Skip to main content

Advertisement

Log in

Electroconvulsive therapy in the management of chronic pain

  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Electroconvulsive therapy (ECT) is used predominantly to treat major depressive illness but has also been used for chronic pain. ECT causes a variety of neurochemical and neurophysiologic effects, some of which may interact with the pathophysiologic mechanisms in complex pain states. An extensive literature on the use of ECT in pain patients identifies subgroups for whom ECT may result in substantial pain relief. In this article, we review the literature on the use of ECT in pain patients, suggest possible neurobiologic bases for the efficacy of ECT in such patients, and conclude with our recommendations for current clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. American Psychiatric Association Committee on Electroconvulsive Therapy: The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging, edn 2. Washington, D.C.: American Psychiatric Association; 2001. Represents the standard of care in current ECT practice.

  2. Pisetsky JE: Disappearance of painful phantom limbs after electric shock treatment. Am J Psychiatry 1946, 102:599–601.

    Google Scholar 

  3. De Gutierrez-MahoneyCG: The treatment of painful phantom limb by removal of post-central cortex. J Neurosurg 1949, 1:156–162.

    Google Scholar 

  4. Bornstein B: Sur le phenomene du membrane fantome. L’Encephale 1949, 38:32–46.

    Google Scholar 

  5. Hohman LB, Wilkinson WE: Pain equivalents treated with electroshock. US Armed Forces Med J 1953, 7:1025–1029.

    Google Scholar 

  6. Boyd DA: Electric shock therapy in atypical pain syndromes. Lancet 1956, 76:22–25.

    Google Scholar 

  7. Weiss DM, Bloomberg W, Drew JH: The use of electroshock as therapy for atypical and intractable pain. Trans Am Neurol Assoc 1957, 82:166–168.

    PubMed  Google Scholar 

  8. Von HagenKO: Chronic intolerable pain. Discussion of its mechanisms and report of eight cases treated with electroshock. JAMA 1957, 165:773–777.

    Google Scholar 

  9. Weinstein EA, Kahn RL, Bergman PS: Effect of electroconvulsive therapy on intractable pain. Arch Neurol Psychiatry 1959, 81:37–42.

    CAS  Google Scholar 

  10. Bradley JJ: Severe localized pain associated with the depressive syndrome. Br J Psychiatry 1963, 109:741–745.

    Article  PubMed  CAS  Google Scholar 

  11. Mandel MR: Electroconvulsive therapy for chronic pain associated with depression. Am J Psychiatry 1975, 132:632–636.

    PubMed  CAS  Google Scholar 

  12. Salmon JB, Hanna MH, Williams M, et al.: Thalamic pain—the effect of electroconvulsive therapy (ECT). Pain 1988, 33:67–71.

    Article  PubMed  CAS  Google Scholar 

  13. Hampf G, Kuoppasalmi K, Henrikson M, et al.: Chronic facial pain together with severe depression is responsive to electroconvulsive therapy. A case report. Acta Odontol Scand 1992, 50:129–132.

    PubMed  CAS  Google Scholar 

  14. King JH, Nuss S: Reflex sympathetic dystrophy treated by electroconvulsive therapy: intractable pain, depression, and bilateral electrode ECT. Pain 1993, 55:393–396.

    Article  PubMed  CAS  Google Scholar 

  15. Bloomstein JR, Rummans TA, Maruta T, et al.: The use of electroconvulsive therapy in pain patients. Psychosomatics 1996, 37:374–379.

    PubMed  CAS  Google Scholar 

  16. McCance S, Hawton K, Brighouse D, et al.: Does electroconvulsive therapy (ECT) have any role in the management of intractable thalamic pain? Pain 1996, 68:129–131.

    Article  PubMed  CAS  Google Scholar 

  17. Hoshimo T, Sakamoto A, Suzuki N, et al.: Electroconvulsive therapy for the depressed patients associated with chronic pain. Masui 1999, 48:763–766.

    Google Scholar 

  18. Rasmussen KG, Rummans TA: Electroconvulsive therapy for phantom limb pain. Pain 2000, 85:297–299. Provides data on how ECT may have a primary benefit for phantom limb pain.

    Article  PubMed  CAS  Google Scholar 

  19. Abrams R: Electroconvulsive Therapy, edn 3. New York: Oxford University Press; 1997.

    Google Scholar 

  20. Tortella FC, Long JB, Hong J-S, et al.: Modulation of endogenous opioid systems by electroconvulsive shock. Convulsive Ther 1989, 5:261–273.

    Google Scholar 

  21. Holaday JW, Tortella FC, Long JB, et al.: Endogenous opioids and their receptors: evidence for involvement in the postictal effects of electroconvulsive shock. Ann N Y Acad Sci 1986, 462:124–139.

    Article  PubMed  CAS  Google Scholar 

  22. Alexopoulas GS, Inturrisi CE, Lipman R, et al.: Plasma immunoreactive beta-endorphin levels in depression. Effect of electroconvulsive therapy. Arch Gen Psychiatry 1983, 40:181–183.

    Google Scholar 

  23. Ghadirian AM, Gianoulakis C, Nair NPV: The effect of electroconvulsive therapy on endorphins in depression. Biol Psychiatry 1988, 23:459–464.

    Article  PubMed  CAS  Google Scholar 

  24. Young EA, Grunhaus L, Haskett RF, et al.: Heterogeneity in the beta-endorphin immunoreactivity response to electroconvulsive therapy. Arch Gen Psychiatry 1991, 48:534–539.

    PubMed  CAS  Google Scholar 

  25. Weizman A, Gil-Ad I, Grupper D, et al.: The effect of acute and repeated electroconvulsive treatment on plasma beta-endorphin, growth hormone, prolactin and cortisol secretion in depressed patients. Psychopharmacology 1987, 93:122–126.

    Article  PubMed  CAS  Google Scholar 

  26. Freeman W, Watts JW: Pain of organic disease relieved by prefrontal lobotomy. Lancet 1946, 29:953–955.

    Article  Google Scholar 

  27. Grantham EG, Spurling RG: Selective lobotomy in the treatment of intractable pain. Ann Surg 1953, 137:602–608.

    PubMed  CAS  Google Scholar 

  28. Walker AE: Pain—the neurosurgeon’s viewpoint. J Chronic Dis 1955, 2:91–95.

    Article  PubMed  CAS  Google Scholar 

  29. Nobler MS, Sackeim HA, Prohovnik I, et al.: Regional cerebral blood flow in mood disorders, III: treatment and clinical response. Arch Gen Psychiatry 1994, 51:884–897.

    PubMed  CAS  Google Scholar 

  30. Nobler MS, Sackeim HA, Solomou M, et al.: EEG manifestations during ECT: effects of electrode placement and stimulus intensity. Biol Psychiatry 1993, 34:321–330.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rasmussen, K.G., Rummans, T.A. Electroconvulsive therapy in the management of chronic pain. Current Science Inc 6, 17–22 (2002). https://doi.org/10.1007/s11916-002-0019-4

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11916-002-0019-4

Keywords

Navigation