PRT - Pain Reprocessing Therapy and The Power of Belief
The new results from trials and studies done with PRT has some heads turning, and some from necks that are finally pain free.
The study, which you can find in Jama Network Open can be found here. The results are quite incredible. “Our study shows that discussing pain attributions with patients and helping them understand that pain is often ‘in the brain’ can help reduce it,” said Yoni Ashar, PhD, assistant professor of internal medicine at the University of Colorado Anschutz Medical Campus and the studies first author.
The details of the study were as follows. 150 adults (81 female) from ages 21-70 experiencing moderately severe chronic pain were enrolled in a PRT treatment group. The study welcomed all spinal conditions such as scoliosis, bulged discs, herniations ect. The most common things patients attributed to the source of their chronic pain were things such as previous injury, bad posture and stress. In the PRT group, participants completed a 1-hour telehealth session with a physician followed by 8 individual 1-hour sessions with PRT therapist twice weekly for 4 weeks.
Practices such as physiotherapy, were not used as the aim on the study was to only use a combination of education and Pain Reprocessing Therapy
PRT, also known as Pain Reprocessing Technique, is a therapeutic modality designed to alleviate chronic pain by reprocessing the brain's response to pain signals. Developed by leading experts in the field of psychology and pain management, this technique is founded on the principle that the brain's perception of pain can be altered through specific psychological interventions.
The methodology of PRT involves a series of structured sessions that aim to reframe and modify the way the brain processes pain signals. By engaging in targeted exercises and cognitive techniques, individuals undergoing PRT are guided to reassess and reframe their relationship with pain, potentially leading to a reduction in its intensity and impact on daily life.
Normally, in the current field of treating chronic pain, not many tread outside the realm of pain management. Unfortunately for a lot of people, this sounds like a life sentence. Without proper education around the intricacies of how pain can become chronic and how to unravel it, the ‘managing’ does tend to go on for life, creating an unnecessary amount of suffering. But the PRT study continues to break down that illusion, showing that in many cases participants left the program completely pain free!
Two-thirds of people treated with PRT reported being pain-free or nearly so after treatment, compared to only 20% of placebo controls. This remained the case a year after the study was performed.
Most of the remaining participants showed great reduction in pain.
So what happened? How does this work? No surgery, no physical treatment, no meds. Only a specific form of psychological intervention.
Before the patients entered the program they had the belief that their pain was most likely from peripheral pathophysiology
(eg, a bulging disc, osteoarthritis). But as clearly shown in works such as ‘Healing Back Pain’ by Dr. John Sarno and ‘The way out,’ by Alan Gordon, peripheral findings are often incidental in nature and not the predominant cause of symptoms (pain). Below is a table from a study that will give you more insight. Asymptomatic means no symptoms i.e. No pain. The table states that most of the people you see walking around everyday have things like bulging discs, disc degeneration, labral tears etc but have no pain.
|------------------------|----------------------------------------------| | Body Part | Prevalence in ASYMPTOMATIC populations | |------------------------|----------------------------------------------| | Back | 52% disc degeneration | |------------------------|----------------------------------------------| | Neck | 87% bulging discs | |------------------------|----------------------------------------------| | Shoulder | 72% superior labral tears | |------------------------|----------------------------------------------| | Hip | 69% of adults (89% of athletes) have | | | labral tears | |------------------------|----------------------------------------------| | Knee | 97% show "abnormalities" | |------------------------|----------------------------------------------| | Ankle & Foot | 63% with Achilles tendon changes, | | | 68% of runners have retrocalcaneal changes | |------------------------|----------------------------------------------|
@Brinjikji 2015; Sajid et al 2021
Yoni Ashar, PhD and the rest of the crew involved in the study wanted to explore some of the key components that the recovered patients internalized to heal the perception of pain.
Here’s the kicker. The study group gave the participants a questionnaire they labelled “The fearful pain beliefs.”
The fearful pain beliefs questionnaire
Pain always means I have injured my body
I wouldn't have this much pain if there
wasn't something potentially dangerous
going on in my body
I'm afraid I might injure myself if I exercise
My accident/problem has put my body at
risk for the rest of my life
Sound familiar?
I know for me when I was healing chronic pain these beliefs were very alive in my experience. They can create a fearful loop of thought, emotion and pain that seems unbreakable. Here’s what Yoni Ashar, PhD had to say about the connection between these beliefs, pain and healing. “Critically, the extent that people reported reduction in these fear beliefs correlated with their reduction in pain intensity.”
Changes in our perception and belief of the causes of pain changes how we experience pain and can even eliminate it.
For myself and for the clients I have guided through pain resolution it usually goes something like this. At the beginning we think the pain comes from causes strictly in the body like all the disc abnormalities that were shown in my spine. Then through exposure to new information and studies we start to realize the pain may have a different origin. We begin to see the connection and start to believe a new story for the pain, one that involves a way out. This creates a positive feedback loop in which our new belief grows symbiotically with the experience of relief of pain. Eventually one fears the pain less and less and it all of a sudden becomes a memory.
If you really see what is happening here, you can tune into something very special…The power of belief. In this case many of the beliefs involved were conscious, but subconscious beliefs can also play a huge role in increasing the quality of one’s life. I have an article here that addresses subconscious healing methods.
To experience high-speed mindset shifts around beliefs check out the Psych K page and book an appointment.