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Therapeutic neuroscience education via e-mail: a case report.
[thoracic outlet syndrome]
Abstract
Therapeutic
neuroscience
education
(
TNE
)
aims
to
alter
a
patient
's
thoughts
and
beliefs
about
pain
and
has
shown
efficacy
in
treating
chronic
pain
.
To
date
,
TNE
sessions
mainly
consist
of
one
-on-
one
verbal
communication
.
This
approach
limits
availability
of
TNE
to
pain
patients
in
remote
areas
.
A
32
-
year
-old
patient
with
chronic
low
back
pain
(
CLBP
)
who
underwent
surgery
for
thoracic
outlet
syndrome
(
TOS
)
attended
a
single
clinic
one
-on-
one
TNE
session
followed
by
TNE
via
electronic
mail
(
e-mail
)
,
pacing
and
graded
exposure
over
a
4
-
month
period
.
A
physical
examination
,
Numeric
Rating
Scale
(
NRS
)
,
Oswestry
Disability
Index
(
ODI
)
,
the
Disabilities
of
Arm
,
Shoulder
and
Hand
(
DASH
)
,
and
Fear-
Avoidance
Beliefs
Questionnaire
(
FABQ
)
were
assessed
during
her
initial
physical
therapy
visit
as
well
as
1
and
4
months
later
.
Pre-
TNE
,
the
patient
reported
:
NPRS
(
arm
)
 
=
 
7
/
10
;
NPRS
(
leg
)
 
=
 
4
/
10
;
ODI
 
=
 
10
.
0
%
;
DASH
 
=
 
36
.
7
%
;
FABQ-W
 
=
 
24
;
and
FABQ-
PA
 
=
 
17
.
After
5
e-mail
sessions
all
outcome
measures
improved
,
most
noticeably
NRS
(
arm
)
 
=
 
2
/
10
;
NRS
(
leg
)
 
=
 
0
/
10
;
DASH
 
=
 
16
.
7
%
;
FABQ-W
 
=
 
8
;
and
FABQ-
PA
 
=
 
7
.
TNE
can
potentially
be
delivered
to
suffering
pain
patients
in
remote
areas
or
to
individuals
who
have
time
and
financial
constraints
,
and
likely
at
a
significant
reduced
cost
via
e-mail
.
Diseases
Validation
Diseases presenting
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated