PRT: What Is Pain Reprocessing Therapy?

Chronic pain can feel like an endless cycle, the more you try to push through, the worse it gets. You might have visited specialists, tried medications, or even undergone procedures, only to find the pain stubbornly remains.

If you've ever wondered, "Why won't my pain go away even when my body has healed?", you're not alone, and there's a growing body of science that has an answer.

It's called Pain Reprocessing Therapy (PRT), and it's a breakthrough approach that works by retraining the brain to accurately interpret pain signals.

At Menda Health, we specialize in science-backed methods, such as PRT, to help Californians reclaim their lives from chronic pain. Let's explore what it is, how it works, and why it may be the missing piece in your recovery journey.

Understanding Chronic Pain & the Brain

For decades, pain was seen as purely a physical symptom, a signal from injured tissue. But modern neuroscience shows that many chronic pain conditions are "nociplastic" or "central sensitization" pain, meaning the brain has become hypersensitive and continues to send pain signals even after the original injury has healed.

Think of it like a fire alarm that keeps going off long after the smoke has cleared. Your body is fine, but your brain has learned to misinterpret harmless signals as dangerous.

This is where pain neuroscience education becomes crucial. When you understand that your pain is not a sign of new damage, but rather a false alarm in the nervous system, you open the door to changing how your brain processes those signals.

What Is Pain Reprocessing Therapy?

Pain Reprocessing Therapy (PRT) is an evidence-based psychological approach designed to help people with chronic pain retrain their brains to interpret pain signals accurately.

Developed by Alan Gordon and colleagues, PRT is grounded in the principle of neuroplasticity, the brain's ability to change and form new pathways.

The therapy teaches you to recognize when pain is coming from the brain rather than the body, and to respond in a way that reduces fear and promotes healing.

Core Principles of PRT

• Pain is often reversible when it's generated by the brain rather than ongoing tissue damage.

• The brain can learn safety just as it has learned danger, breaking the pain-fear-pain cycle.

• Fear and avoidance fuel chronic pain, while calm and curiosity can quiet it.

How It Helps

• Encourages you to view sensations through a lens of safety instead of threat.

• Replaces fear-based responses with confident, relaxed movement.

• Builds new, pain-free neural pathways by repeatedly practicing safe reactions to sensations.

In simple terms, PRT helps you move from a state of danger and fear to a state of safety and calm, where your brain no longer feels the need to produce pain.

How Does PRT Work? Key Steps & Techniques

PRT isn't about ignoring your pain, it's about changing your relationship with it so your brain no longer feels the need to send constant danger signals. The process typically involves five interconnected components:

1. Pain Neuroscience Education

By learning how pain works in the brain, you begin to reframe it from a sign of damage to a reversible brain process. Understanding that your body is safe helps dismantle fear, which is a major driver of persistent pain.

2. Gathering Personal Evidence

You look for real-life proof that your pain is brain-generated rather than caused by ongoing injury. Examples include noticing pain that changes with mood or stress, or activities you feared would hurt but didn't. These moments build trust in your body's resilience.

3. Somatic Tracking

This gentle awareness practice involves observing sensations with curiosity, calmness, and compassion, rather than fear. By noticing without judgment, you reduce the threat response in your nervous system, teaching your brain that the sensation is safe.

4. Safety Reassurance

Through self-talk, visualization, and body language, you continually remind yourself that your body is okay. This repeated message of safety helps deactivate the "alarm system" in the brain that drives pain.

5. Shifting Focus

Instead of staying locked in discomfort, you intentionally bring your attention to neutral or pleasant sensations, such as the warmth of your hands or the feeling of the sun on your skin. Over time, this reinforces pain-free neural pathways and reduces the brain's tendency to default to a state of danger.

These steps work together to retrain neural pain pathways, reducing the brain's overactive danger response. If you've noticed pain flaring during emotional strain, our article Why Does My Pain Get Worse When I'm Stressed? Explains why.

Evidence & Effectiveness of PRT

One of the most notable studies on PRT was conducted at the University of Colorado Boulder and published in a leading medical journal. It was found that 98% of participants with chronic back pain experienced improvement, and two-thirds became wholly or nearly pain-free.

Even more encouraging, these results were sustained for at least a year after treatment, suggesting that the changes were long-lasting rather than temporary relief.

PRT's effectiveness lies in its ability to break the fear-pain cycle. When pain is perceived as dangerous, the brain stays in a protective mode, reinforcing pain pathways. By teaching patients to view sensations as safe, PRT helps calm the nervous system, allowing the brain to "turn down the volume" on pain signals.

Additional research and case studies have shown PRT's benefits extend beyond back pain, with promising results in conditions like fibromyalgia, neck pain, and other forms of nociplastic pain.

This growing evidence base is why an increasing number of pain specialists are incorporating PRT principles into their treatment plans.

Why Focus on the Brain Instead of the Body?

If pain is caused by the brain's misinterpretation of signals, treating only the body may miss the root cause. While physical treatments like stretching, massage, or medication can provide short-term relief, they often don't address the underlying neural patterns that keep the pain cycle going.

The brain employs a process known as predictive coding to interpret sensory information. If it has learned, often through fear, past injury, or repeated flare-ups, that specific movements or sensations are dangerous, it will generate pain even when there's no physical harm. For example, bending down after a back injury might trigger pain months later, not because of damage, but because the brain is "expecting" danger.

By retraining the brain's response, PRT helps resolve this "false alarm" and allows you to move freely again. This shift from fear to safety is central to lasting recovery and is a cornerstone of Menda's broader care model, as outlined in 'How Our Approach Works: Pain Psychology Treatment'.

PRT vs. Other Pain Therapies

While approaches like Cognitive Behavioral Therapy (CBT) or mindfulness can be beneficial for pain management, PRT has a unique focus.

CBT works on identifying and changing unhelpful thought patterns and emotional responses that can worsen pain. It's effective for reducing stress, depression, and anxiety related to chronic pain, but it doesn't always target the specific neural pathways that create pain signals.

Mindfulness teaches present-moment awareness, which can lower stress hormones and promote relaxation. However, while mindfulness encourages acceptance, it may not provide the targeted safety reassurances that help rewire the brain's predictive coding around pain.

PRT blends elements of both but takes them a step further by:

• Directly addressing brain-generated pain through somatic tracking and focused neuroplastic retraining.

• Using specific techniques to replace fear-based responses with safety-based responses.

• Encouraging gentle exposure to feared movements or sensations in a safe, controlled way to dismantle the fear-pain link.

In short, CBT and mindfulness can support your recovery. Still, PRT is purpose-built to target and rewire the brain's pain response, making it a powerful tool for conditions like chronic back pain, fibromyalgia, and other forms of nociplastic pain.

How Menda Health Aligns with PRT Principles

At Menda Health, we believe in treating the root cause of chronic pain through compassionate, science-based care. Our virtual pain recovery programs integrate many of the same principles as PRT, from pain neuroscience education to guided somatic awareness practices that help rewire pain pathways.

We work with patients to create personalized recovery plans that address not just the pain itself, but the fear, stress, and daily limitations that come with it. This whole-person approach ensures that you're supported mentally, emotionally, and physically.

Whether you're dealing with chronic back pain, fibromyalgia, or pain that lingers long after an injury, our team helps you retrain your brain's response, restore confidence in movement, and rebuild your quality of life. You can see these principles in action in this inspiring recovery story, where years of debilitating pain gave way to lasting relief.

Learn more about our approach to pain psychology and how it supports long-term recovery.

Conclusion

So, what is Pain Reprocessing Therapy? It's a groundbreaking, evidence-based approach that helps you overcome chronic pain by retraining your brain to interpret signals from the body accurately.

For many people, it's not just about reducing pain, it's about regaining confidence, mobility, and joy in daily life.

If you're in California and ready to explore a new path to healing, connect with Menda Health today. You deserve a life where pain doesn't dictate your choices.

Frequently Asked Questions About PRT

What is the PRT technique in physiotherapy?

PRT is a psychological, not manual, therapy, although physiotherapists trained in PRT principles may integrate it into their work.

How do you use pain reprocessing therapy?

PRT is typically practiced with a trained therapist and involves education, somatic tracking, and guided exercises to reduce fear and reframe sensations.

Is PRT useful for arthritis?

If arthritis pain persists after inflammation has resolved, PRT can help address the nervous system's ongoing pain response.

How effective is PRT for chronic back pain?

Clinical trials show high success rates, with many patients achieving lasting relief.

Why does pain persist after the injury heals?

The brain can learn to associate certain movements or sensations with danger, continuing to generate pain even after physical healing has occurred.

What techniques are used in PRT?

Core techniques include somatic tracking, safety reassurance, and shifting focus toward positive sensations.

Who developed PRT?

Alan Gordon, a psychotherapist specializing in chronic pain, developed PRT based on decades of neuroscience research.

Why is PRT different from CBT or mindfulness?

PRT targets the neural pathways responsible for pain signaling, whereas CBT and mindfulness address broader patterns of thought and awareness.