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Physiotherapy Theory and Practice
An International Journal of Physical Therapy
Volume 38, 2022 - Issue 11
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Case Report

Effect of pain neuroscience education and transcutaneous electrical nerve stimulation on trigeminal postherpetic neuralgia. A case report

, PTORCID Icon, , MSc, PTORCID Icon, , MSc, PTORCID Icon, , PTORCID Icon & , MSc, PTORCID Icon
Pages 1813-1822 | Received 18 Mar 2020, Accepted 19 Dec 2020, Published online: 05 Feb 2021
 

ABSTRACT

Introduction

Postherpetic neuralgia (PHN) is a complex neuropathic painful condition in which pain is a direct consequence of the response to peripheral nerve damage experienced during herpes zoster attack. PHN is the most common chronic complication of herpes zoster and it causes considerable suffering, affecting the physical functioning and psychological well-being of patients.

Objective

To describe the effect of a conservative treatment using pain neuroscience education (PNE) and transcutaneous electrical nerve stimulation (TENS) in a patient with trigeminal PHN.

Case Description

A 67-year-old woman sought care for pain, dysfunction, and sensory loss in the left jaw. The assessment included: 1) pain, using the numerical pain rating scale (NPRS), pressure pain threshold (PPT), Douleur Neuropathique 4 (DN4), McGill Pain Questionnaire (MPQ), Graded Chronic Pain Scale (GCPS), and classic body charts of the cranial region; 2) somatosensory function, by means of mechanical detection threshold (MDT) and pressure pain threshold (PPT); 3) jaw function, using the Jaw Functional Limitation Scale-20 (JFLS-20); and 4) psychosocial features, by means of the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorders Questionnaire-7 (GAD-7). Treatment consisted of 12 sessions of PNE and TENS.

Outcomes

After treatment, a clinically significant improvement in NPRS, DN4, MDT, GCPS, and PHQ-9 was observed.

Conclusion

In this case report, a treatment based on the combination of PNE and TENS seemed to have contributed to improving pain, sensory abnormalities, and jaw function. Psychosocial factors also showed a trend to improve after the treatment.

Disclosure of Interest

The authors report no conflict of interest.

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