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Pain Reprocessing Therapy

Animation of neural networks firing in the brain

What is Pain Reprocessing Therapy?

Pain Reprocessing Therapy, or PRT, is a revolutionary approach that teaches your brain to see pain differently. It is a new treatment method that helps you unlearn chronic pain by retraining your brain. It's like a reset button for your mind, helping it recognize that sensations it once deemed dangerous are, in fact, safe.

How does Pain Reprocessing Therapy work?

PRT involves a series of techniques that retrain your brain to interpret and respond to signals from your body differently. These techniques allow you to create new neural pathways and ‘unlearn' pain. Here's how it works:

  1. Pain Education: Gain a deep understanding of pain science and explore the origins of pain in the brain. Knowledge is power, and understanding is the first step towards relief.

  2. Gather Personalized Evidence: We'll gather evidence based on your unique experience, and tailor our approach to your situation, helping your brain understand that it can change its perception of pain.

  3. Sensations Through a Lens of Safety: After an injury has healed, fear, anxiety, and worry are often the driving factors behind chronic pain. You'll discover how to view pain sensations through a lens of safety, reducing the fear and anxiety that often keep chronic pain alive.

  4. Explore Emotional Well-being: PRT doesn't stop at physical sensations. We address emotional factors that may contribute to your pain, creating a holistic approach to healing.

  5. Positive Focus Transformation: As you progress, you'll naturally gravitate towards positive feelings and sensations, creating a snowball effect of well-being.

The Power of PRT: Proven Results

A groundbreaking study at the University of Colorado Boulder has confirmed the effectiveness of Pain Reprocessing Therapy. In this study, 100 chronic back pain patients were divided into two groups: one received PRT twice a week for four weeks, and the other received standard treatment.

The results were as follows:

  • 98% of patients who underwent PRT showed improvement.

  • 66% of patients experienced either complete pain relief or a significant reduction in pain.

  • These outcomes were sustained one year later.

Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A randomized clinical trial

Clinical Outcomes: A, Shading indicates standard error. B, Dots represent individual participants; thick lines represent the group mean. C, Percentage of patients reporting pain scores of 0 or 1 of 10 (ie, pain-free or nearly pain-free) at posttreatment and at 1-year follow-up. PRT indicates pain reprocessing therapy.

Read the study in JAMA Psychiatry here.

What conditions can be treated using PRT?

If your pain has persisted for 6 months or longer without relief, if your doctors have no explanation for your pain, or if you have multiple symptoms that include pain or other sensations or symptoms listed below, you are a good candidate for PRT.

PRT has been used to successfully many symptoms, including but not limited to:

  • Back and Neck Pain

  • Joint Pain

  • Migraines and Tension Headaches

  • Fibromyalgia

  • Sciatica

  • Irritable Bowel Syndrome

  • POTS

  • Chronic Tendonitis

  • TMJ

  • Complex Regional Pain Syndrome

  • Plantar Fasciitis

  • Repetitive Strain injuries

  • Tinnitus

  • Myofascial Pain Syndrome

Even if you have structural abnormalities as shown by MRI or other imaging techniques, PRT can work for you. Learn more about structural abnormalities here (coming soon!).

A full list of conditions that can be treated using PRT has been compiled by David Clarke, MD, David Schechter, MD, and Howard Schubiner, MD. More information can be found in their book: A Diagnostic Guide for Psychophysiologic Disorders .

Will Pain Reprocessing Therapy Work for You?

There are several positive indicators of pain that is generated in the brain (neuroplastic pain). The more indicators listed below you have, the more likely that your pain can be successfully treated using PRT. If you answer yes to even one of the criteria, you may benefit from PRT.

  • Symptoms began without a physical injury or persist after an injury has healed

  • Symptoms originated during a stressful time

  • Symptoms originated without an injury

  • Symptoms are inconsistent - not always there, change with time of day, change with activities

  • Multiple symptoms are present (ie pain and IBS or tinnitus)

  • Symptoms spread or move over time

  • Symptoms are worse when you are stressed, and better when you are engaged in joyful or fulfilling activity

  • Triggers have nothing to do with the body (ie symptoms caused by foods, smells, sounds, lights, time of day)

  • Symptoms triggered by light touch, wind or cold

  • Symptoms are symmetrical

  • Lack of physical diagnosis; doctors have not been able to give a reasonable consistent explanation for your symptoms

  • You possess personality traits that are common in those with chronic pain including: perfectionism, people-pleasing, conscientiousness, worrying, self criticism, history of anxiety or depression, family history of chronic pain

  • You have a history of adverse childhood experiences (even mild traumas)

If you answered yes to one or more of the items above, you are good candidate for PRT. There is hope for recovery, and we can help you find the path to get there.

Personalized coaching

Partner with us to find your path to freedom from chronic pain

Together we will embark on a comprehensive journey to transform your experience with chronic pain. We'll explore your unique pain history, identifying triggers and unraveling the layers of your pain experience. We'll work to reduce fear and create a sense of safety in your body. Our work will also extend beyond pain, aiming to reconnect you with your core self. This holistic approach aims for symptom reduction and a profound and lasting transformation, empowering you to embrace life with newfound freedom and joy. In our work together you can expect to:

  1. Learn about pain and how pain is generated

  2. Explore your unique pain history and pain triggers

  3. Learn somatic practices to help you reduce fear of the pain and create a sense of safety in your body

  4. Practice journaling and other reflective techniques to better understand your pain and learn strategies to communicate safety to your brain

  5. Learn to lean into positive sensations, fostering a shift in your focus

  6. Reconnect to your values, strengths, passions, gifts, and goals

  7. Build new neural pathways that will replace the old pain-generating neural networks

Selected References

Please find below selected references on Pain Reprocessing Therapy and additional brain-focused treatment methods that we may use in our work together.

Ashar, Y.K., PhD; Gordon, A., LCSW; Schubiner, H., MD; Uipi, C., LCSW; Knight, K., MD; Anderson, Z., BS; Carlisle, J., MA; Polisky, L., BA; Geuter, S., PhD; Flood, T.F., MD, PhD; Kragel, P.A., PhD; Dimidjian, S., PhD; Lumley, M.A., PhD; Wager, T.D., PhD. (2022). Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry, 79(1), 13-23.

  • This paper describes a randomized clinical trial investigating the effectiveness of PRT for chronic back pain. Results showed a notable reduction in pain for the PRT group (66%) compared to placebo (20%) and usual care (10%), suggesting that PRT may offer substantial relief for chronic back pain.

Ashar YK, Lumley MA, Perlis RH, Liston C, Gunning FM, Wager TD. Reattribution to Mind-Brain Processes and Recovery From Chronic Back Pain: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2023 Sep 5;6(9).

Please stay tuned for additional references coming soon!

For more information or to work with us, please contact us here. We look forward to hearing from you!