Pain Reprocessing Therapy (PRT)

Original Editor - Tara DiRocco

Top Contributors - Tara DiRocco

Introduction[edit | edit source]

Chronic pain can affect the brain as much as it affects the body. Chronic pain can actually change the structure of the brain by strengthening neural pathways. This teaches the brain the familiar sensation of pain, which leads sufferers to experience “centralized” or “primary” pain. This type of pain isn’t caused by a problem within our bodies, but instead, the changes in the neural pathways of the brain.

This is where neuroplastic treatment like pain reprocessing therapy[1] can be beneficial. Developed by Alan Gordon[2] from the Pain Reprocessing Therapy Center in Los Angeles, California, the purpose of pain reprocessing therapy (PRT) is to break the chronic pain cycle by retraining the brain to react to body signals properly.

Chronic pain, whether back, neck, knee, recurring headaches, or even fibromyalgia, can be psychophysiologic and have no structural basis. If, upon examination, there is no physical damage or reason to account for the pain, then neuroplastic pain will be the diagnosis. This doesn’t mean the pain is all in your head or that you’re imagining it. The pain itself is very real but can be reversed with pain reprocessing therapy.

Definition[edit | edit source]

Pain reprocessing therapy is the use of psychological strategies to retrain the brain to react to pain signals properly, and eventually eliminate brain-fabricated chronic pain.[3]

Purpose of Pain Reprocessing Therapy[edit | edit source]

Chronic pain proven to have no physical or structural cause, is often referred to as “neuroplastic”. Neuroplasticity is an alarm generated by the brain to protect us from danger. Regarding chronic pain, this is essentially a false alarm.

When an injury occurs, the body sends a warning signal to the brain that there may be potential tissue damage. To protect the body from harm, the brain responds by sending out the pain signal. This alerts the body to avoid further damage as quickly as possible and to make corrective measures as needed.

For example: when a knee hurts while walking, the body will signal you to either stop walking altogether or to change the way you’re walking to lessen the pain.

If it’s neuroplastic pain that you’re feeling, the brain has made a mistake by sending out the wrong signals. In most cases, this type of chronic pain derives from some kind of trauma or discomfort that the body endured in the past but has since healed. The pain you feel is still very real, but the signal has been misinterpreted.

Over time, the body learns the associations of pain. The painful area becomes hypersensitive to triggers like physical activity, certain movements, temperatures, touch, and even stress.

Pain reprocessing therapy is aimed toward changing the way the brain reacts when faced with a chronic pain trigger. Essentially, the brain will unlearn what it has associated with danger and break any identifiers surrounding it. Only then will physical activities be pain free again.

Pain Reprocessing Therapy Techniques[edit | edit source]

The most common pain reprocessing therapy technique used to treat chronic pain is Somatic Tracking. This treatment combines mindfulness with safety reassurance, and having a positive attitude. Putting this technique into practice during an activity or movement that causes you pain will help break the psychological attachment between your brain and the particular activity. Gradually, your pain will be reduced or eliminated entirely.

Key Features of Somatic Tracking[edit | edit source]

  • Mindfulness: Notice the pain but have no fear or anxiety surrounding it because you know there is no physical or structural reason for it
  • Safety reassurance: Remind yourself that your body isn’t in danger. Your pain is a false alarm sent by mistake from your brain. You and your body are safe
  • Positive attitude: Stay positive that the pain will disappear if you keep working on rewiring your brain. Read testimonials and true stories about pain reprocessing therapies, so you continue believing, knowing it’s worked for others. Remember: frustration, anxiety, and stress will only prolong the pain. This alone should give you reason for staying upbeat and positive

Other methods of pain reprocessing treatment involve relaxation activities like yoga, meditation, and progressive muscle relaxation. Being aware of your stress factors and avoiding them as much as you can will only help the effect of pain reprocessing therapy.

It will take time and dedication to eliminate your fear of pain and the stress and anxieties that come with it. The key to pain reprocessing therapy is to eliminate the imagined dangers surrounding your pain. In turn, your brain will eliminate or at least reduce chronic pain.

  1. S Afr J Physiother Pain neuroscience education: Which pain neuroscience education metaphor worked best?. PMC. 2019 Aug 13.
  2. Yoni K. Ashar, PhD; Alan Gordon, LCSW; Howard Schubiner, MD. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain. JAMA Psychiatry. 2021 Sep 29.
  3. Shannon Dougherty. Pain Reprocessing Therapy: a New Path to Relief. [last accessed 11/1/2021]