Effect of Pain Neuroscience Education and dry needling on chronic elbow pain as a result of cyberchondria

This case report describes a 31-year-old male who presented with complaints of chronic pain in his right elbow. Detailed subjective examination uncovered that the patient had searched Google for extensive online information relating to his pain, ultimately self-labeling with various diagnoses. After researching in YouTube, the patient self-treated with ice, exercises, neural mobilization, self-massage and taping, all resulting in a failed outcome. Clinical findings revealed trigger points in his right brachioradialis muscle with added symptoms of central pain. This is possibly the first-time description of physical therapy management of brachioradialis myofascial pain syndrome with superadded central pain caused as a result of cyberchondria where the patient used the Internet for arriving at a wrong self-diagnosis and incorrect self-treatment with failed or worsening pain outcomes leading to pain sustenance or chronicity. Physical therapy consisted of Pain Neuroscience Education, dry needling and Exercise Therapy. The patient was completely pain free and fully functional at the end of the sixth session, which was retained at a one-month follow-up.

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