Pain Reprocessing Therapy: A Shift in the Way Chronic Pain is Treated
Chronic pain is experienced by over 25 million in the United States, and billions worldwide (Reynolds, 2021). This debilitating condition is defined as long standing pain, lasting more than three months, that persists beyond the usual recovery period or occurs with a chronic health condition. Chronic pain can be crippling, hindering people’s ability to participate in activities of daily living (ADLs) including working, eating, personal hygiene and physical activity. Individuals who suffer from chronic pain are increasingly susceptible to depression, anxiety, irritability, sleeplessness, drug dependency, and several other impairing conditions. However, a new treatment option tested at the University of Colorado, Boulder has shown much promise in its early stages. The technique is known as Pain Reprocessing Therapy, or PRT, which aims to eliminate, rather than simply manage chronic pain
The first clinical test of PRT was ran in 2021 at the University of Colorado, Boulder and led by Dr. Yoni Ashar and Dr. Tor Wager. The key distinction of this new treatment option is that its focus lies on “primary pain.” While some cases of chronic pain can be attributed to conditions such as cancer, arthritis, endometriosis, and multiple sclerosis, “primary pain” presents with no physical cause. In such cases, pain is often due to misinterpretations made by the brain, as it reads safe messages from the body as if they were dangerous. Dr. Ashar explains that if pain is meant to act as a warning signal that there is something wrong, primary chronic pain resembles a “false alarm stuck in the ‘on’ position” (Marshall, 2021). This phenomenon can be onset by a past injury or traumatic event, from which the brain’s signaling and reading never recovered and the baseline brain maps were disrupted indefinitely.
PRT teaches people to perceive pain signals sent to the brain as less threatening and helps to retrain the nervous system to “unlearn neuroplastic pain pathways” that create very real sensations of pain. PRT typically follows a five-stage process including pain re-education, gathering of individual evidence, somatic tracking, addressing emotional threats, and gravitating towards positive feelings and sensations (Szmelskyj, 2023).
The experiment conducted at the University of Colorado involved a series of 151 individuals with mild to moderate chronic back pain who were randomized into one of the following three treatments: four weeks of intensive PRT, a placebo injection of saline into the back, or a continuation of their usual pain management care. The patients rated their pain at the beginning and end of the four-week trial and underwent functional MRI scans to view any changes in brain activity.
The results of this initial study showed much promise in the viability of this treatment. After 4 weeks, 66% of the group subject to intensive PRT claimed to be pain free or nearly pain free, compared to only 20% of the placebo group, and 10% of the group which continued with their usual management practices (Marshall, 2022). Researchers hope that the favorable results of this trial will bring relief to those who have struggled to mitigate their chronic pain symptoms and minimize contributions to the rising prevalence of mental health issues and the opioid epidemic (Murray, 2024).
The success of PRT affirms the importance of determining the root cause when innovating ideas to solve problems. In the cases of chronic pain, while some may be caused by physical ailments, others are due to neurological misinterpretations, a distinction that has allowed PRT to generate the pain relief that many have been searching for.
References:
Chronic pain. Johns Hopkins Medicine. (2021, August 8). https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-pain#:~:text=Chronic%20pain%20is%20long%20standing,physical%20activity%2C%20or%20enjoy%20life
Marshall, L. (2021, October 6). How therapy, not pills, can nix chronic pain and change the brain. CU Boulder Today. https://www.colorado.edu/today/2021/09/29/how-therapy-not-pills-can-nix-chronic-pain-and-change-brain
Marshall, L. (2022, March 11). Unlearning Pain: How Psychological Therapy Could Aid Chronic Pain. Coloradan Alumni Magazine. https://www.colorado.edu/coloradan/2022/03/11/unlearning-pain-how-psychological-therapy-could-aid-chronic-pain
Murray, K. (2024, February 22). Chronic pain and addiction. Addiction Center. https://www.addictioncenter.com/addiction/chronic-pain-addiction/
Pain reprocessing therapy. Pain Reprocessing Therapy Institute. (2024, March 22). https://www.painreprocessingtherapy.com/
Reynolds, S. (2021, November 9). Retraining the brain to treat chronic pain. National Institutes of Health. https://www.nih.gov/news-events/nih-research-matters/retraining-brain-treat-chronic-pain
Staff, L. S. (2012, May 18). Chronic pain due to mixed up brain. LiveScience. https://www.livescience.com/20420-chronic-pain-due-mixed-body-map.html#:~:text=It%20is%20possible%20for%20the,benign%20stimulus%20as%20an%20attack
Szmelskyj, A., MD (2023, July 8). Pain reprocessing therapy (PRT): 5-step process. CAM Therapies. https://cam-therapies.co.uk/prt/pain-reprocessing-therapy-process/
