Rare Diseases Symptoms Automatic Extraction

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.