“Changes in the brain cause the pain to persist. Basically, the brain learns the pain. What we tried to do in this study was teach people how to unlearn the pain.” – Yoni Ashar, PhD, Lead author of the JAMA Psychiatry RCT

A secondary analysis of clinical trial data shows that Pain Reprocessing Therapy significantly reduces pain intensity and fear avoidance behaviors by increasing mind- or brain-related attributed causes of pain.

“Negative thoughts and emotions can worsen chronic pain, but the reverse is also true — positive thoughts and emotions can relieve pain.”

Maladaptive body awareness [is] characterized as a tendency to respond to bodily sensation with beliefs of catastrophic outcomes or to apprise bodily sensations as a threat to bodily integrity. Maladaptive body awareness is thought to enhance hypersensitivity in central pain processing through activation of limbic brain regions, which contributes to and sustains central sensitization.” 

Pain can beget more pain. For example, an injury may turn up the volume on your pain response to future injuries. Stress may cause pain to persist long after an injury has healed. And if your back twinges and you start imagining all the ways it could get worse, that fear can magnify your pain, which may lead you to avoid physical activity, which then makes the pain even worse. Experts call this the pain cycle.

The goal of the clinical trial testing pain reprocessing therapy was to reprogram patients’ brains by teaching them that “ongoing agony was not caused by lingering tissue injury, but by misfiring neural circuits related to [their] dread of pain. | One promising area of research is looking at the way “catastrophizing” about pain—thinking it will never get better, that it’s the worst ever, or that it will ruin your life—plays a central role in whether these predictions come true.

A study evaluating Pain Reprocessing Therapy shows that psychological treatment focused on changing beliefs about the causes and consequences of chronic low back pain may provide substantial, long-lasting pain relief.

The latest pain science is showing that the communication between the brain and the body can be corrected and that patients who have spent years, sometimes decades, of their life in pain, can finally overcome it.

Perceptions of injustice, feelings of anger, feeling misunderstood or stigmatized often drive hypervigilance towards painful sensations. “Higher levels of perceived injustice have been associated with an attentional bias towards pain in people with chronic low back pain, and this bias can amplify the pain experience as well as contribute to avoidance behaviors and long-term disability.

People with back pain are often told their back is vulnerable and needs protecting. This changes how we filter and interpret information from our back and how we move our back. Over time, the back becomes less fit, and the way the back and brain communicate is disrupted in ways that seem to reinforce the notion that the back is vulnerable and needs protecting. The treatment we devised aims to break this self-sustaining cycle,” says Professor McAuley from UNSW’s School of Health Sciences.

"For many people like me, it turned out, moving away from pain as an identity isn’t the result of recovery—it’s actually the treatment.” – Isobel Whitcomb for Slate

A growing pile of research suggests that talk therapy may help you retrain your brain so that you experience less pain and can cope with it better. This isn’t suggesting that your pain is not real or that it’s ‘all in your head,’ says Tor Wager, PhD.

Pain-reprocessing therapy is one of the only psychological treatments known to cure pain — at least in some patients with nociplastic pain, or pain that occurs in the absence of obvious physical damage.

Pain reprocessing therapy (PRT) is a recent treatment approach based on the premise that the brain can generate pain without injury. Learning and practicing ways to think differently about chronic pain and changing one’s beliefs about it can significantly reduce one’s pain.

CU Boulder researchers recruited patients to participate in Pain Reprocessing Therapy. Two-thirds of studied participants were pain-free at the end of four weeks.

Los Angeles Psychotherapist Alan Gordon featured on CBS’ hit TV Show, ‘The Doctors’, explains the brain science behind the neural pathways responsible for chronic pain experienced by millions and why his treatment methods are getting so much attention.