New research is showing that many forms of chronic pain are generated and maintained by neural pathways in the brain, rather than structural issues in the body. This pain is not “in your head”- it is VERY real and is an important danger signal that provides information. Because pain is often a learned danger signal, it may be telling you something about your emotional state. Since pain can be learned by the brain, it can also be unlearned.
Pain Reprocessing Therapy (PRT) is a type of therapy that retrains the brain to interpret and respond to signals from the body with the goal of breaking the cycle of chronic pain. PRT can be used for many forms of chronic pain and symptoms, including but not limited to chronic back pain, neck pain, headaches/migraines, fibromyalgia, pelvic pain, and more.
A 2021 study published in JAMA Psychiatry validated Pain Reprocessing Therapy as the most effective treatment to date for chronic back pain. In the PRT group of the randomized controlled study, 98% of patients improved and 66% of patients were pain-free or nearly pain-free at the end of treatment, which was maintained one year later. You can read the original study in JAMA Psychiatry here. PRT is also effective for other forms of chronic pain and symptoms, and research is currently ongoing to test PRT for different types of chronic pain and with a wider variety of research participants.
PRT has five main components, consisting of:
1) Education about the brain origins and reversibility of pain. This consists of learning about the latest research behind the origin of pain in the brain, how this pain is generated and maintained by neural pathways, and how it can be reversed.
2) Gathering and reinforcing personalized evidence for the brain origins and reversibility of pain. This part of PRT involves learning about the common signs of brain-generated pain, how to differentiate brain-generated pain from structural pain, and compiling a personalized evidence list to refer to.
3) Attending to and re-appraising pain sensations through a lens of safety. This part of PRT consists of components of mindfulness and body-based work to begin changing your relationship with pain and discomfort and increasing feelings of safety in the body and mind.
4) Addressing other emotional threats, which may include addressing other difficult emotions contributing to pain-fear cycles, addressing unhelpful learned tendencies such as perfectionism and people pleasing, and any other factors contributing to keeping the nervous system in a high-alert state.
5) Leaning into positive feelings and sensations. This aspect of PRT emphasizes focusing on movements and sensations that promote feelings of comfort and safety in the body and mind, with the goal of creating new neural pathways.