Which Types of IV Infusion Work for Chronic Pain?

29 Nov Which Types of IV Infusion Work for Chronic Pain?

A significant proportion of the population is living with a chronic pain syndrome. This includes chronic lower back pain and conditions like fibromyalgia (a condition where patients feel pain all over their body with no apparent cause). In fact, one study by the British Medical Journal estimated between one third and two-thirds of the population suffers from chronic lower back pain. At the moment the common treatment options leave a lot to be desired yet the burden of chronic pain conditions on society continues. One study estimates that including losses in productivity and the cost of pain medication the US spend $560 billion dollars a year on chronic pain.  Could IV infusions work for chronic pain and if so which types?

There are a number of medications currently available via an IV infusion. They can be used to treat a wide range of chronic pain conditions like fibromyalgia, phantom limb pain, post-herpetic neuralgia, complex regional pain syndrome as well as stroke pain. An IV infusion means the drug is given to the blood system directly – meaning they are much more effective than when taking via the oral route where they are digested. The drugs that are available include Lidocaine, ketamine, clonidine, and magnesium.

Lidocaine is the most studied and best-researched option. IV lidocaine infusion for fibromyalgia is an increasingly common treatment option. As a local anesthetic lidocaine numbs the pain by stopping pain signals from being transmitted to the brain. It does this by stopping nerves that take a signal from the painful area up to the brain from “firing” or letting off a signal. This reduces pain as without a signal the brain cannot detect pain!

Other options of treatment for chronic pain include ketamine. This drug is often associated with the recreational use or its equestrian use as a horse tranquilizer but it is increasingly being researched for its pain relieving and antidepressant properties. A very small amount of the drug is infused (far lower than a recreational dose which may make a patient hallucinate) which stops pain signals from going up with spinal cord into the brain.

Are there any risks?

No treatment comes without risks. And so IV infusions are no exception. There is some risk of infection from the needle (the same as if you had a drip in hospital!) and there are also risks associated with the individual drug being given (for instance ketamine has hallucinogenic properties as previously mentioned).  

Is there any evidence it works?

IV infusions have not been used to treat chronic pain for long. However there is an increasing body of scientific work that suggests its benefits could be what the world of chronic pain has been looking for. One  review study published in 2017 called lidocaine infusions “a promising therapeutic approach for chronic pain!”