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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
"has shown efficacy in treating chronic pain"
symptom
thoracic outlet syndrome
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