How Pain Reprocessing Therapy (PRT) Is Used in Psychotherapy to Treat Chronic Pain
Understanding Chronic Pain and Its Hidden Roots
Chronic pain affects millions worldwide, often lingering despite no clear physical cause. This type of pain is known as nociplastic, neuroplastic, or central sensitization pain—pain generated and sustained by the brain’s misinterpretation, not by tissue damage. Traditional treatments like medication, injections, or surgery frequently fall short for these cases.
What Is Pain Reprocessing Therapy (PRT)?
Pain Reprocessing Therapy (PRT) is an evidence-based, neuroscience-informed form of psychotherapy that helps the brain “unlearn” chronic pain. It reframes pain not as a sign of injury but as an alarm—often a false one—triggered by neural misfiring. PRT retrains the brain to reinterpret these signals and dismantles the pain‑fear cycle.
Key Components of PRT in Psychotherapy
PRT integrates several core elements commonly used in psychotherapy—cognitive, somatic, mindfulness, and emotional techniques:
Education & Reattribution – Patients learn how chronic pain originates in the brain and how it’s reversible. This knowledge reframes pain as safe rather than threatening.
Cognitive Restructuring – Therapists help clients identify and challenge catastrophic or fear‑based thoughts about pain, replacing them with more balanced and empowering beliefs.
Somatic Tracking & Mindfulness – Patients are guided to observe pain sensations with curiosity and safety. They combine mindfulness (noticing pain without fight or avoidance), safety reassurance (the body is not in danger), and positive, neutral emotional framing.
Emotional Processing & Exposure – Emotional factors, like stress, anxiety, or unresolved trauma, that amplify pain are addressed. Patients are also gradually exposed to feared movements to challenge avoidance and learn that “safe” movement does not worsen pain.
Positive Sensations & Behavior Activation – Patients are encouraged to engage in previously avoided activities, reclaiming agency and building new, positive neural pathways toward safety and comfort.
Effectiveness: What the Research Shows
Clinical Evidence: A prominent randomized controlled trial at the University of Colorado Boulder compared PRT to placebo and usual care in 151 adults with chronic back pain. After four weeks of PRT, 66% were pain-free or nearly so, compared to 20% in the placebo group and 10% in usual care. These results were sustained at one‑year follow‑up PubMedPMC.
Another study reported that 98% of patients improved, reinforcing PRT's long‑term benefits Pain Reprocessing Therapy Center.
Final Thoughts
Pain Reprocessing Therapy stands out in chronic pain psychotherapy by directly targeting the brain-based mechanisms that often maintain pain—rather than masking symptoms. It combines education, cognitive restructuring, mindfulness-based somatic tracking, emotional processing, and behavioral activation to help patients disarm pain's power and reclaim control.
With strong research evidence showing lasting pain reduction and growing real-world testimonials, PRT is a promising tool in the psychotherapeutic treatment of chronic nociplastic pain. Always consult qualified professionals trained in PRT to tailor the approach to your personal needs.
Want to learn more about PRT? You can book online to schedule an appointment or by email liz@slacktidecounselling.ca
