pain "volume control" being turned up too high.
One of the pathways involved in this process is the brain's glutamate system, particularly NMDA receptors. Ketamine temporarily blocks NMDA receptors, which may help interrupt some of the amplified pain signaling associated with chronic pain.
Research in people with fibromyalgia has found that IV ketamine can temporarily reduce pain as well as temporal summation—a phenomenon where repeated pain signals become progressively more intense.¹˒²
So, Does Ketamine Help Fibromyalgia?
The answer right now is: possibly, but we need more research.
A recent systematic review examining ketamine specifically for fibromyalgia identified only six studies involving 115 patients. Most found some degree of short-term pain reduction following ketamine treatment, but the studies were small and used different doses and treatment protocols.³
Importantly, we don't yet have strong evidence that a single ketamine infusion produces lasting improvement.
In one randomized, double-blind study, patients receiving ketamine initially experienced greater pain relief, but researchers did not find a significant sustained benefit during the eight weeks following treatment.⁴
This suggests that ketamine can influence pain processing in fibromyalgia, but we still don't know which patients are most likely to benefit or whether longer or repeated infusion protocols might produce more durable results.
What About Neuroplasticity and Inflammation?
Ketamine's effects extend beyond pain signaling. Research—particularly in depression—suggests ketamine can influence glutamate signaling, BDNF, and neuroplasticity, or the brain's ability to form and reorganize neural connections.⁵
There is also growing research into the potential role of inflammation and neuroinflammation in chronic pain.
These mechanisms are exciting areas of research, but it is important not to get ahead of the science. We do not currently have evidence showing that ketamine improves fibromyalgia specifically by reducing neuroinflammation or increasing neuroplasticity.
A Whole-Person Approach at Áureo
At Áureo Clinic in Portland, Oregon, we recognize that chronic pain rarely exists in isolation. Fibromyalgia may overlap with sleep problems, depression, anxiety, chronic stress, nutritional concerns, hormonal changes, and other health conditions.
Our naturopathic doctors take an individualized approach that may include nutrition and lifestyle support, supplements or botanical medicine, acupuncture, bodywork, IV nutrient therapy, and strategies to support sleep and nervous-system regulation alongside conventional medical care.
These therapies are not proven to make ketamine more effective, but they allow us to address the broader health picture rather than focusing on pain alone.
For patients with difficult-to-treat fibromyalgia or chronic pain—particularly when depression or anxiety are also present—ketamine may be worth discussing as one potential part of a comprehensive treatment plan.
If you're interested in learning whether ketamine therapy may be appropriate for you, contact Áureo in Portland, Oregon to schedule an individualized consultation.
References
Graven-Nielsen T, Aspegren Kendall S, Henriksson KG, et al. Ketamine reduces muscle pain, temporal summation, and referred pain in fibromyalgia patients. Pain. 2000;85(3):483-491. doi:10.1016/S0304-3959(99)00308-5.
Sörensen J, Bengtsson A, Bäckman E, Henriksson KG, Bengtsson M. Pain analysis in patients with fibromyalgia: effects of intravenous morphine, lidocaine, and ketamine. Scand J Rheumatol. 1995;24(6):360-365. doi:10.3109/03009749509095181.
de Carvalho JF, de Sena EP. Ketamine in fibromyalgia: a systematic review. Adv Rheumatol. 2024;64. PubMed
Noppers I, Niesters M, Swartjes M, et al. Absence of long-term analgesic effect from a short-term S-ketamine infusion on fibromyalgia pain. Eur J Pain. 2011;15(9):942-949. doi:10.1016/j.ejpain.2011.03.008. PubMed
Kang MJY, Hawken E, Vazquez GH. The mechanisms behind rapid antidepressant effects of ketamine: a systematic review with a focus on molecular neuroplasticity. Front Psychiatry. 2022;13:860882. doi:10.3389/fpsyt.2022.860882. PubMed
Dr. Lindsay Wilkinson, ND, is a compassionate naturopathic doctor dedicated to empowering her patients to achieve optimal health and well-being. With a focus on integrative medicine, she combines evidence-based treatments with holistic approaches to address a wide range of health concerns. Dr. Wilkinson's passion lies in guiding her patients toward balanced wellness through personalized care and support.