Pain treatment often includes education about the pathoanatomical model which emphasizes pain resulting from tissue pathology. The model can be accurate in cases of acute pain, but it impedes progress, elevates anxiety, and increases fear of movement in the chronic pain population; therefore, methods of education that de-emphasize tissue damage need to be implemented. This case illustrates both disability driven by fear of movement resulting from a pathoanatomical explanation of pain and return to function following 9 treatments over 6 months. Treatment included manual therapy and incorporation of Therapeutic Neuroscience Education (TNE). Quantified improvements of 16 points in the Oswestry Disability Index (ODI), 19 points on the Fear Avoidance Belief Questionnaire Physical Assessment(FABQ-PA), and 25 points on the Neck Disability Index (NDI) occurred following treatment. Implementing TNE in conjunction with manual therapy in this case resulted in a significant decrease in disability related to the low back and neck pain and fear related to movement.
Author keywords: Chronic Pain; Therapeutic Neuroscience Education, Low Back Pain
Author affiliations: NH: VA Central Iowa Healthcare System, Des Moines, Iowa; JP: Palmer College of Chiropractic (Student), Davenport, Iowa
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