The Pain Is Real. The Fatigue Is Real. And the Treatments You Have Tried Have Not Been Enough.

Fibromyalgia is not in your head. It is in your central nervous system, and that distinction matters enormously for treatment.

People living with fibromyalgia typically spend years before getting a diagnosis. Then they spend more years trying medications that help incompletely, physical therapy that improves function at the margins, and sleep interventions that address a symptom without touching the cause. The three FDA-approved medications for fibromyalgia, duloxetine, milnacipran, and pregabalin, provide meaningful relief for some patients and underwhelming results for many others. They address neurotransmitter levels. They do not address the neurological mechanism generating the pain.

At Ketamine Wellness Infusions PA, located minutes from Lower Merion Township in Bala Cynwyd, we offer IV ketamine infusions for fibromyalgia patients who have not achieved adequate relief through conventional treatment. Ketamine is an NMDA receptor antagonist that directly targets the central sensitization mechanism at the root of fibromyalgia, working at a level that no FDA-approved fibromyalgia medication reaches.

Our founder Jill Gabay is a senior CRNA with more than 30 years of anesthesia experience and a member of the American Society of Ketamine Physicians, Psychotherapists and Practitioners. She is personally present for every infusion.

If you have fibromyalgia and conventional treatment has not given you adequate control, schedule a consultation. The mechanism of ketamine is specifically suited to what is actually wrong.

What Fibromyalgia Actually Is, Neurologically

Fibromyalgia affects 1 to 5% of the population and is the second most common musculoskeletal condition after osteoarthritis. Its hallmarks are widespread chronic pain, profound fatigue, sleep disturbance, cognitive difficulties often called fibro fog, and heightened sensitivity to touch, temperature, pressure, and sound. Despite the absence of tissue damage or detectable inflammation on standard tests, the pain is neurologically real and measurable.

The International Association for the Study of Pain defines central sensitization as an increased responsiveness of nociceptive neurons in the central nervous system to their normal or subthreshold input. This is the core neurobiological mechanism of fibromyalgia. The brain and spinal cord become amplifiers, generating and intensifying pain signals far beyond what any peripheral stimulus would warrant. The nervous system is not broken in the way a joint is broken or a disc is herniated. It has been reorganized into a state of chronic hyperexcitability.

At the molecular level, this reorganization is driven by upregulation and sustained activation of NMDA receptors at spinal and supraspinal sites, mediated by glutamatergic neurotransmission. Research has found elevated glutamate levels in specific brain regions of fibromyalgia patients, and the pattern of NMDA receptor dysregulation in this condition matches closely with the receptor that ketamine blocks.

This is not a coincidence. It is the clinical rationale for investigating ketamine as a fibromyalgia treatment, and it is why the research consistently points in the same direction.

What the Research Shows About Ketamine for Fibromyalgia

The evidence base for ketamine in fibromyalgia is growing, with an important nuance that is worth being transparent about: single low-dose infusions produce short-term relief, while higher doses and longer infusion courses produce more substantial and more durable outcomes.

A systematic review published in the Ochsner Journal examined all available IV ketamine studies in fibromyalgia patients and found that clinical studies consistently revealed reduction in self-reported pain intensity attributable to NMDA receptor blockade addressing central sensitization. The review identified a clear dose response, with case studies suggesting that increases in total ketamine dose and longer, more frequent infusions are associated with more effective pain relief and longer-lasting analgesia.

A 2024 systematic review published in Advances in Rheumatology analyzed six published studies totaling 115 fibromyalgia patients treated with ketamine. Visual analog scale pain scores before treatment ranged from 59 to 100 millimeters. After treatment, they fell as low as 2 millimeters in responsive patients, with the review concluding that ketamine demonstrates effectiveness and safety in fibromyalgia patients in the short term.

A real-world retrospective study published in 2025 examining 53 fibromyalgia patients who underwent a three-day IV ketamine induction protocol found that 41.5% were complete responders and 15% were partial responders at three-month follow-up. Complete responders continued benefiting from maintenance ketamine for a mean of 15.6 months.

Research published in Pain also documented that ketamine reduces muscle pain, temporal summation, and referred pain in fibromyalgia patients, all three of which are characteristic manifestations of the central sensitization that defines the condition.

The honest clinical picture is this: not every fibromyalgia patient responds to IV ketamine, and the evidence supports a series of infusions rather than a single treatment. For patients who have exhausted standard options and are living with significant functional impairment, the potential benefit is real and the mechanism is directly aligned with the known pathophysiology of the disease.

How Ketamine Addresses Fibromyalgia Differently Than Standard Medications

The three FDA-approved fibromyalgia medications, duloxetine, milnacipran, and pregabalin, work through monoaminergic pathways, either adjusting serotonin and norepinephrine reuptake or blocking calcium channels to modulate neural activity. They provide partial relief for some patients, often plateau, and address the symptoms of central sensitization rather than the sensitization mechanism itself.

Ketamine works directly on the NMDA receptors driving central sensitization. By blocking these receptors, it interrupts the self-reinforcing excitatory feedback loop in the dorsal horn of the spinal cord and supraspinal pain processing centers. Research suggests ketamine may provoke what some investigators have described as a reset of the central nervous system, reversing the sensitization state that fibromyalgia has established in the pain-processing network.

Ketamine also interacts with dopamine receptors in the limbic system, a mechanism hypothesized to contribute to its analgesic effects in fibromyalgia specifically, given that disrupted dopaminergic function has been implicated in fibromyalgia pain pathways. And it produces anti-inflammatory effects at central sites that standard fibromyalgia medications do not engage.

For patients whose fibromyalgia has not adequately responded to duloxetine, milnacipran, or pregabalin, either individually or in combination, ketamine offers a genuinely different biological approach.

What to Expect During Treatment at Our Clinic

Your consultation begins with Jill Gabay reviewing your fibromyalgia diagnosis, symptom history, prior treatment responses, current medications, and overall health picture. Fibromyalgia frequently presents alongside depression, anxiety, and sleep disorders, and understanding the full clinical picture matters for determining whether IV ketamine is a well-suited next step.

The standard initial course is six IV ketamine infusions completed over approximately two to three weeks. Each session lasts 40 to 60 minutes in a calm, quiet room with blankets, an eye mask, and essential oil diffusers. Jill or a member of our care team is present throughout every infusion, monitoring your vital signs continuously. You are not in that room alone at any point.

Many fibromyalgia patients describe the infusion experience as deeply calming. The mild dissociative effects that occur during the session are temporary, resolve quickly when the infusion ends, and are well understood by our clinical team. Patients who have spent years living in persistent pain often describe the experience of reduced pain during and after infusions as disorienting in the best possible way.

After your series, Jill conducts personal follow-up check-ins to assess your response to treatment. Some patients with fibromyalgia find sustained relief following the initial six-infusion series. Others benefit from periodic maintenance infusions. The research supports a maintenance approach for complete responders, and your ongoing plan is built around how your body actually responds.

Why Fibromyalgia Patients Find Meaningful Care at Our Clinic

People with fibromyalgia are often dismissed. They have been told their pain is psychological, or that there is nothing more to try, or that they simply need to manage. They have spent years advocating for themselves with providers who do not fully understand the neurobiological reality of what they are living with.

That experience is not what you will find here.

Jill Gabay takes fibromyalgia seriously as the neurological condition it is. Her depth of experience in anesthesia pharmacology and her specific clinical expertise in ketamine at psychiatric and pain dosing levels means she understands what she is administering and why. Her physician supervisor Dr. Rubin brings more than 20 years of clinical experience as a board-certified oncologist and Clinical Associate Professor at Drexel University College of Medicine. Staff member Tee completes a care team that patients consistently describe as warm, attentive, and genuinely present.

Our clinic at 146 Montgomery Ave, Suite 202 in Bala Cynwyd sits inside Lower Merion Township, accessible from Ardmore, Wynnewood, Narberth, Penn Valley, Bryn Mawr, and throughout the Main Line. We hold a 5.0 Google rating built entirely on patient experience.

Frequently Asked Questions About Fibromyalgia Treatment in Lower Merion Township