Evidence-based treatment for chronic pain and other symptoms

What is Pain Reprocessing Therapy?

  • Pain Reprocessing Therapy (PRT) is an evidence-based approach designed to help people reduce or even resolve chronic pain and other chronic symptoms by teaching the brain to interpret nerve signals more accurately.

  • Instead of viewing pain as a sign of ongoing damage, PRT helps individuals understand that many forms of chronic pain are maintained by the nervous system, not by injury or an uncontrollable illness.

  • Through guided practices—such as pain science education, fostering safety, and exploring sources of everyday vigilance—people learn to calm their nervous system and retrain the brain’s response to everyday sensations in the body.

  • It’s important to acknowledge that in all cases the pain is real - it’s not “imagined”, “fake”, or “all in your head”. The intensity of this pain is no different from an active injury. It can last for several decades and be extremely consistent. It’s just that the mechanism by which this pain is created and maintained is a little bit different from what we thought until recently. Now we’ve gotten to know this mechanism better. And that’s good news, because now we can do something about it - with next to no risk involved.

What benefits does PRT offer?

According to experts in the field, humanity has learned more about pain in the past 20 years than in the preceding 1000 years combined. This modality of treatment is rooted in the new science of pain and the brain. By creating new, reassuring associations with bodily sensations, PRT is a promising tool that can break the cycle of fear and pain, helping people move more freely and live with greater ease.

PRT has been shown to provide a range of positive outcomes for people struggling with chronic symptoms:

  • Reduced or completely alleviated pain intensity and frequency

  • Increased confidence in the body’s safety and resilience

  • Improved mobility and daily functioning

  • Less fear and preoccupation with pain

  • Greater emotional well-being

PRT is administered as a talk therapy, through conversation and skills practice. While no single treatment is effective for everyone and every situation, PRT is designed to help the client acquire the knowledge, skills, and habits to live a more free and enjoyable life.

Sounds fishy!

  • That’s a completely healthy and useful reaction - I would have said the same thing no more than 2 years ago.

  • Now, the supporting evidence combined with my own personal and clinical experience has led me to conclude that many people who have learned that their chronic pain can “only be managed” can indeed live pain-free.

  • I find the science behind PRT is valid, but new. If you’re into reading scientific articles, then examples of research on the effects of PRT have been published here (Ashar et al, 2021), here (Tankha et al, 2023), and here (Fishbein et al, 2025). Several randomized control trials on the generalizability of PRT are underway and will likely be published from 2026 onward.

  • Clinical experience from experts in the field of chronic pain treatment has validated PRT for use with chronic pain (like back and neck pain, headaches, joint pain, fibromyalgia, CRPS) as well as other chronic symptoms like fatigue, tinnitus, dizziness etc, although compelling research is yet to be published on many of these symptoms specifically.

  • In addition, the amount of work supporting the tenets of PRT, such as the bio-psycho-social model of chronic symptoms, is overwhelmingly large, summarized well by Löwe et al (2024) here.

  • You’ve experienced chronic pain and/or other symptoms for longer than 6 months (regardless of whether the initial onset was due to a specific injury or not).

  • You’ve consulted with doctors and have had normal or inconclusive medical tests, yet the symptoms persist.

  • You’ve been told your symptoms are "functional”, “unspecified”, “central”, “primary”, “psychosomatic”.

  • You’ve tried physiotherapy, medication, injections, surgery or other interventions with limited or temporary relief.

  • You notice your pain gets worse when you’re tired, anxious, or under pressure.

  • You avoid activities or movements you used to do out of fear that it might worsen your symptoms.

Pain Reprocessing Therapy may be a good fit for you if your situation includes the following characteristics or diagnoses:

  • Chronic back or neck pain

  • Migraine and tension headaches

  • Fibromyalgia, chronic joint inflammation, joint pain

  • CRPS (chronic regional pain syndrome)

  • Chronic pelvic pain

  • Foot pain syndromes, heel spur

  • Chronic fatigue

  • Irritable bowel syndrome (IBS), functional digestive issues (dyspepsia), inconsistent food intolerance

  • Piriformis syndrome, sciatica

  • Irritated bowel syndrome

  • Chronic dizziness, POTS (dizziness while standing without a drop in blood pressure)

  • Parestesia (eg numbness, tingling burning sensations)

  • Tinnitus, insomnia, allodynia, etc

Additional information regarding Pain Reprocessing Therapy and chronic symptom treatment:

  • Science Vs podcast: Chronic Pain: Can Our Brains Fix It? (25 minute introduction to the topic with several experts)

  • Book: “The Way Out” (Alan Gordon & Alon Ziv, 2021), also available as an audiobook

  • App: Curable (based on the same principles as PRT, and employs many of the same techniques)

  • Podcast: Tell Me About Your Pain - a small number of episodes recorded by the authors of “The Way Out” where they share and demo the concepts of PRT.

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