This is why your IBS keeps coming back
If you live with Irritable Bowel Syndrome (IBS), you know how real and disruptive the symptoms can be. Abdominal pain, cramping, bloating, urgency, constipation, diarrhea—or all of the above. Many of my clients come to me exhausted after years of dietary restrictions, medications, tests, and frustration, often being told, “Everything looks normal.”
Here’s the important part: normal test results do not mean your pain isn’t real. They often mean your nervous system is stuck in a state of threat.
This is where Pain Reprocessing Therapy (PRT) comes in.
PRT is a neuroscience-based approach that helps retrain the brain and nervous system when pain or GI symptoms are being generated by learned neural pathways rather than ongoing tissue damage. Research has shown that IBS is strongly linked to central nervous system sensitization—meaning the brain and gut are communicating through a loop of alarm, even when the body is safe.
In IBS, the gut becomes overly monitored and protected by the brain. Normal sensations—gas, digestion, bowel movement—are interpreted as dangerous. The brain responds by increasing pain, urgency, and discomfort. The more this happens, the stronger the neural pathway becomes.
PRT works by helping you:
Identify the neural nature of symptoms
Reduce fear and hypervigilance around gut sensations
Send signals of safety to the brain
Interrupt the pain–alarm loop
Create new, calmer neural pathways
This isn’t positive thinking or ignoring symptoms. It’s a structured, evidence-based process that uses education, somatic awareness, emotional processing, and cognitive techniques to change how the brain interprets gut signals.
Many clients with IBS notice improvements not just in pain, but in frequency, urgency, bloating, and overall quality of life. Perhaps most importantly, they regain trust in their bodies.
If you’ve been told “IBS is chronic” or “you’ll just have to manage it,” I want you to know there is another option. When the brain learns safety, the gut often follows.
You don’t have a broken digestive system.
You have a nervous system that can learn to calm again.
Learn more about working with me at prtcoach.com.
How Pain Reprocessing Therapy Retrains the Brain to Ease Neck Pain
Chronic neck pain affects countless people daily. Many have tried pillows, stretches, posture fixes, medications, and various therapies, yet pain and fear of movement persist. Pain reprocessing therapy offers a fundamentally different approach: it doesn’t treat the neck as fragile or broken but addresses the brain’s role in maintaining pain.
Pain reprocessing therapy understands chronic neck pain as neuroplastic pain — pain driven by a nervous system stuck in overprotection. It’s like a smoke alarm that blares at burnt toast, even when no real fire exists. In fact, research shows pain reprocessing therapy is among the most effective treatments for chronic pain conditions, often leading to significant and durable pain reduction.
Key components of pain reprocessing therapy include educating patients about the difference between tissue damage and nervous system sensitization; somatic tracking, which cultivates gentle, curious awareness of painful sensations paired with safety messages such as “This is uncomfortable but safe”; and gradual exposure to previously feared movements, guided by new, calming interpretations.
Additional nervous-system regulation techniques such as mindful breathing and body awareness breaks further support the process. Clinical trials have found that most patients receiving pain reprocessing therapy report substantial improvement, with many achieving near or complete pain relief lasting beyond the treatment period.
Consider a common scenario: after a minor car accident, neck pain lingers despite medical reassurance that MRI findings like “mild disc changes” require no surgery. Structural treatments like physical therapy and massage offer temporary relief at best, while avoidance of movements (e.g., turning the head while driving) becomes habitual due to fear of damage.
Pain reprocessing therapy reframes this cycle, teaching the brain to reinterpret safe sensations accurately. Patients learn to notice neck tension without panic, practice small movements with safety cues like “This is okay,” and build daily regulation habits to quiet the overactive alarm.
For chronic neck pain that has been medically cleared but remains stubborn, pain reprocessing therapy provides an evidence-based, brain-focused path to healing. Its integration of cognitive, somatic, and exposure-based strategies empowers people to change how their brain processes pain signals, breaking the cycle of fear and avoidance.
If you or someone you know struggles with lasting neck pain unresponsive to usual structural therapies, pain reprocessing therapy may be the key to retraining the brain and reclaiming freedom of movement and peace.
From Stuck to Free: How Pain Reprocessing Therapy Helps You Overcome Chronic Back Pain
Pain Reprocessing Therapy (PRT) is an evidence-based approach that has helped many people find relief from chronic back pain. As a PRT coach, I have witnessed firsthand how retraining the brain can lead to true and lasting change for those who struggle with persistent pain.
What Is Pain Reprocessing Therapy?
Pain Reprocessing Therapy is a set of psychological techniques that teach the brain to reinterpret and respond differently to pain signals. Unlike conventional treatments that focus solely on the body, PRT targets the brain’s role in generating and sustaining chronic pain, especially when no clear physical cause remains.
PRT and Chronic Back Pain
Recent clinical trials have shown that PRT is highly effective for chronic back pain. In a randomized controlled study, 98% of participants experienced significant improvement, and two-thirds became pain-free or nearly pain-free following treatment. These benefits persisted one year later, with individuals in the PRT group reporting much lower pain scores than those receiving placebo or usual care. Long-term follow-ups even indicate that relief often lasts for several years.
How PRT Works
PRT’s techniques include:
• Educating clients on the science of pain and the brain’s role in pain processing.
• Cognitive reframing to help clients interpret pain as less dangerous.
• Somatic and exposure exercises to reduce sensitivity and fear of pain.
• Cultivating positive emotions and self-compassion to further reduce suffering.
Why Choose PRT for Back Pain?
PRT can be life-changing for those whose pain remains stubborn despite traditional solutions. It is especially effective for individuals whose pain is not explained by ongoing injury or clear physical disease. By addressing fear, anxiety, and the brain’s learned pain responses, PRT often succeeds where other methods have failed, empowering clients to reclaim their lives.
If you are dealing with unresolved back pain, consider exploring Pain Reprocessing Therapy—a treatment that helps the brain “unlearn” pain and rewires your relationship with discomfort for lasting relief.
Contact me today to learn more!
Treating New Daily Persistent Headaches with Pain Reprocessing Therapy
If you’ve been living with a new daily persistent headache—pain that seemed to appear suddenly and never went away—it can feel confusing and exhausting. Unlike other headaches that come and go, NDPH is constant from day one, often leaving people desperate for answers and relief. At prtcoach.com, I work with clients using Pain Reprocessing Therapy (PRT) to target this kind of chronic, unexplained pain at its root.
Understanding New Daily Persistent Headache
New daily persistent headache, or NDPH, presents as a constant headache that starts one day and continues daily without relief. Many clients describe waking up one morning with head pain that simply never stopped. Medical evaluations often rule out structural problems, infections, or other identifiable causes, leaving many feeling frustrated when traditional treatments like medications fail to help.
That frustration is valid—and it’s often where PRT comes in.
How Pain Reprocessing Therapy Helps with NDPH
Pain Reprocessing Therapy is a mind-body approach designed to teach the brain that pain sensations can be safely deactivated. In conditions like NDPH, the brain may become “stuck” in a sensitized state where it continues to send pain signals even after the original triggering event has resolved. This is known as central sensitization, and research shows it plays a key role in chronic pain conditions—including persistent headaches.
Through PRT, clients learn to:
• Recognize the learned, reversible nature of chronic pain.
• Develop new ways of responding to sensations of pain with calm and safety instead of fear.
• Rewire brain pathways through emotional awareness, mindfulness, and evidence-based neuroscience techniques.
Over time, these changes can reduce or even eliminate the sensation of pain entirely.
The Brain’s Role in NDPH
For many, NDPH begins after a stressful event, illness, or period of emotional strain. The pain itself is real, but it can be generated by the brain’s protective system—a system that has become overly vigilant. By retraining this system through PRT, clients can signal safety back to the brain and help restore balance to the pain response.
This process doesn’t happen overnight, but it offers a powerful, science-backed route to healing that doesn’t rely on medication or invasive treatments.
Finding Relief
If you’re living with new daily persistent headache, it’s not your fault—and it’s not “all in your head.” Pain Reprocessing Therapy offers a path to relief rooted in compassion and neuroscience. At prtcoach.com, I help clients understand their pain, calm their nervous systems, and retrain their brains toward peace and comfort again.
If this approach resonates with you, consider booking a free consultation. Together, we can explore how Pain Reprocessing Therapy can help you find lasting relief from NDPH and reclaim a life free from constant head pain.
Migraines & Pain Reprocessing Therapy: Hope for Lasting Relief
Migraines can feel overwhelming—sharp pain, light sensitivity, and a never-ending hunt for real solutions. If you’re like many people who’ve tried everything from medications to lifestyle tweaks with little success, Pain Reprocessing Therapy (PRT) might be the fresh approach you’re looking for. Let’s take a friendly walk through what PRT is and how it’s being used to tackle even stubborn migraine pain.
What Is Pain Reprocessing Therapy (PRT)?
PRT is a mind-body, neuroscience-based therapy that empowers people to change how their brains process pain. Pain, especially chronic pain like migraines, is often maintained by learned threat associations in the brain—even when there’s no ongoing physical damage. In short, the brain gets “stuck” in pain mode. PRT aims to help your brain break that cycle by teaching it to recognize pain as a false alarm, rather than an ongoing threat.
PRT doesn’t just help with migraines—research shows it can be a game-changer for chronic back pain, neck pain, fibromyalgia, and more. Excitingly, recent case studies reveal major reductions in migraine frequency and intensity after PRT, even for patients who didn’t respond to conventional treatments.
Why Might Migraines Respond to PRT?
Migraine brains are sensitive. After just a few intense attacks, your brain can become “sensitized,” triggering more attacks and ramping up pain perception. This sensitization is a form of neuroplasticity—learned pain. The good news: if pain can be learned, it can be unlearned. That’s exactly what PRT focuses on—retraining your brain out of this painful loop.
The Five Steps of PRT for Migraines
Here’s how a typical PRT journey might look for someone with migraines, broken down into core steps:
1. Education About Pain
We start by diving into the neuroscience of migraine pain. You’ll learn how pain is generated in the brain, why sensitization happens, and how this is different from physical injury. Understanding that migraines can be “false alarms” helps strip away some of the fear and confusion around chronic pain.
2. Gathering Evidence for a Brain-Based Cause
Next, we collaboratively investigate your personal migraine patterns. Are there times when pain arises with no clear injury or trigger? When does it ebb and flow? Collecting real-life evidence that supports a brain-based (not injury-based) origin increases your confidence in PRT’s approach—and your ability to recover.
3. Somatic Tracking
This is a core technique in PRT. Rather than fighting or fearing your pain, you’ll learn to pay gentle, nonjudgmental attention to the sensations of migraine. Through mindful body scanning, relaxed observation, and guided imagery, you gradually retrain your brain to interpret these signals as safe—not threats. Over time, this reduces both the pain and the anxiety that fuels it.
4. Addressing Emotional Threats
Many people with migraines also experience stress, perfectionism, or people-pleasing tendencies that keep their nervous system on high alert. PRT works to identify and address these underlying emotional contributors, helping to break the pain-fear cycle and create a more resilient, relaxed brain.
5. Embracing Positive Sensations
Finally, PRT helps you shift focus from pain to positive bodily sensations. This stage is about savoring comfort and pleasure—cultivating new, positive associations that tip your brain further away from pain and toward healing.
What Results Can You Expect?
Although research on PRT for migraines is still growing, early case reports are inspiring. People with frequent, disabling migraines have seen dramatic reductions—from 18–30 headache days per month to just 3–5—after completing PRT. They also report less pain intensity, better function, and less reliance on medication. The most significant improvements seem to come after shifting toward a brain-based understanding of pain and practicing somatic tracking daily.
The Future of Migraine Care
While PRT isn’t yet mainstream for migraines, mounting evidence supports its promise as a drug-free, empowering way to reclaim your life from chronic pain. Curious to learn how PRT could work for you? As your coach at prtcoach.com, I’m always ready to have a conversation about your story and help you take those hopeful first steps to lasting relief.
How to Use Pain Reprocessing Therapy to Treat Burning Mouth or Burning Skin
If you’re struggling with burning sensations in your mouth, skin, or other areas of your body — and medical tests keep coming back “normal” — you’re not alone. Many people experience these mysterious burning symptoms that seem to come from nowhere, often leading to frustration and fear.
The good news is that these sensations can often be explained — and relieved — through Pain Reprocessing Therapy (PRT), a proven, science-based approach that helps retrain your brain’s pain system.
Understanding Burning Sensations
When your mouth or skin feels like it’s burning, it’s natural to assume there’s tissue damage or inflammation. But in many chronic cases, there isn’t. Instead, the nerves and brain regions responsible for sensing pain have become sensitized — they’re sending “danger” signals even when your body is safe.
This process, called neuroplastic pain, means the brain has learned to interpret normal sensations as threatening. Common triggers include:
Chronic stress or anxiety
Previous injury or illness
Fear of symptoms or medical uncertainty
Perfectionism or people-pleasing tendencies (common among chronic pain sufferers)
Pain Reprocessing Therapy teaches your brain to unlearn those false danger signals.
How Pain Reprocessing Therapy Works
PRT is based on the idea that when pain or burning is generated by the brain rather than by tissue damage, the key to healing is changing your brain’s perception of threat.
Here’s how it works in simple terms:
Recognize that your pain is real — but not dangerous.
The first step is understanding that your burning sensations are real experiences created by your nervous system, not imagined or “in your head.” But equally important: they don’t mean your body is damaged.Reframe the meaning of the sensation.
Each time you feel burning, remind yourself gently:
“This is my brain misinterpreting a signal. I’m safe right now.”
Shifting from fear to reassurance helps calm the brain’s alarm system.Bring curiosity instead of fear.
Fear fuels pain. Curiosity quiets it. Try exploring the sensations with interest:“Where exactly do I feel this?”
“Does it move or change when I shift my focus?”
“What happens when I relax and breathe into it?”
Soften your body’s stress response.
Burning sensations often flare when the nervous system is tense. Gentle breathing, mindfulness, or grounding exercises can signal safety to your brain.Resume normal activities gradually.
Avoiding triggers (certain foods, products, or movements) can accidentally reinforce the brain’s “danger” prediction. As you build confidence, try reintroducing things you’ve avoided, pairing them with calm reassurance.Practice daily safety messages.
The brain changes through repetition. Regularly tell yourself:“My body is safe.”
“This sensation is temporary.”
“My brain can calm these signals.”
Over time, your brain learns there is no real threat — and the burning begins to fade.
A Real Example
One of my clients had months of burning skin sensations that seemed to move from her face to her arms. After medical tests ruled out physical causes, we used PRT to help her reinterpret the sensations as harmless brain signals. She practiced daily reassurance, calming techniques, and resumed activities she had been avoiding. Within weeks, the burning decreased dramatically.
When to Seek Help
If you’re dealing with chronic burning sensations, a Pain Reprocessing Therapy coach or therapist can guide you through this process safely and effectively. Having support can make it easier to overcome fear and build confidence in your body again.
Key Takeaway
Burning mouth or burning skin can be the brain’s way of expressing stress, fear, or hypervigilance — not necessarily a sign of damage. With Pain Reprocessing Therapy, you can teach your brain to feel safe again, and your body can return to comfort and calm.
Pain Reprocessing Therapy and Fibromyalgia: A New Way to Understand and Heal Chronic Pain
For years, fibromyalgia has been one of the most misunderstood and frustrating conditions—for both patients and practitioners. Widespread pain, fatigue, poor sleep, and brain fog can make even the simplest daily tasks exhausting. Traditional medical treatments often focus on symptom management through medication, yet many people continue to struggle.
But what if fibromyalgia isn’t just a problem in the body—what if it’s also a problem in the brain?
That’s where Pain Reprocessing Therapy (PRT) comes in. This emerging approach offers hope for those living with fibromyalgia by helping the brain “unlearn” pain that’s no longer serving a protective purpose.
Understanding Fibromyalgia Through a Neuroplastic Lens
Fibromyalgia is often described as a “central sensitization” condition—meaning the nervous system becomes overly sensitive to signals from the body. The brain begins to interpret normal sensations, such as muscle tension or mild pressure, as painful.
In other words, the pain is real, but the cause is not tissue damage—it’s a miscommunication in the nervous system.
This is what’s known as neuroplastic pain, and it’s the same mechanism that PRT targets.
What Is Pain Reprocessing Therapy (PRT)?
Pain Reprocessing Therapy is a mind-body approach developed from the latest neuroscience of pain. It teaches people how to retrain the brain to interpret signals from the body accurately again—essentially rewiring neural pathways that have been stuck in a danger loop.
PRT is based on three key principles:
Pain is not always a sign of injury. In fibromyalgia, the brain has learned to associate certain sensations with danger, even when there’s no physical threat.
The brain can change. Through neuroplasticity, new neural pathways can replace old pain circuits.
Safety is the antidote to pain. When the brain feels safe, it turns down the “pain alarm.”
How PRT Helps People with Fibromyalgia
PRT involves gentle awareness practices that shift your relationship with pain. Instead of fearing it or fighting it, you learn to observe pain sensations calmly and reinterpret them as safe.
Here’s what that process often looks like:
Somatic tracking: Paying close attention to sensations in the body with curiosity rather than fear. This helps the brain learn that the sensations are not dangerous.
Reassessing pain beliefs: Understanding that pain can come from the brain—not damage—helps reduce fear, which in turn lowers pain intensity.
Emotional connection: Many people with fibromyalgia notice their pain increases during stress. PRT includes exploring emotional patterns that may be amplifying the body’s alarm system.
Reinforcing safety: By repeatedly pairing body sensations with a feeling of safety and calm, the brain begins to “rewire” itself away from chronic pain.
The Science Behind It
Research has shown promising results. In a 2021 study at the University of Colorado Boulder, people with chronic back pain who underwent PRT reported significant reductions in pain—and many were pain-free at follow-up.
While fibromyalgia-specific studies are still emerging, the same underlying mechanisms apply: central sensitization, fear of pain, and neuroplastic change. Early clinical observations suggest that PRT can help reduce pain, fatigue, and emotional distress in fibromyalgia patients.
A New Hope for Healing
Fibromyalgia can make people feel powerless. But when you begin to understand that your pain is being generated by a sensitized brain—not a broken body—you start to see new possibilities for recovery.
PRT doesn’t mean your pain is “all in your head.” It means your brain and body are capable of change.
Through consistent practice and compassionate awareness, many people find that their symptoms begin to soften, energy returns, and life starts to feel open again.
Moving Forward
If you live with fibromyalgia, it’s worth exploring PRT as part of a holistic healing plan. Working with a trained PRT coach or therapist can help guide you through the process safely and effectively.
Remember—your brain learned to create pain, and it can learn to let it go.
Is My Pain Caused by My Brain? Understanding Neuroplastic Pain Through Pain Reprocessing Therapy
If you’ve been in pain for months or even years, it’s normal to wonder:
“Is there something wrong with my body—or could my brain be causing this pain?”
That question can feel confusing, even frustrating. But understanding the answer is often the turning point in recovery.
The Brain’s Role in Pain
All pain—no matter where it starts—is generated in the brain.
That doesn’t mean your pain is “imaginary.” It means your nervous system decides when to produce pain as a way of protecting you from perceived danger. When the brain believes something is wrong or unsafe, it sends a pain signal to get your attention.
This system works beautifully when you actually have an injury.
But sometimes, after an injury heals—or even without one—the brain can get stuck in protection mode. It keeps producing pain even though your body is safe. This is what we call neuroplastic pain: pain that is learned and maintained by the brain, rather than by tissue damage.
How Pain Becomes a Habit
Just like learning to ride a bike or play an instrument, your brain learns patterns.
When pain persists, the neural pathways that produce pain become stronger. Your brain gets better at generating pain—especially when it’s been paired with fear, stress, or worry about the body. Over time, the pain can appear even without a physical trigger.
That’s not psychological—it’s neurophysiological. The brain’s prediction system is simply misfiring, expecting danger where there is none.
Signs Your Pain May Be Neuroplastic
While no single sign “proves” anything, these patterns can suggest that your pain is brain-based rather than structural:
The pain moves around, changes sides, or fluctuates in intensity
Medical tests show nothing alarming or “unexplained” findings
The pain increases with stress, fear, or attention
It improves when you’re distracted, relaxed, or on vacation
You’ve tried many physical treatments with little or inconsistent results
If several of these sound familiar, your pain might be maintained by the brain’s protective system—not by ongoing injury.
How Pain Reprocessing Therapy Helps
Pain Reprocessing Therapy (PRT) is a mind-body approach that helps retrain your brain to interpret pain sensations as safe rather than dangerous.
Through techniques like somatic tracking (mindful, curious awareness of pain without fear) and cognitive reappraisal (reframing what pain means), you teach your brain that it no longer needs to produce pain signals for protection.
Over time, the brain learns new associations—safety instead of threat, calm instead of alarm.
As that happens, the pain pathways quiet down, and many people experience dramatic reductions or complete resolution of chronic pain.
The Bottom Line
If you’ve ruled out serious medical issues but pain persists, it may be time to look beyond your body and toward your brain.
Understanding that pain can be learned—and therefore unlearned—is one of the most hopeful discoveries in modern neuroscience.
Your pain is real. But it’s also reversible.
Pain Reprocessing Therapy As It Relates to Chronic Fatigue
Let’s connect the dots between Pain Reprocessing Therapy (PRT) and Chronic Fatigue Syndrome (CFS / ME-CFS).
Chronic Fatigue Syndrome in Context
CFS/ME is characterized by:
Persistent, disabling fatigue not relieved by rest
Post-exertional malaise (symptoms worsen after activity)
Widespread pain, sleep disturbances, and cognitive difficulties (“brain fog”)
Sensory hypersensitivity and autonomic issues (e.g., dizziness, digestive problems)
A key concept in research is central sensitization — the nervous system becomes stuck in a hyper-alert state, amplifying signals of fatigue, pain, and threat.
Where PRT Fits In
PRT is designed to help people with neuroplastic symptoms (pain, fatigue, dizziness, etc.) by retraining the brain’s misinterpretation of safe signals as dangerous.
Applied to CFS, it focuses on shifting the nervous system from threat mode back into safety mode.
Core connections:
Brain misinterpretation – In CFS, the brain often interprets normal exertion, sensations, or stress as dangerous. PRT helps patients learn these sensations are safe.
Fear-symptom cycle – Fatigue and crashes can be worsened by fear of symptoms. PRT interrupts this cycle by reducing symptom-related fear.
Somatic tracking – Observing fatigue, pain, or dizziness with curiosity (not fear) teaches the brain to reclassify signals as safe.
Neuroplastic change – Repeated safety experiences calm the limbic system, which can improve energy, reduce fatigue, and restore resilience.
Practical Adaptations of PRT for CFS
Gentle somatic tracking: Observe fatigue or heaviness in the body without judgment, instead of bracing against it.
Reframe exertion signals: When energy dips, remind yourself “this is my brain misfiring, not actual damage.”
Graded exposure to activity: Slowly reintroduce safe movement and life activities while practicing a safety mindset.
Parts work (IFS integration): Many with CFS have inner parts that fear crashing or being judged. PRT can be paired with compassion toward these parts.
Self-compassion & nervous system regulation: Practices like slow breathing, grounding, or mindfulness enhance the “safety messages” of PRT.
Important Notes
Not all CFS symptoms are purely neuroplastic — there can be physiological drivers (immune, metabolic, autonomic). PRT doesn’t dismiss biology but focuses on the brain’s role in amplifying fatigue.
Success often depends on pacing: moving gently, not pushing too hard into activity, while slowly rewiring fear-based patterns.
Bottom line:
PRT can be a powerful tool for CFS because it targets the fear-fatigue-threat loop in the brain. By retraining the nervous system to interpret body signals as safe, it can help reduce fatigue, improve resilience, and break the cycle of symptom amplification.
What drives neuroplastic pain, and why does our brain sometimes misinterpret danger?
Neuroplastic pain is driven by changes in the brain’s neural pathways, not damage in the body. It’s a type of pain that occurs when the brain learns to interpret certain signals as dangerous—even when there’s no actual tissue damage. This misinterpretation is rooted in the brain’s survival system, which is designed to protect you but can become overly sensitive or “stuck” in protection mode.
What Drives Neuroplastic Pain?
Fear and Threat Perception
When you perceive something as dangerous (like movement, posture, or even a memory), your brain may produce pain to stop you from doing it.
This is known as the pain-fear cycle—fear increases tension, attention, and stress, which amplifies the pain.
Past Experiences and Conditioning
If you’ve been injured or had pain in the past, your brain may associate certain movements, situations, or even emotions with danger.
Over time, these associations become conditioned responses, like Pavlov’s dogs salivating at the bell.
Emotional Suppression and Stress
Chronic stress, suppressed emotions, or trauma can drive pain by activating the brain’s limbic system, which governs emotion and pain.
For example, if anger or sadness is repressed, it can manifest as physical pain.
Hypervigilance
Constant body scanning or worry about symptoms keeps the nervous system on high alert.
This over-sensitization lowers the pain threshold—your brain starts interpreting normal sensations as threats.
Lack of Safety Signals
Your brain calms down when it gets signals of safety (relaxation, joy, movement without harm).
If your environment, thoughts, or self-talk don’t offer those safety cues, the brain stays defensive.
Why the Brain Misinterprets Danger
It’s Wired for Survival, Not Accuracy
Your brain evolved to err on the side of caution. It’s better (from a survival standpoint) to produce pain unnecessarily than to miss a real threat.
This “better safe than sorry” mechanism is protective—but it can go overboard.
It Uses Predictions, Not Just Sensory Input
The brain doesn’t just receive signals from the body—it predicts what they mean based on context and past experiences.
If it expects pain in a certain situation, it might create that pain even without physical cause.
Emotions and Cognitions Influence Perception
Pain is not just physical—it’s sensory, emotional, and cognitive.
Thoughts like “this will never go away” or “I’m broken” can signal danger to the brain, reinforcing pain pathways.
Neuroplasticity (the brain’s ability to change)
This is both the cause and the cure.
The brain can “learn” pain, but it can also “unlearn” it through tools like Pain Reprocessing Therapy, somatic tracking, mindfulness, and emotional processing.
How Pain Reprocessing Therapy Helps Neuroplastic Pain
PRT works by teaching the brain to reinterpret pain signals as safe, rather than dangerous. Since neuroplastic pain is rooted in misinterpreted danger, PRT targets the very mechanisms that are driving the pain—using the brain’s own neuroplasticity to unlearn it.
🔁 Core Ways PRT Helps:
Breaking the Fear-Pain Cycle
How: Through somatic tracking, PRT helps you observe the pain without fear or resistance.
Why it works: This sends a signal of safety to the brain, retraining it to recognize that the sensation is not dangerous, which helps reduce pain intensity over time.
Changing the Brain’s Predictions
How: PRT uses cognitive reframing to challenge the belief that the pain is caused by tissue damage.
Why it works: When the brain understands that the pain is neuroplastic, not structural, it begins to downregulate the danger response.
Creating New, Safe Associations
How: Clients engage in previously painful movements or situations while practicing calm attention and reassurance.
Why it works: This rewires the brain to associate these actions with safety instead of threat, weakening the old neural pain pathways.
Accessing Suppressed Emotions
How: PRT includes gentle emotional work to uncover and process feelings that may be driving the pain subconsciously.
Why it works: When emotional conflict is resolved or expressed, the brain no longer needs to use pain as a protective distraction.
Restoring a Sense of Agency
How: Clients are taught that pain is not a fixed condition but a reversible brain habit.
Why it works: This shift in belief alone can often reduce symptoms, because it removes the perceived threat that keeps the pain alive.
Summary
PRT helps by:
Calming the brain’s overactive danger alarm
Teaching safety through experience
Rewiring neural pathways through mindful attention, movement, and emotional insight
The core message your brain learns is:
🧠 “This sensation is safe. You’re not in danger. You can let go now.”
How Can I Do Pain Reprocessing Therapy On My Own?
You can do Pain Reprocessing Therapy (PRT) on your own, and many people have found relief using self-guided approaches. However, it’s important to understand that PRT is a mind-body practice—not just mental tricks or physical stretches. It’s based on neuroplasticity, meaning your brain can “unlearn” pain by changing how it interprets signals.
Here’s a simple self-guided roadmap to begin PRT on your own:
🧠
Step 1: Understand What Neuroplastic Pain Is
PRT works best if your pain is neuroplastic—caused by the brain’s misinterpretation of safe signals rather than tissue damage.
Ask yourself:
Has your pain lasted longer than typical healing time (3–6 months)?
Does it move around, or vary in intensity?
Did it start during a stressful period or after a minor injury?
Do scans or tests show little or no clear damage?
If yes to many, your pain might be neuroplastic.
🧩
Step 2: Learn to Reframe the Pain
PRT teaches that your body is safe, and the pain is a false alarm. Begin by telling yourself this often:
“This pain is real, but it’s not dangerous. It’s coming from my brain, not my body. My body is safe.”
You need to believe this at a gut level, and that takes repetition. Write it, say it aloud, or even record and replay it to yourself.
🪞
Step 3: Feel the Feelings Beneath the Pain
Often, chronic pain is your brain’s way of protecting you from difficult emotions. Ask:
What was I feeling emotionally when the pain first started?
What am I feeling right now, under the surface of this pain?
Let yourself feel those emotions without judgment or trying to fix them. This process is called emotional expression and is often a key step in recovery.
🧘♀️
Step 4: Somatic Tracking (The Core Tool of PRT)
This is a 1–2 minute practice where you gently pay attention to your pain without fear.
Find a quiet moment.
Tune into the pain. Describe it like a scientist (e.g., “a tight, buzzing sensation”).
Stay calm and curious, not trying to fix it. Just observe.
Remind yourself: “This is safe. My brain is learning it doesn’t need to sound the alarm.”
You can do this several times a day. It helps teach your brain there’s no emergency.
📖
Step 5: Educate and Reinforce Daily
Repetition changes the brain. Use:
Books like “The Way Out” by Alan Gordon (highly recommended).
Podcasts or apps like Curable.
Journaling your pain journey: track what reduces or increases your symptoms.
🏃♂️
Step 6: Resume Normal Activities Gradually
Start returning to things you’ve been avoiding because of pain—but with a new mindset:
“I’m safe. My body can handle this. This is a learning moment, not a danger signal.”
Pair activity with self-compassion and curiosity.
🛠️ Tools That Can Help
The Way Out by Alan Gordon – explains PRT step-by-step.
Curable App – structured mind-body exercises.
Nicole Sachs’ JournalSpeak – great for emotional expression.
Dr. Howard Schubiner’s “Unlearn Your Pain” – deeper dive with journaling and education.
⚠️ When to Seek Support
You can do a lot solo, but if:
You’re struggling to make progress,
You’re feeling emotionally overwhelmed,
Or you’re unsure if your pain is neuroplastic,
…working with a trained PRT coach or therapist can accelerate healing.
How to Tell if Your Pain is Neuroplastic
Telling if your pain is neuroplastic—meaning it’s rooted in brain and nervous system changes rather than ongoing tissue damage—requires a mix of observation, self-reflection, and sometimes professional input. Here are some common signs that suggest your pain may be neuroplastic:
Signs Your Pain Might Be Neuroplastic
The pain moves or varies in intensity
It may shift locations, come and go, or flare without a clear physical trigger.No clear physical cause or injury
Medical tests (X-rays, MRIs, blood work) often come back normal or don’t match the level of pain.Pain began during or after a stressful time
Emotional trauma, life changes, or chronic stress preceded the onset.It gets worse with attention or fear
Pain increases when you focus on it, worry about it, or avoid movement due to fear.You’ve tried many treatments with little success
Especially when structurally-focused treatments (e.g., surgery, physical therapy) haven’t helped long-term.Pain improves with education or relaxation
Understanding neuroplastic pain (like through Pain Reprocessing Therapy or similar approaches) leads to relief.Sleep and mood are affected
Chronic neuroplastic pain often comes with anxiety, depression, or sleep issues—not because they cause the pain, but because the brain is sensitized.“Symptom hunting” becomes a habit
You become hyper-aware of sensations, always checking your body for signs of danger.
What To Do If You Suspect Neuroplastic Pain
Learn about the brain’s role in pain (books like The Way Out by Alan Gordon or Healing Back Pain by Dr. John Sarno).
Try journaling or expressive writing to explore emotional links to pain.
Work with a coach or therapist trained in Pain Reprocessing Therapy (PRT), Somatic Tracking, or related methods.
Practice safe movement and gradually expose yourself to feared activities.
Migraines and Neuroplasticity as it Relates to Pain Reprocessing Therapy
Migraines and neuroplasticity are deeply interconnected, especially in the context of Pain Reprocessing Therapy (PRT), which is built on the principle that the brain can “unlearn” chronic pain patterns. Here’s how it connects:
1. Understanding Migraines Through a Neuroplastic Lens
Migraines aren’t just vascular events; they’re increasingly understood as a brain-based disorder involving altered sensory processing. This includes:
Heightened sensitivity to stimuli (light, sound, smell)
Hyperexcitability in brain regions like the thalamus, somatosensory cortex, and insula
Dysfunction in pain modulatory systems (e.g., reduced descending inhibition)
Over time, repeated migraine episodes may cause the brain to “learn” or reinforce pain pathways—this is maladaptive neuroplasticity.
2. Pain Reprocessing Therapy (PRT) and Migraines
PRT is grounded in the idea that chronic pain (including some forms of migraines) can become a learned brain response rather than just a signal of tissue damage or physical dysfunction.
PRT works by:
Helping the brain reinterpret pain signals as safe
Interrupting fear-pain loops
Encouraging new, healthier neural pathways using mindfulness, somatic tracking, and reappraisal
In migraines, this could involve:
Recognizing early symptoms without fear
Interrupting catastrophic thinking (“I’m going to be out for days”)
Creating new associations (e.g., calming instead of bracing when pain arises)
3. Neuroplasticity in Action
Chronic migraine sufferers may develop heightened vigilance and fear toward any trigger or prodrome. This reinforces the brain’s pain circuits. PRT helps leverage positive neuroplasticity to:
Downregulate the “threat” value of migraine symptoms
Reduce sensitivity to triggers by removing the fear-response
Potentially decrease frequency and intensity over time
4. Research & Clinical Perspective
While PRT is most researched in back pain (e.g., Ashar et al., 2021), its principles are applicable to other centralized pain conditions, including migraines—especially those not responding well to traditional treatments.
In clinical practice, when migraine sufferers begin to change their relationship to the pain, the brain starts to “unlearn” the pattern, and symptoms may become less frequent or severe.
What is Central Sensitization Syndrome as it Relates to Pain Reprocessing Therapy?
Central Sensitization Syndrome (CSS) refers to a condition in which the central nervous system (CNS) becomes hypersensitive to stimuli, leading to an exaggerated pain response even when no actual tissue damage is present. In the context of Pain Reprocessing Therapy (PRT), CSS is seen as a key mechanism underlying chronic pain that Pain Reprocessing Therapy aims to reverse by retraining the brain’s response to pain signals.
Central Sensitization Syndrome and Chronic Pain
1. Definition and Mechanism
Central sensitization occurs when the neurons in the brain and spinal cord become hyperactive and overly responsive to input. This results in:
• Increased pain sensitivity – Stimuli that wouldn’t normally cause pain (like light touch) become painful (allodynia).
• Amplified pain response – Pain that would normally be mild feels severe (hyperalgesia).
• Persistent pain – Even after the initial injury or tissue damage has healed, the pain continues due to the heightened sensitivity of the CNS.
2. How Central Sensitization Develops
• Prolonged or intense pain signals from an injury or illness can trigger changes in the CNS.
• The nervous system essentially “learns” pain, reinforcing the neural pathways that carry pain signals.
• Emotional and psychological factors, such as fear, stress, and anxiety, can further amplify this process, creating a pain-fear cycle where fear and hypervigilance around pain increase neural sensitivity.
Pain Reprocessing Therapy and Central Sensitization
Pain Reprocessing Therapy directly addresses the maladaptive neural pathways involved in CSS through a combination of cognitive and emotional strategies aimed at decreasing the brain’s learned pain response.
1. Education on the Brain’s Role in Pain
• Pain Reprocessing Therapy begins by teaching clients that chronic pain is often driven by neural sensitization rather than structural damage.
• Understanding that pain is a false alarm generated by the brain (rather than a sign of physical harm) reduces fear and helps disrupt the pain-fear cycle, which is central to central sensitization.
2. Somatic Tracking
• Pain Reprocessing Therapy uses somatic tracking to help clients shift their attention toward pain in a non-threatening, curious manner.
• This involves observing pain sensations without judgment or fear, which calms the overactive threat response and reduces central sensitization over time.
3. Cognitive Reframing and Emotional Regulation
• Pain Reprocessing Therapy helps clients identify and reframe maladaptive thoughts about pain (“I am damaged” or “This pain means something is wrong”).
• Addressing underlying emotional stressors (like fear, anger, and grief) reduces the activation of the brain’s threat detection system, which contributes to central sensitization.
4. Breaking the Pain-Fear Cycle
• By reducing fear and emotional reactivity around pain, Pain Reprocessing Therapy helps “rewire” the neural circuits involved in pain processing.
• This decreases the brain’s hypervigilance and reduces the heightened sensitivity of the CNS.
How Pain Reprocessing Therapy Reverses Central Sensitization
1. Decreasing fear reduces the amygdala and limbic system activation, lowering the threat response.
2. Somatic tracking increases interoceptive safety signals, which retrain the brain to interpret body sensations as non-threatening.
3. Cognitive restructuring reduces the brain’s tendency to amplify pain signals by challenging maladaptive pain-related beliefs.
4. Over time, this process results in desensitization of the CNS, reducing both pain intensity and the likelihood of chronic pain recurrence.
Research and Evidence
The connection between central sensitization and Pain Reprocessing Therapy is supported by research on neuroplasticity and the role of emotional and cognitive factors in chronic pain. For example, the Boulder Back Pain Study demonstrated that Pain Reprocessing Therapy significantly reduced chronic back pain by targeting the brain’s learned pain response, which aligns with the mechanisms of central sensitization.
Summary
Central Sensitization Syndrome reflects a state where the brain and spinal cord become hypersensitive to pain signals, even when no injury is present. Pain Reprocessing Therapy addresses CSS by retraining the brain’s response to pain through education, cognitive restructuring, emotional processing, and somatic tracking — effectively reversing the hypersensitivity that underlies chronic pain.
Is Pain Reprocessing Therapy a Good Alternative to Chronic Pain Surgeries?
It depends on the cause of the chronic pain, but for many types of chronic pain, Pain Reprocessing Therapy (PRT) can be a very good alternative to surgery, especially when the pain is due to neural plastic pain rather than clear structural damage.
When PRT could be a good alternative:
Back pain, neck pain, or joint pain with no clear structural damage on imaging.
Pain that has lasted for months or years despite physical therapy, medications, or other treatments.
Pain that seems to move around, or flare up with stress, emotions, or life changes.
Conditions like fibromyalgia, tension headaches, or chronic pelvic pain.
Doctors have told you there’s nothing wrong, or the structural changes found (like mild disc degeneration) are normal for your age.
When surgery may still be needed:
Severe structural damage (e.g., complete rotator cuff tears, unstable fractures, severe nerve compression causing loss of function, etc.).
Clear mechanical issues that directly correlate with your pain and limit function in ways that conservative care can’t address.
Emergencies, like cauda equina syndrome or rapidly progressing neurological deficits.
Why PRT can help avoid unnecessary surgery:
In many cases of chronic pain, surgery is performed because no other options seemed to work but if the pain is actually due to the brain being stuck in a protective pain cycle, surgery won’t resolve the root cause. PRT helps retrain the brain to perceive safe sensations as safe again, reducing or eliminating the pain.
Bottom line:
If your chronic pain fits the profile of neuroplastic pain, PRT could be a very effective, non-invasive, and lasting alternative to surgery. If the pain is caused by clear structural damage, surgery might still be needed.
Can Pain Reprocessing Therapy Cure Chronic Pain?
Pain Reprocessing Therapy (PRT) is not necessarily a cure in the traditional sense, but it has been shown to be highly effective in reducing or even eliminating chronic pain in some cases. PRT is based on the idea that many forms of chronic pain are caused by neural pathways in the brain rather than structural damage in the body. By retraining the brain’s response to pain signals, PRT aims to reduce fear and change the way pain is processed.
Clinical studies, including a 2021 study published in JAMA Psychiatry, have demonstrated that PRT can lead to significant pain reductions, with some participants becoming pain-free. However, results vary from person to person, and success depends on factors such as the individual’s openness to the approach, the nature of their pain, and their commitment to the process.
How Pain Reprocessing Therapy Helps With Knee Pain
Pain Reprocessing Therapy (PRT) helps with knee pain by addressing the brain’s role in amplifying and perpetuating chronic pain. It is particularly effective for pain that persists beyond normal tissue healing time, often referred to as neuroplastic or centralized pain. Here’s how PRT works for knee pain:
1. Retraining the Brain’s Response to Pain
Chronic knee pain can become a conditioned response, where the brain mistakenly interprets normal or mild sensations as painful.
PRT helps patients recognize that their pain is not necessarily caused by structural damage but by misfiring pain pathways.
2. Reducing Fear and Catastrophizing
Many people with knee pain develop fear around movement, leading to avoidance and increased sensitivity.
PRT encourages safe movement and reintroduces normal activities without fear, breaking the cycle of pain reinforcement.
3. Somatic Tracking and Mindfulness
Patients learn to observe their pain with curiosity rather than fear, which helps to reduce the brain’s overactive pain response.
This process involves noticing pain without reacting emotionally, which can lead to a decrease in pain intensity.
4. Cognitive Reframing
PRT teaches individuals to reinterpret knee pain signals as non-threatening, shifting the focus from danger to safety.
This helps in rewiring neural pathways to decrease pain over time.
5. Gradual Exposure to Movement
By engaging in movements that were previously avoided, patients help their nervous system unlearn the pain association.
This can restore confidence in movement and reduce pain sensitivity.
Who Can Benefit?
PRT is most effective for people with persistent knee pain that isn’t clearly linked to ongoing structural damage, such as:
Osteoarthritis with disproportionate pain levels.
How Does Pain Reprocessing Therapy Help with Back Pain?
Pain Reprocessing Therapy (PRT) is a psychological approach aimed at treating chronic pain, including back pain, by addressing the brain’s role in perceiving and perpetuating pain. The therapy is based on the idea that chronic pain often results from neural pathways in the brain becoming overly sensitized to signals from the body, even in the absence of tissue damage. Here’s how it helps:
1. Understanding the Pain Origin
• Reconceptualization: PRT helps patients understand that their chronic back pain may not be caused by structural damage or injury but by misfiring neural circuits. This shift in perception reduces fear and anxiety around the pain, which can perpetuate the cycle of pain.
2. Reducing Fear and Catastrophizing
• Chronic pain often triggers fear and avoidance behaviors, leading to increased sensitivity and heightened pain perception. PRT teaches patients that their pain is safe and not a sign of harm, which helps calm the nervous system.
3. Rewiring the Brain
• Neuroplasticity: Through techniques like mindfulness, somatic tracking, and positive reinforcement, PRT helps patients “retrain” their brains to interpret pain signals differently. Over time, this reduces the intensity and frequency of pain.
4. Somatic Tracking
• Patients are guided to observe their pain with curiosity and without fear, helping them disconnect from the emotional and fearful response to pain. This reduces the brain’s tendency to amplify pain signals.
5. Breaking the Pain-Fear Cycle
• Fear and stress can exacerbate pain. PRT works to disrupt this cycle by teaching relaxation and reframing techniques, helping patients feel more in control of their pain.
Evidence of Effectiveness
Clinical studies have shown that PRT can significantly reduce or even eliminate chronic pain in some individuals, particularly when the pain is driven by central sensitization (overactive pain pathways) rather than ongoing physical damage.
By addressing the brain’s role in maintaining pain, PRT offers a non-invasive, drug-free approach to managing and potentially overcoming chronic back pain.
Can Pain Reprocessing Therapy Help with Phantom Limb Pain?
Yes, Pain Reprocessing Therapy (PRT) has shown potential for helping with phantom limb pain. PRT is a psychological approach that focuses on retraining the brain to reinterpret pain signals as non-threatening. Since phantom limb pain is thought to involve maladaptive neural plasticity and the brain misinterpreting signals, PRT may be beneficial in reducing or even resolving this type of pain.
How PRT May Help with Phantom Limb Pain:
1. Changing the Brain’s Interpretation of Pain:
• Phantom limb pain often arises from the brain’s persistent misinterpretation of signals from a missing limb. PRT helps teach the brain that these signals are not harmful, which can reduce pain perception.
2. Addressing Neural Pathways:
• PRT works by targeting the neural pathways that perpetuate chronic pain, helping to “rewire” the brain to create healthier patterns.
3. Reducing Fear and Hypervigilance:
• Many individuals with phantom limb pain develop heightened anxiety or fear of pain, which can exacerbate symptoms. PRT addresses the emotional and psychological components, helping reduce the intensity and frequency of pain episodes.
4. Promoting Relaxation and Neuroplasticity:
• Techniques used in PRT, such as somatic tracking and mindfulness, can help calm the nervous system, creating an environment conducive to neuroplastic changes.
Evidence and Limitations:
While studies on PRT have primarily focused on conditions like back pain, migraines, and fibromyalgia, its principles are applicable to phantom limb pain.
If you’re considering PRT for phantom limb pain, consulting with a trained PRT practitioner or pain psychologist experienced in treating phantom pain is a good first step.
Can Pain Reprocessing Therapy Help With Conditioned Pain?
Yes, Pain Reprocessing Therapy (PRT) has shown promise in helping with conditioned pain. Conditioned pain refers to chronic pain that persists even in the absence of physical damage or injury, often maintained by learned neural pathways. Pain reprocessing therapy is based on the idea that chronic pain can be the result of the brain misinterpreting signals and continuing to activate pain pathways unnecessarily.
Pain reprocessing therapy aims to retrain the brain to interpret these signals correctly and reduce or eliminate the chronic pain. It combines elements of cognitive-behavioral therapy, mindfulness, and somatic tracking to help individuals:
1. Recognize that the pain is due to neural pathways, not tissue damage: This reduces the fear and anxiety that can intensify pain.
2. Engage with the pain in a new way: Rather than avoiding or bracing against the pain, patients are encouraged to observe it with curiosity and without fear, helping to break the conditioned response.
3. Recondition the brain’s response to stimuli: Over time, this can help the brain stop misfiring pain signals.
There have been studies, such as one published in JAMA Psychiatry in 2021, showing that pain reprocessing therapy can lead to significant reductions in chronic pain, especially in conditions like chronic back pain where no structural damage explains the pain. By addressing the brain’s role in chronic pain, PRT can help reduce or eliminate pain that has become conditioned.