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.
Can Pain Reprocessing Therapy Help With the Pain of Endometriosis?
Endometriosis is a chronic condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus, often causing severe pain, particularly during menstruation. The pain from endometriosis is typically due to inflammation, the formation of scar tissue, and irritation of nearby tissues. Because of this, the pain associated with endometriosis has a strong physiological basis.
Pain Reprocessing Therapy (PRT) and Endometriosis:
PRT primarily targets chronic pain that is thought to be maintained or amplified by the brain’s processing of pain signals, often in conditions where pain persists after the initial injury or insult has healed. While PRT is helpful with the central sensitization aspect of chronic pain in endometriosis—where the nervous system becomes more sensitive to pain signals—it’s important to note that endometriosis involves ongoing tissue damage and inflammation.
In cases where endometriosis pain has become chronic and the nervous system is amplifying the pain signals (a phenomenon known as central sensitization), PRT helps reduce the perception of pain by retraining the brain to down regulate its response to pain signals.
Traditional treatments for endometriosis include:
1. Medication:
• Pain relievers (NSAIDs like ibuprofen)
• Hormonal therapies (birth control pills, GnRH agonists)
• Progestin therapy
2. Surgery:
• Laparoscopic surgery to remove endometrial tissue
• Hysterectomy in severe cases
3. Lifestyle and Alternative Therapies:
• Dietary changes
• Acupuncture
• Pelvic floor physical therapy
Conclusion:
PRT can definitely offer some relief as a complementary therapy for managing chronic pain associated with endometriosis, particularly if central sensitization is involved.
Can pain reprocessing therapy be used with emotions like depression and anxiety?
Yes, Pain Reprocessing Therapy (PRT) can be adapted for emotions like depression and anxiety.
Originally designed to treat chronic pain, PRT focuses on altering the brain’s perception of pain by addressing psychological factors. Since depression and anxiety also involve the brain’s response to emotional pain or stress, PRT’s principles can be applied to help reframe and reduce these emotional responses.
The core idea is that the brain can be “retrained” to respond differently to triggers. In the case of depression and anxiety, PRT can help individuals recognize and reframe negative thought patterns, much like how it helps people reprocess pain signals.
Pain Reprocessing Therapy (PRT) can potentially be adapted to address a range of emotions beyond depression and anxiety, particularly those that are rooted in maladaptive or distorted thought patterns. These emotions include:
1. Fear: Fear often stems from perceived threats or danger, and PRT can help reframe these perceptions, reducing the intensity of the emotional response.
2. Anger: Anger can be linked to unprocessed pain or perceived injustice. PRT can help individuals understand the underlying causes and change their response to triggers.
3. Guilt: Feelings of guilt, especially when they are disproportionate to the situation, can be addressed by reframing the thoughts that lead to this emotion.
4. Shame: Shame is a deeply internalized emotion often tied to self-identity. PRT can help by challenging and altering the beliefs that contribute to this emotion.
5. Grief: While grief is a natural response to loss, PRT can help with prolonged or complicated grief by helping individuals reprocess the emotional pain associated with their loss.
6. Resentment: Resentment is often linked to past hurts or injustices. PRT can help individuals reprocess these feelings, reducing their hold over the person.
By applying the principles of PRT, individuals can learn to reinterpret and reframe their emotional experiences, potentially reducing the intensity and impact of these emotions on their daily lives.
It Hurts To Sit. Is this Neuroplastic Pain? If So, Will Pain Reprocessing Therapy Help?
Pain Reprocessing Therapy (PRT) is a psychological approach primarily aimed at treating chronic pain that is thought to be maintained by neural pathways rather than ongoing tissue damage. PRT focuses on altering the brain’s perception of pain by teaching the individual to reinterpret the pain signals as non-threatening.
If tailbone pain is neuroplastic, meaning it is maintained or amplified by changes in the brain’s neural pathways rather than by ongoing tissue damage, Pain Reprocessing Therapy (PRT) could potentially be effective.
Neuroplastic pain occurs when the brain continues to send pain signals even after the original injury or cause of pain has healed, often due to central sensitization or maladaptive pain processing.
PRT aims to rewire the brain’s response to pain by helping individuals reinterpret their pain signals as non-threatening. The therapy involves techniques like mindfulness, cognitive restructuring, and somatic tracking, which help reduce fear and anxiety associated with pain, thereby diminishing the brain’s overreaction to these signals.
In cases where tailbone pain has become chronic and is believed to be driven by these neuroplastic changes, PRT could help reduce or eliminate the pain by retraining the brain to stop generating these pain signals. However, it’s important to have a thorough evaluation by a healthcare provider to confirm that the pain is neuroplastic and that PRT is an appropriate treatment.
In summary, PRT could be effective for tailbone pain if the pain is thought to be maintained or amplified by neural mechanisms rather than purely physical causes.
Is Pain Reprocessing Therapy Evidence-Based?
Yes, Pain Reprocessing Therapy (PRT) is considered evidence-based, particularly for chronic pain conditions like chronic back pain. A notable study published in 2021 in the journal JAMA Psychiatry demonstrated the effectiveness of PRT. In this randomized clinical trial, participants who received PRT showed significant reductions in pain intensity and improved physical and emotional functioning compared to those in control groups.
The study's findings suggest that PRT can be an effective treatment option by addressing the brain's perception and response to pain, thus altering the pain experience. This approach focuses on retraining the brain to interpret pain signals differently, ultimately reducing the intensity and frequency of pain.
A New Approach to Treating Chronic Back Pain: The Boulder Study
Chronic back pain can be debilitating, often persisting without a clear physical cause. Recent research from the University of Colorado Boulder has introduced an innovative treatment known as Pain Reprocessing Therapy (PRT), focusing on retraining the brain’s response to pain. This study, involving 151 participants, demonstrated that PRT could significantly reduce pain by changing how the brain processes pain signals. Remarkably, two-thirds of participants reported being pain-free or nearly pain-free after just four weeks of treatment, with benefits lasting up to a year. This breakthrough suggests that chronic pain may be effectively managed by addressing the neurological pathways associated with pain perception, offering a promising alternative to traditional pain management methods.
Key Insights from the Study
1. Understanding Chronic Pain: Chronic pain is often maintained by persistent brain signals, even after an initial injury has healed. This study highlights the role of the brain in sustaining pain sensations, suggesting that altering these neural pathways can provide relief.
2. Pain Reprocessing Therapy (PRT): PRT involves techniques that help patients reframe their understanding of pain, recognizing it as a brain-generated phenomenon rather than a purely physical one. This cognitive shift can help reduce the intensity and frequency of pain.
3. Study Outcomes: Participants underwent eight one-hour PRT sessions. After just four weeks, two-thirds of them experienced significant pain relief, with many becoming pain-free or nearly pain-free. This improvement was not only rapid but also sustained, with follow-up assessments indicating continued benefits up to a year later.
4. Implications for Treatment: The findings from the Boulder study suggest that psychological and neurological approaches like PRT can be effective for chronic pain management. This challenges the traditional focus on physical interventions, such as medication and surgery, and opens the door to more holistic and brain-centered therapies.
The Boulder study offers hope to those suffering from chronic back pain, providing a new perspective on treatment that emphasizes the power of the brain in managing and alleviating pain. As research in this area continues, it may lead to more effective, non-invasive treatments for chronic pain sufferers worldwide.
Dr. Sarno’s Daily Reminders for Chronic Pain
The pain is due to TMS, not to a structural abnormality
The direct reason for the sensation is Neuroplasticity
TMS is a harmless condition caused by my repressed emotions
The principal emotion is my repressed ANGER/RAGE
TMS exists only to distract my attention from the emotions, and limiting beliefs
Since my back (replace with whatever pain you’ve got) is basically normal there is nothing to fear
Therefore, physical activity is not dangerous
And I MUST resume all normal physical activity (slowly)
I will not be concerned or intimidated by the pain. I will be indifferent instead
I will shift my attention from my sensations to the emotional issues (Anger, rage, depression, not feeling good enough, not feeling safe, and not feeling worthy of being well, etc.)
I intend to be in control-NOT my subconscious mind
I must think Psychological at all times, NOT physical.
Is Pain Reprocessing Therapy a Good Alternative Treatment for Headaches, Migraines, and New Daily Persistent Headaches?
Pain Reprocessing Therapy (PRT) is a promising approach for treating chronic pain conditions by helping patients reframe how they perceive pain. Though, its use for headaches, including tension headaches or other types, needs careful consideration.
Current Evidence and Research
Chronic Pain Treatment:
PRT has shown efficacy in conditions like chronic back pain where the chronic pain is believed to be perpetuated by central nervous system sensitization and maladaptive neural pathways.
Headaches:
The principles of PRT, which involve altering the brain's perception of pain, benefit some headache sufferers, particularly if their headaches have a strong stress or nervous system component. In my practice, I have had great success in treating all kinds of headaches—the principles of PRT work for all kinds of pain.
I have worked with multiple clients with new daily persistent headaches. Each client is different, but using a combination approach of PRT practices and TMS coaching resulted in near complete reduction of symptoms.
My prescription for headaches is a combination of PRT and mindbody principles developed by Dr. John Sarno in the 80s and 90s (TMS.) Our central nervous systems become programmed for pain. This means that it is important to go in and decondition the CNS so that it calms down, creating less need for pain.
Mechanism of PRT
PRT aims to retrain the brain to view pain signals as non-threatening, reducing the intensity and frequency of pain experiences. For headaches, particularly tension-type headaches which are often linked to stress and muscle tension, this reprocessing reduces headache frequency and severity.
Practical Considerations
Multifactorial Nature of Headaches:
Headaches can result from a wide range of causes including stress, muscle tension, hormonal changes, dietary factors, and more. Addressing headaches often requires a multifaceted approach.
Complementary Approach:
PRT may be most effective when used alongside other treatments such as mindbody approaches, medication, lifestyle changes, meditation, and stress management techniques.
Individual Variation:
The response to PRT can vary. Some individuals may find significant relief, while others may need additional or alternative treatments.
Professional Guidance:
Working with healthcare professionals who understand both headache management and PRT can help tailor a treatment plan that incorporates PRT appropriately and monitors its effectiveness.
Conclusion
Pain Reprocessing Therapy is a useful alternative and complementary treatment for headaches, especially for those with a significant stress or nervous system component. Though, given the limited specific research on PRT for headaches, it is best used as part of a comprehensive treatment plan under professional guidance.
How Does One Become Certified in Pain Reprocessing Therapy?
Pain Reprocessing Therapy (PRT) certification is generally achieved through specialized training programs offered by recognized institutions. Here’s a step-by-step guide to becoming certified in PRT:
1. Prerequisite Education: Most programs require participants to have a background in mental health or a related field, such as psychology, counseling, social work, or medicine.
2. Find a Training Program: Look for a reputable organization that offers PRT training. The Pain Reprocessing Therapy Center, for example, offers certification programs.
3. Complete Training Modules: Enroll in the training program and complete the required modules. These programs typically include lectures, workshops, case studies, and supervised practice.
4. Supervised Practice: Engage in supervised clinical practice, where you apply PRT techniques under the guidance of experienced practitioners.
5. Examination: Pass any required examinations that assess your understanding and application of PRT principles.
6. Certification: Upon successful completion of the training and examination, you will receive your certification in Pain Reprocessing Therapy.
To find specific programs and their requirements, it’s best to visit the official websites of organizations that offer PRT certification.
Is Pain Reprocessing Therapy the Same as CBT
Pain Reprocessing Therapy (PRT) and Cognitive Behavioral Therapy (CBT) are not the same, though they share some similarities. Here’s a breakdown of each:
Cognitive Behavioral Therapy (CBT)
• Focus: CBT aims to change negative patterns of thought and behavior that contribute to psychological distress. It is used to treat a variety of mental health conditions, including anxiety, depression, and chronic pain.
• Method: Involves identifying and challenging negative thoughts and beliefs, developing coping strategies, and engaging in behavioral changes.
• Application: Broadly applicable to numerous psychological and physical health issues.
Pain Reprocessing Therapy (PRT)
• Focus: PRT specifically targets chronic pain by addressing the brain’s role in pain perception. It posits that chronic pain can be due to learned neural pathways rather than ongoing physical injury.
• Method: Helps patients understand and reframe their pain as a product of brain activity rather than tissue damage. Techniques include mindfulness, cognitive strategies, and somatic tracking (paying attention to pain in a non-judgmental, curious way).
• Application: Primarily used for chronic pain conditions, especially when pain persists without clear ongoing physical causes.
Key Differences
• Scope: CBT has a wider application for various mental health issues, while PRT is specifically focused on chronic pain.
• Approach: PRT is more centered on changing the brain’s perception and response to pain, whereas CBT encompasses a broader range of cognitive and behavioral interventions.
Both therapies share the goal of altering the way the brain interprets and responds to certain stimuli, but they differ in their specific techniques and areas of focus.