Your brain isn’t broken. It’s just trying to protect you — loudly. Pain Reprocessing Therapy (PRT) offers a new way to turn down those signals, especially when chronic pain has stuck around long after the injury.
Pain Reprocessing Therapy (PRT) is a brain-based method designed to help people rewire the way their nervous system responds to pain. It’s not about pretending pain away — it’s about teaching the brain that pain signals are no longer necessary. This article explains what PRT is, how it works, what the science says, and who’s most likely to benefit.
🪴 What Is Pain Reprocessing Therapy?
Pain Reprocessing Therapy is a psychological approach developed by therapist Alan Gordon, LCSW, and popularized through his work at the Pain Psychology Center in Los Angeles. It aims to retrain the brain’s interpretation of pain signals — especially in cases of chronic pain that persists without ongoing injury or structural damage.
At its core, PRT is built on this idea:
Sometimes pain sticks around not because something is wrong in the body — but because the brain has gotten stuck in “protection mode.”
Think of it like a fire alarm that keeps going off even though the fire’s long been put out. PRT works to convince the alarm that you’re safe again.
🔁 Why PRT Is a Big Shift
Traditionally, chronic pain has been treated as a structural problem — a bulging disc, joint degeneration, or scar tissue. And in some cases, that’s accurate.
But in many chronic pain conditions (like back pain, fibromyalgia, or tension headaches), there’s no clear damage to explain the symptoms.
That’s where PRT comes in. It focuses on function rather than structure — how the brain is processing pain, not just where it’s coming from.
This shift opens the door to healing for people who’ve tried everything else — medications, surgeries, physical therapy — without relief.
🔍 How Pain Reprocessing Therapy Works
PRT combines elements from:
- Cognitive neuroscience
- Exposure therapy
- Mindfulness
- Somatic psychology
Here are the key tools used in PRT:
🎯 1. Somatic Tracking
This is the heart of PRT. It means observing pain sensations with curiosity, not fear.
When you do this, you show your brain that the sensation isn’t dangerous — and over time, it may turn down the volume.
🧠 2. Reappraisal
You gently challenge your assumptions about the pain:
- Is this pain consistent?
- Does it shift with stress or emotion?
- Have I seen it reduce when I’m distracted or relaxed?
You’re not denying the pain — you’re reframing it as learned, not broken.
❤️ 3. Emotional Processing
Many people with chronic pain have unprocessed emotional stress.
PRT encourages exploring emotional connections to pain: suppressed anger, grief, anxiety — all of which can heighten nervous system reactivity.
🔍 4. Evidence Gathering
PRT often asks you to look for inconsistencies:
- Does your pain change based on your environment?
- Can you do something sometimes but not others?
These clues help show the brain that the threat isn’t consistent — and maybe, just maybe, not so dangerous after all.
📊 What the Research Says
One of the most promising studies on PRT came from the University of Colorado Boulder in 2021, where researchers tested PRT on 151 adults with chronic back pain.
Key results:
- 66% of participants who received PRT were pain-free or nearly pain-free after just four weeks
- These improvements were maintained for at least one year
- Brain scans showed reduced activity in pain-processing regions of the brain
That’s a big deal. Especially for people who’ve lived with pain for years.
However, it’s worth noting:
- Most research so far is on back pain — more studies are needed on other conditions
- The therapy works best for centralized pain (not active inflammation or structural damage)
🙋 Who Might Benefit Most?
PRT tends to work well for people with:
- Chronic pain with no clear physical cause
- Conditions like fibromyalgia, IBS, tension headaches, pelvic pain
- Fluctuating pain symptoms that worsen with stress
- High anxiety about their symptoms
- A willingness to explore emotional or nervous system causes
If your pain doesn’t fully “make sense” on paper — but is 100% real in your body — PRT might be worth exploring.
🚫 Who PRT Might Not Be Ideal For (Yet)
PRT isn’t a silver bullet. And it’s not appropriate for all pain types.
It may not be helpful if you have:
- Active injuries (sprains, fractures, wounds)
- Autoimmune or inflammatory diseases in flare (e.g., RA, lupus)
- Neurological degeneration causing structural damage
- Significant untreated trauma (PRT may help later, but isn’t step one)
It’s also not a replacement for medical care. If something feels new or urgent, always rule out medical causes first.
🧰 What to Expect If You Try It
PRT can be explored through:
- Certified PRT therapists
- Online programs (e.g., the Mindbody Program or Curable app)
- Books like The Way Out by Alan Gordon
What success with PRT usually requires:
- Openness to the mind–body connection
- Daily short practices
- Patience — it’s about progress, not perfection
- A willingness to question long-held beliefs about pain
You won’t be gaslit or told your pain isn’t real. You’ll be taught how to calm the brain’s threat response — so pain doesn’t dominate your life anymore.
🌱 Final Thoughts: Real Pain, New Pathways
PRT isn’t about pretending your pain doesn’t exist. It’s about helping your brain understand that it’s safe to let go of pain patterns.
For many people, this shift has been life-changing.
Not because they ignored their pain — but because they finally understood it differently.
And from that understanding… came relief.
👉 Coming next: “The Science of Somatic Tracking: Noticing Without Panic” — a deeper dive into the main technique used in PRT and how to try it safely on your own.