Low-Dose Ketamine for Chronic Pain: Our Biopsychosocial Case Series (Published in Frontiers)
Our team’s case series was just published in Frontiers in Pain Research, describing a multidisciplinary chronic pain model that pairs low-dose ketamine (IV/IM/sublingual, individualized) with structured adjunct care—including Somatic Tracking / Pain Reprocessing Therapy (PRT), IFS/EMDR when appropriate, breathwork/meditation, and functional movement coaching.
Chronic pain is rarely “just” a tissue problem. For many people, it becomes a full-body, full-life experience shaped by the nervous system, stress physiology, past injury (and sometimes trauma), beliefs and expectations, movement habits, and the social reality of living with persistent symptoms.
That’s the foundation of the biopsychosocial model: pain is influenced by biology (the body and nervous system), psychology (attention, fear, mood, meaning-making), and social context (relationships, roles, work, and environment). In that lens, effective care often needs more than one lever—especially when pain and disability have been present for months or years.
This post breaks down the paper’s key points in “plain English”: the clinical approach we used, the rationale for pairing conservative ketamine dosing with integration-forward therapies, and what three real-world disability cases reported in terms of pain, suffering, function, and quality of life.
What we studied:
This publication isn’t a large randomized trial. It’s a detailed report of three real-world patients treated in a private clinic (NeuroPain Health) in Florida from March to July 2024, with follow-up information gathered for about a year after the initial treatment period.
Because each person’s history and needs were different, treatment was individualized. Still, the overall structure was consistent:
Low-dose ketamine was used as a clinical tool (not as a stand-alone “fix”).
Integration-forward adjunct therapies were layered in to help patients retrain the nervous system’s relationship to pain, rebuild function, and change the day-to-day experience of symptoms.
The paper reports short-term outcomes after an initial 4–6 week phase, plus longer-term patient-reported outcomes. Importantly, the authors note these findings are preliminary and intended to support further, more rigorous research.
Why pair ketamine with adjunct therapies?
Ketamine is known for analgesic effects at sub-anesthetic doses, and it can also shift perception, threat responses, and mental flexibility for some patients during and after treatment. In a chronic pain population, that temporary shift can be clinically useful, especially when it’s followed by structured work that helps the brain and body “learn” something different.
Adjunct therapies in this model were selected to target common chronic pain patterns, like:
heightened threat reactivity (“my body isn’t safe”),
fear-based avoidance of movement,
pain catastrophizing and rigid narratives,
dissociation from the body or over-fixation on symptoms,
deconditioning and protective movement habits.
If ketamine helps loosen the grip of entrenched pain circuits for a period of time, the adjunct care is designed to use that window for re-patterning—cognitively, emotionally, and physically.
What the three cases reported:
The case series includes three chronic pain disability presentations:
Patient A: chronic pain following tethered spinal cord syndrome after a motor vehicle accident
Patient B: lower limb dystonia with significant pain and functional limitations
Patient C: spinal cord injury with chronic facial pain following a cycling accident
Outcomes were summarized in a table using pain ratings and patient-reported change in suffering and function.
Patient A
Pain rating: decreased from 8/10 to 5/10
Suffering: reported ~75% reduction
Function: reported meaningful improvements in day-to-day movement and coping, with better interpretation of sensations and fewer pain flares over time.
Patient B
Pain rating: decreased from 8/10 to 4/10
Suffering: reported ~50% reduction
Function: reported improved participation in activities of daily living, returning to movement (including swimming/cycling), and a notable shift in identity—less fused with the diagnosis and more able to relate to symptoms with perspective and agency.
Patient C
Pain rating: decreased from 6/10 to 5/10
Suffering: reported ~10–15% reduction
Function: reported being ~70–80% back to prior function, resuming cycling with increased distance per ride, and improved ability to shift focus from pain to gait mechanics, with better coping around triggers and facial pain.
Across all three cases, the “win” was not limited to the pain score. The reported gains included improvements in function, coping, emotional tone, and quality of life…areas that often define whether someone feels like they’re getting their life back.
The paper also reports that no serious adverse events occurred during ketamine administration sessions in these cases.
What this case series does (and doesn’t) mean:
A case series is valuable because it shows what a real clinical approach looks like in real patients, including nuance and individualized decision-making. It can highlight patterns worth studying.
At the same time, it has clear limitations:
There’s no control group, so we can’t isolate which component drove which outcome.
The sample is small (n=3), so the findings can’t be generalized broadly.
Outcomes rely heavily on patient-reported experience, which is meaningful clinically, but future studies benefit from validated measures (pain interference, functional scales, catastrophizing, mood, etc.).
That’s why the paper frames these results as hypothesis-generating—a signal that this conservative, integration-forward model is worth evaluating in larger, controlled trials.
The takeaway:
This publication describes a multidisciplinary approach for chronic pain that pairs low-dose ketamine (IV/IM/sublingual, individualized) with structured adjunct therapies (Somatic Tracking/PRT, IFS/EMDR when appropriate, breathwork/meditation, and functional movement coaching). In three chronic pain disability cases, patients reported improvements in pain, suffering, function, and quality of life, with an intentional focus on minimizing ketamine exposure.
If you’re a clinician, researcher, or patient exploring chronic pain care models, the full paper includes protocol details, timelines, and richer case narratives that may help guide future research and clinical discussion.
Why low-dose?
We intentionally focused on conservative, individualized dosing for two reasons:
First, it supports a “minimum effective dose” approach—aiming for a therapeutic experience a patient can tolerate, remember, and integrate, rather than assuming more intensity leads to better outcomes.
Second, lower-dose protocols tend to feel more approachable for many patients who are curious about ketamine but understandably cautious.
Ketamine is a controlled medication, so responsible clinical use matters. That includes appropriate screening, medical oversight, monitored administration, and structured follow-up—along with clear boundaries that reduce misuse risk and keep the treatment anchored in safety and outcomes.
Educational note: This article summary is for informational purposes only and is not medical advice. Ketamine is not appropriate for everyone and should be administered and integrated within an appropriate medical and therapeutic container.