Spasticity Pain Specialist, Tampa, FL

What is Spasticity?

A condition in which there is an abnormal increase in muscle tone or stiffness of muscle, which might interfere with movement, speech, or be associated with discomfort or pain.

What can cause Spasticity?

Some of the conditions associated with spasticity are Spinal cord injury, Multiple sclerosis, Cerebral palsy, Stroke, Brain or head trauma, Amyotrophic lateral sclerosis (ALS), Hereditary spastic paraplegias, Metabolic diseases such as Adrenoleukodystrophy, Phenylketonuria, and Krabbe disease.

What treatments do we offer for Spasticity?

Pain management is considered integral part of addressing spasticity. Nerve blocks, Botox injections, Cryoneurolysis are minimally invasive interventions which help reduce or eliminate the need for muscle relaxants and improve function and quality of life.

What is the evidence on using Cryoneurolysis in Spasticity?

Rubenstein J, Harvey AW, Vincent D, Winston P. Cryoneurotomy to Reduce Spasticity and Improve Range of Motion in Spastic Flexed Elbow: A Visual Vignette. Am J Phys Med Rehabil. 2021 May 1;100(5):e65

Scobie J, Winston P. Case Report: Perspective of a Caregiver on Functional Outcomes Following Bilateral Lateral Pectoral Nerve Cryoneurotomy to Treat Spasticity in a Pediatric Patient With Cerebral Palsy. Front Rehabil Sci. 2021 Sep 6;2:719054.

Why Dr. Kalava?

Our practice stays ‘‘patient centric” with a goal of improving lives and eliminating need for medications and/or surgical procedures with minimally invasive interventions. Learn more when you come in for a consultation.

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Frequently Asked Questions

Ketamine is an anesthetic medication. It is a schedule 3 dissociative anesthetic, which has shown promising antidepressant effects that are both rapid and robust. It has been safely used for years as the ideal anesthetic in hospital and medical settings. When used under medical supervision, studies have shown ketamine infusions to have significant effects in healing treatment-resistant depression. It is on the World Health Organization’s List of Essential Medicines because of its safety and efficacy for anesthesia.

More recently, ketamine has been discovered as a safe and effective treatment for depression, and randomized controlled trials have shown rapid improvement in mood as well as reduction in suicidality compared to people who receive a placebo or another drug. Ketamine has the ability to go to work right away, unlike most antidepressants, which take weeks, sometimes months, to provide relief.

Ketamine infusion therapy is an IV procedure performed in-office by Dr. Kalava. Dr. Kalava & his associates will monitor your response and level of consciousness throughout the infusion.

Please contact our office to discuss Ketamine Infusion Therapy, and see if it is right for you.

The most important factors when choosing a ketamine provider are the doctor’s experience and commitment to providing safe, compassionate care. Dr. Kalava is the nation’s leading practitioner of ketamine infusion therapy and is a recognized expert in the field of anesthesiology.

[Scientific articles on Ketamine published by Dr. Kalava: Article 1 & Article 2 ]

Every patient is unique and deserves special care. Whether determining dose, infusion duration, the number of initial infusions, or the interval between return visits, we make individual assessments and structure ketamine treatments to match each patient’s response and unique needs.

Low dose ketamine is administered by Dr. Kalava, who is a Double Board Certified, Mayo Clinic fellowship trained Anesthesiologist. Ketamine, as we know, is an anesthetic and is best administered under the constant vigilance of a qualified anesthesiologist.

Depending on the medical condition being treated, IV ketamine can be administered over 1 minute, 40 minutes, one hour, or 4 hours. The actual type of treatment will be discussed with you during your initial consultation. The number of infusions and duration of ketamine therapy varies and is individualized. An average of 6-8 treatments are required for a good clinical response.

There are a handful of studies since 2014 that show promising results in managing symptoms from PTSD after ketamine infusion. (Study 1) (Study 2)(Study 3).

Mild psychotomimetic (confusion, hallucinations) effects, increase in heart rate, blood pressure, mild headache, and nausea are possible in some patients and are usually well tolerated.