Chronic Pain Relief
& Wellness Therapy

Are you tired of living with constant pain that hinders your quality of life? Look no further than Medical Pain and Spine Care, where our dedicated team of experienced healthcare professionals is committed to helping you find relief. We understand the physical, emotional, and psychological toll that chronic pain can take on you, and we're here to provide compassionate care and effective solutions tailored to your unique needs.

Whether you're struggling with back pain, neck pain, joint pain, or any other type of chronic pain condition, our expert team is well-equipped with the latest advancements in pain management. From innovative treatments to personalized care plans, we offer a comprehensive approach that targets the root cause of your pain, aiming to improve your overall well-being and restore your ability to enjoy life to the fullest.

J Peter Klim, DO




Emily Hackett, FNP-C


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Booking an appointment with Medical Pain and Spine Care is your first step towards taking control of your pain. Our friendly staff will guide you through the process, ensuring your comfort and addressing any concerns you may have. We pride ourselves on providing a supportive and compassionate environment where you can openly discuss your symptoms and collaborate with our specialists to develop a customized treatment plan. Text us today at 317-776-7028

At Medical Pain & Spine Care of Indiana, treatment options may include imaging, physical therapy, spine procedures, muscle and joint injections, pain management device implants, medication management, and even medical weight loss which can improve joint and lower back pain

Ketamine has gained significance in treating chronic pain and depression since the 1990s. At our clinics, ketamine infusions are performed in a comfortable, private setting by qualified experts. Our clinicians are members of American Society of Ketamine Physicians, Psychotherapists and Practitioners. We are dedicated to the safe clinical use of ketamine for pain and mental health conditions. If you have been struggling with unsuccessful treatments, ketamine may work for you.

What is Ketamine?

Ketamine is a member of a class of drugs called phencyclidines. Phencyclidines are dissociative anesthetics and cause pain relief, unresponsiveness while maintaining airway reflexes and breathing. Ketamine affects multiple nervous system pathways. Regarding the biological experience of pain, ketamine reduces pain by blocking the NMDA receptor which is an ion channel involved in excitation of the central nervous system. By interfering with the NMDA receptor, ketamine interferes with pain signal transmission. Ketamine has also been shown to directly bind opioid (pain medication) receptors in the brain and spinal cord. Studies have shown ketamine is beneficial in the treatment of chronic pain syndromes, particularly those with a neuropathic component.

Ketamine Role in Treating Chronic Pain

Chronic stimulation of pain pathways in the nervous system of patients with chronic pain can lead to increased density of NMDA receptors in the spinal cord. When this happens, a process called central sensitization, pain signals sent to the brain are intensified. With central sensitization the nervous system can perceive pain from normally non-painful stimulation. By blocking NMDA receptors, ketamine reduces pain and contributes to reversal of central sensitization. Conditions such as migraine headaches, fibromyalgia, peripheral neuropathy syndromes (for example, from diabetes or after a herpetic infection), phantom limb syndrome, complex regional pain syndrome have been shown to respond to ketamine.

Ketamine Side Effects

Ketamine is generally considered safe. The main side effects are dissociation, intoxication, sedation, high blood pressure, dizziness, headache, blurred vision, anxiety, nausea, and vomiting. Ketamine is avoided or used with extreme caution in the following groups: people with psychosis or schizophrenia, with substance abuse disorders, teenagers, pregnant or breastfeeding patients, older adults with dementia, people with uncontrolled blood pressure, high-risk coronary artery disease, unstable angina, certain endocrine disorders like pheochromocytoma, elevated intraocular or intracranial pressure and those with severe liver disease.

Can Ketamine Infusions Help Me?

If you suffer from chronic regional pain syndrome, phantom limb syndrome, fibromyalgia, chronic back or neck pain, chronic joint pain or neuralgia, Ketamine Infusions may give you the relief you've been missing.

Ketamine History

Ketamine was initially used as an anesthesia medicine in the 1960s. It was administered to soldiers on the front lines during the Vietnam War. Since the 1990s, many clinical studies have found that ketamine is not only useful to relieve pain short term, but can be an effective way to treat certain chronic pain syndromes such as fibromyalgia, migraines and burns. In the 2000s, medical studies showed ketamine was a viable alternative treatment for depression. Today mental health professionals are using ketamine to treat treatment-resistant depression and other mental conditions such as PTSD. Ketamine is also used to treat chronic moderate to severe pain.


How Many Ketamine Treatments Do I Need?

We individualize treatment plans for every patient. Generally, we recommend a series of three infusions within one week before making additional treatment recommendations.

What can I expect during ketamine infusions?

If you've completed a Ketamine infusion consultation and are scheduled for an infusion, the length of your ketamine infusion may vary depending on your condition. After your infusion, we  recommend you remain at the office for observation for about 30 minutes and arrange to have someone bring you home.  We also recommend that you take it easy for the remainder of the day. To get the most benefits out of your ketamine infusions, you may need a series of treatments.  

Ketamine Role in Treating Depression

By binding to NMDA receptors, ketamine increases the amount of a neurotransmitter called glutamate. Glutamate participates in the activation of AMPA receptors. Together these processes lead to new pathways of communication between nerve cells called synaptogenesis. As a result, mood, thought patterns and cognition are changed. Ketamine is used to improve treatment-resistant depression. In fact, ketamine was approved by the FDA for treatment resistant depression in 2019.

Why choose Medical Pain and Spine Care for your ketamine infusions?

We are IV infusion experts. Ketamine is an anesthetic, commonly used in the operating room for general anesthesia. Dr. Klim and Dr. Nielson are double board certified by the American Board of Anesthesiology in both anesthesiology and pain medicine. Additionally, both doctors are members of the American Society of Ketamine Physicians, Psychotherapists and Practitioners. Our approach to patient care combines meticulous attention to safety, effectiveness and patient satisfaction.

Does Medical Insurance Pay for Ketamine Infusions?

Medical insurance providers do not cover the cost of ketamine infusion therapy for any disorders. Treatment costs depend on the disorder being treated, the number of infusion treatments needed, the length of the infusion and the dose used.  The average cost to the patient is anywhere between $325 - $1,350 per infusion session. Compared to these rates, our services are lower than average. Our goal is to allow patient access this potentially beneficial therapy.
Each Patient Has a Unique Story

At Medical Pain & Spine Care, we strive to show patients how much we care about them. Our providers take time to listen to each patient’s story and then provide an individualized treatment plan to produce maximum pain relief.

Although lower back pain is the most common condition our patients are seen for, it is just one of many chronic pain symptoms we help patients overcome and manage. The spinal cord stimulator is one of the most effective pain controlling therapies we have for patients suffering from chronic pain in the spine and upper and lower extremities. Even patients who have undergone multiple back surgeries and started to lose hope for improvement have found wonderful lasting pain reduction through spinal cord stimulator therapy.

No matter what your story, even if you have lost hope in finding pain relief, our team will listen and help you with an effective pain management treatment plan that's right for you.

J Peter Klim, DO


Haylee Goad, FNP


Emily Hackett, FNP-C


Did you know more people die from overdose than other causes of death?

More people die every year from overdose of prescription drugs than car accidents? The Associated Press reported that in San Francisco, more people died from drug overdose than COVID-19 in 2020.    "A record 621 people died of drug overdoses in San Francisco so far this year, a staggering number that far outpaces the 173 deaths from COVID-19 the city has seen thus far." [12/21/2020]

Most commonly prescribed opioids

  • Hydrocodone
  •  Oxycodone (OxyContin)
  • Morphine
  • Fentanyl (Duragesic)
  • Hydromorphone (Dilaudid)
When combined with acetaminophen, hydrocodone and oxycodone are prescribed under the brand names Vicodin and Percocet.  Opioids are available in pills, liquids, shots, patches, and suppositories.

At Medical Pain and Spine Care of Indiana, we offer a comprehensive pain management plan, which will sometimes include prescription opioids for pain relief. 

Most common reasons for opioid prescriptions

Opioids are a class of narcotic drugs that are derived from morphine. They work with opioid receptors to disrupt pain signals sent to the brain by the nervous system to offer pain relief.  In general, opioids are most effectively prescribed for short-term, episodic pain relief from injury or illness. Conditions for which opioids may be prescribed include:

  • BACK PAIN -- including degenerative disc disease, ruptured or herniated disc, spinal stenosis, and vertebral compression fractures
  • CANCER PAIN -- especially in late-stage cancer patients
  • HIP PAIN -- with osteoarthritis and fractures as the most commonly treated with opioids
  • INFLAMMATORY BOWEL DISEASE -- such as Crohn’s disease and ulcerative colitis
  • NEUROPATHY -- including diabetic neuropathy and any other types of nerve pain
While some patients benefit tremendously from opioid therapy, recent research into the effectiveness of opioids on chronic pain has shown that opioids may do more harm than good when it comes to treating chronic pain. In 2015, an analysis by the National Institute of Health (NIH) looked at existing studies regarding the effectiveness of opioids for long-term chronic pain and found no evidence that opioids were effective at treating long-term pain. This same study found evidence that indicated a high risk of dose-dependent, serious side effects including abuse and dependence, bone fracture, and myocardial infarction.

As of 2014, an estimated 1.9 million people in the U.S. had a substance abuse disorder involving prescription opioids. From 1999 to 2008, opioid addiction rates and opioid prescription rates rose in parallel with the death rate from overdose increasing 400% during the same period. Opioids are powerful narcotics that change the structure of the brain such that it adapts to the dose and gradually requires more to feel the same pain relief. Even when taken as directed, long-term use can result in dependence.

Possible side effects of opioid treatment

Opioid-induced hyperalgesia, or increased pain sensitivity, is also a possibility with long-term use of opioids for chronic pain. Previously, opioid-induced hyperalgesia was thought to be a byproduct of opioid withdrawal, but new research has shown that it can occur at any stage of opioid use.

Other lesser-known side effects of long-term opioid use can include:
  •  IMMUNOSUPPRESSION making patients more vulnerable to other health issues. This can be especially difficult for those patients with other chronic, immune-related illness. 
  • DECREASED LIBIDO -- For men, long-term opioid use can result in lower levels of testosterone production (hypogonadism). In women, this same long-term use can disrupt hormone production, causing amenorrhea (lack of menstrual cycle). In both cases, this can result in a decreased sex drive. 
  • OSTEOPOROSIS developing in both men and women. 
We believe the risks associated with long-term opioid use warrant caution and restraint when it comes to prescribing these medications. Our pain management specialists focus on a comprehensive pain diagnosis and management options. To that end, we look at other treatment options before prescribing opioids.

How we treat pain

Conventional treatments may include prescription non-steroidal anti-inflammatory drugs, antidepressants, anticonvulsants, and steroids. We may also look at minimally-invasive procedures, such as nerve block procedures, or more invasive techniques such as intrathecal pain pumps, spinal cord stimulation, or radiofrequency ablation. Our pain management specialists believe in a holistic approach to chronic pain and also recommend many complementary and alternative options for pain relief including physical therapy, as well as psychological and behavior interventions available at our office in Noblesville.

While we strive to utilize all other pain-relieving options prior to prescribing opioids, we recognize that for some patients in specific circumstances, opioids may be their best option for relief. Medical Pain and Spine Care of Indiana follows strict prescribing and monitoring guidelines as set forth by the federal government and works closely with patients to resolve their pain in other ways before utilizing opioids.

Part of working closely with our patients includes discussing and signing a pain management agreement form. This form follows the Centers for Disease Control’s updated opioid prescribing guidelines and includes the following provisions:
  1. The agreement acknowledges that opioid therapy is just one part of a patient’s comprehensive treatment plan. 
  2. Patients are to follow all parts of the holistic, comprehensive pain management plan designed with their doctors to include a number of different therapies. This may mean making lifestyle changes as well as undergoing counseling and other complementary therapies tailored to each individual patient. 
  3. Our pain management specialists prescribe the lowest effective dose and will not increase the dose without thoroughly re-evaluating the patient. 
  4. Patients agree to regular follow-up visits, monthly urine screenings, and pill counts within 24 hours if requested by the doctor. 
  5. Doctors and patients work closely together with all other specialists and physicians to avoid over prescription or concurrent benzodiazepine or opioid prescriptions. Each part of this opioid agreement form was designed to protect the patient while undergoing opioid therapy. 
Our goal at Medical Pain and Spine Care is to develop the best possible pain management plan for every patient that improves their quality of life. We work as a pain management team to provide comprehensive diagnostic and therapeutic services. We utilize an extensive array of treatment options specifically designed for each patient. When one of these options is opioid therapy, we provide the support and guidance needed for safe, effective pain relief.

For more information on all of our pain management options, including opioid therapy, please call 317-776-7028 to schedule an appointment.

Happy patients are the best referral sources!