An example of the chronic low back pain patient who has improved in the modified electroconvulsive therapy

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The patient was a 39-year-old man. His chief complaint was pain in the lumbar region and in both legs. At the age of 36, he had an operation for lumbar disk hernia (L3-4-5) to treat lumbago and numbness of both legs. Eight months after total spinal anesthesia, he suffered from sharp lumbar pain again, so he consulted an orthopedic surgeon. At that time, CT and MRI in the lumbar region and blood laboratory examination showed no remarkable findings to explain the causes of the pain. He was referred to a psychiatrist and finally to our pain clinic. Epidural nerve block and other conventional conservative therapy failed to achieve satisfactory pain relief. Psychological examination revealed that there were some evidence for pain disorder. Three consecutive m-ECT (modified electroconvulsive therapy), once a week for three weeks, was planned for him. After the first m-ECT, dramatic improvement was obtained for 3 days. Although the second m-ECT showed little effect, sharp pain disappeared almost completely after the third m-ECT. He has been enjoying daily life for more than 12 months since the third treatment without medication. We conclude that ECT may be an alternative treatment for patients with pain disorder.
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