Pain Reprocessing Therapy

A randomized controlled study at the University of Colorado Boulder validated Pain Reprocessing Therapy (PRT) as the most effective current treatment for chronic pain. In the study, there were 100 chronic back pain patients. Half of them received PRT twice a week for four weeks, and half of them received treatment as usual. In the PRT group, 98% of patients improved and 66% of patients were pain-free or nearly pain-free at the end of treatment. These outcomes were largely maintained one year later. 

Additional studies on the efficacy of Pain Reprocessing Therapy are currently underway.

How does it work?  PRT is a system of psychological techniques that retrains the brain to interpret and respond to signals from the body properly, subsequently breaking the cycle of chronic pain. Pain Reprocessing Therapy has five main components: 1) Education on pain and the brain  2) gathering and reinforcing personalized evidence for neuroplastic pain and reversibility of pain, 3) attending to and appraising pain sensations through a lens of safety, 4) addressing other emotional threats, and 5) leaning into positive feelings and sensations.

It’s simply intuitive to conclude that if you have chronic pain, there must be something wrong with your body. But many recent studies have shown that structural abnormalities in the body are often incidental, and not the cause of pain.

Authors of a New England Journal of Medicine study found that 64% of people with no back pain have disc bulges, protrusions, herniations, or disc degeneration. These structural abnormalities are actually quite normal and often unrelated to pain. Furthermore, researchers at the University of Washington found psychological factors to be more predictive of the onset of back pain than any of the physical variables analyzed.

Studies show that approximately 85% of patients with chronic neck or back pain do not have a clearly identifiable, structural cause for their pain. Of the millions of individuals experiencing tension and migraine headaches, only about 5% have an identifiable structural cause. Very few people with irritable bowel syndrome, fibromyalgia, and many chronic pelvic pain syndromes have tissue damage to account for their pain.

While it’s natural to intuit that chronic pain is caused by a problem in the body, recent studies have found that the true source of chronic pain often lies in the brain.

Researchers at Northwestern University tracked a group of patients after an initial episode of back pain and set out to predict who would go on to develop chronic pain. Rather than conducting physical back exams or taking X-rays or MRIs of the spine, scientists used fMRI brain scans to determine the level of connectivity between two key areas. Simply by looking at the brain, researchers were able to determine with 85% accuracy whose pain would persist and whose would resolve.

So how exactly is the brain able to learn pain? 

A seminal study conducted some years ago demonstrated this process in action. The researchers scanned the brains of people who had recently injured their back and found that the pain was associated with activity in standard pain-processing regions, like the somatosensory cortex and thalamus – as expected. But when they scanned those same people one year later, the pain had shifted to brain regions associated with memory, learning, and emotion among those who had developed chronic pain.

These brain changes can cause the pain to persist “on loop” in the brain, relatively independent of any injuries that may or may not be present in the body.

Neuroplastic pain is extremely real.  It just needs a different type of treatment than is traditionally offered within the biomedical model. Healing Track can help. Contact us to set up a session with one of our coaches, and start your healing journey today.