Chronic Pain/CRPS

Palo Alto Mind Body

Concierge Psychiatry & Ketamine Therapy Clinic located in Palo Alto, CA

Chronic pain affects more Americans than diabetes, heart disease, and cancer combined. Whether your chronic pain is due to fibromyalgia, complex regional pain syndrome, or another underlying cause, M Rameen Ghorieshi, MD, MPH, and colleagues at Palo Alto Mind Body can help you find long-term relief with a customized treatment plan. To learn more about how they can help you overcome chronic pain, call the office in Palo Alto, California, or send a confidential email. We also serve many patients located in the surrounding Bay Area, such as South Bay, North Bay, East Bay, Peninsula, San Jose, and San Francisco.

Chronic Pain/CRPS Q & A

older couple smiling

When does my pain become chronic?

Chronic pain is generally defined as ongoing or recurrent pain that lasts longer than twelve weeks or beyond the time it takes tissues to normally heal. Although chronic pain has many causes, the top three causes are lower back pain, severe headaches, and neck pain.

Why is it hard to treat my pain?

The truth is that most pain relievers aren’t very effective against chronic pain syndromes. The relief they provide is temporary at best, which doesn’t help when your pain is chronic.

Chronic pain also leads to a condition called central sensitization, which worsens the pain cycle. Biochemical changes occur in your central nervous system when your nerves constantly carry pain messages to your brain. As a result, you become overly sensitive and experience pain from non-painful stimuli, like the touch of soft clothing.

What type of pain is caused by mental health disorders?

Mental health disorders like anxiety, depression, and PTSD cause physical pain and may also intensify pain from other physical causes.

This connection between mental health and pain is not “all in your head.”  Psychiatric disorders and pain conditions share some of the same nervous system pathways.  

The shared overlap is so significant that primary care physicians often prescribe tricyclic antidepressants to relieve neuropathic pain, and with recent treatment advancements, mind-body expert Dr. Ghorieshi utilizes evidence-based psychotherapies and advanced treatments such as IV Ketamine infusions to relieve chronic pain disorders, even complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy (RSD).




What is complex regional pain syndrome (CRPS)?

CRPS, also sometimes referred to as chronic regional pain syndrome, is a chronic pain condition that typically affects one limb, whether an arm, hand, leg or foot. In about 90% of all cases, CRPS is triggered by trauma or injury, then one of two types of CRPS develops afterward, type 1 or type 2:

CRPS type 1

Also known as reflex sympathetic dystrophy syndrome (RSD). Type 1 causes chronic pain without nerve damage in the affected limb.

CRPS type 2

This type has the same symptoms as type 1, though with sustained nerve damage.

What symptoms will I develop with CRPS?

Persistent, severe pain is the primary symptom of complex regional pain syndrome. It may spread to the entire arm or leg even when the injury and pain began in your hand or foot. The affected area may be so hypersensitive that the gentlest touch feels painful.

You may also experience:

  • Changes in skin temperature, color, or texture
  • Swelling of the affected limb
  • Changes in hair or nail growth
  • Stiff joints in the affected area
  • Decreased movement in the affected limb
  • Tremors or jerking in the affected limb

When CRPS goes untreated, it can worsen, causing tissue deterioration or muscles that tighten and freeze into a fixed position.



What is fibromyalgia?

Fibromyalgia is a chronic disease known by one key symptom: widespread pain in your muscles and soft tissues. You may be diagnosed when you have pervasive pain for longer than three months and the pain is not explained by an underlying medical condition.

The pain of fibromyalgia ranges from an ache to a shooting pain, often becoming debilitating. You may also develop:

  •  Extreme fatigue
  •  Difficulty sleeping
  •  Anxiety and depression
  •  Difficulty concentrating and paying attention

Fibromyalgia may be caused by neurochemical imbalances in your central nervous system that affect the way your body processes pain.

How are chronic pain conditions treated?

Chronic pain conditions are traditionally treated with a multimodal approach that includes some combination of medication, physical therapy, and interventional techniques such as nerve blocks and spinal cord stimulation.

The providers at Palo Alto Mind Body augment these treatments by offering IV Ketamine infusion therapy proven to reduce and often eliminate chronic pain.  In addition, their functional medicine providers offer food sensitivity analysis.

Studies show that autoimmune conditions, fibromyalgia, idiopathic pain or numbness, and chronic fatigue syndrome can often improve or fully resolve with dietary change. They provide genetic and vitamin testing to address any underlying vitamin deficiencies that could be contributing to your pain.

Psychotherapy can often help patients learn to manage pain, relieve stress, and learn ways to structure their lives to minimize their pain.

Will ketamine infusion relieve my chronic pain?

Ketamine is used in high doses to provide anesthesia during surgery. When it’s given in low doses through an intravenous infusion, it effectively relieves pain and balances neurotransmitters associated with mental health disorders.

At Palo Alto Mind Body, an initial phase of ketamine consists of about