What is Pain Reprocessing Therapy (PRT)?

By: Allison Torsiglieri, Taproot Therapy Clinical Trainee

“I think it's just knowledge that everyone should have. That you have this amplifier… potentially linked to your pain, and your perceptions, or the fears, or the dangers around what might be going on in your body can contribute to that pain, or headaches, or anxieties, or probably all kinds of other things” (Tankha et al., 2023, p. 1588).

Pain Reprocessing Therapy (PRT) is a promising new approach to treating certain types of chronic pain (Pain Reprocessing Therapy Center, n.d.-c). Even after a painful injury heals, the brain can get stuck in a pattern of sensing bodily harm or danger when there is none, and in response, trigger pain unnecessarily. This remembered pain, which doesn’t have a meaningful physiological cause, is called neuroplastic pain (Pain Reprocessing Therapy Center, n.d.-b). PRT helps us to better differentiate between dangerous and safe signals from the body, thereby reducing neuroplastic pain. 

My personal experience with PRT: I first heard about PRT on a podcast, and thought I’d give it a try as part of my own journey to tackle chronic back pain. While I haven’t mastered any of the techniques (described below), after reading The Way Out (a book on PRT, by its developer) I’ve noticed I feel less fear surrounding my back pain and more in touch with what is really going on in my body when I do feel this pain (Gordon & Ziv, 2021). This blog post is my way of sharing what I know about PRT, in case anyone reading might benefit from this model of therapy! 

How Does PRT Work?

There are two main processes PRT uses to help reduce pain (Tankha et al., 2023): 

• PRT uses psychoeducation to change our beliefs about where our pain is coming from: the pain is in the brain, and is not a sign that there is something wrong with our body.
• PRT helps us feel less afraid of the pain we’re accustomed to avoiding, thereby reducing our tendency to try to avoid the pain. 
  • This breaks the pain–fear cycle. The cycle works like this: pain triggers avoidance; this reinforces for our brain that whatever we’re avoiding must be dangerous; and the resulting fear triggers a state of high alert, which fuels pain, and so on. 

What’s Involved in PRT?

PRT uses psychological techniques to retrain the brain to interrupt neuroplastic pain. The main technique PRT uses is called somatic tracking. Somatic tracking is a practice in which we are experiencing our pain while simultaneously experiencing a sense of safety (Pain Reprocessing Therapy Center, 2021). 

Somatic tracking has three main elements (Pain Reprocessing Therapy Center, 2021): 

• Mindfulness, which in PRT involves mentally approaching experiences of pain with curiosity, rather than fear
• Safety reappraisal, which means reminding your brain that a painful sensation is actually safe—that it doesn’t mean there’s any kind of danger
• Positive affect induction, which can mean using humor or other mood-lightening techniques to start to associate the pain with positivity and pleasantness

Therapists trained in PRT also work with clients to process other sources of fear and stress in their lives, which can be contributing to a generalized sense of danger, and exacerbating their experiences of pain by way of the pain–fear cycle.

“...I never would have guessed that childhood issues could be affecting the way I feel in my physical body today” (Tankha et al., 2023, p. 1588).

How Can I Learn More About PRT?

Here are some ways to learn more about PRT:

• Read about others’ experiences of PRT: Tankha et al. (2023) interviewed people who received PRT for back pain to learn about their experiences with the therapy. Read some of their direct quotes in the full text of this article, here.
• Review introductory materials for people interested in trying PRT to help with chronic pain, provided on the Pain Reprocessing Therapy website, here (Pain Reprocessing Therapy Center, n.d.-a).
• Take a look at recent studies that highlight the effectiveness of PRT: 
  • A randomized clinical trial by Ashar et al. (2021) compared the effects of PRT, a placebo back injection, and usual care, in a group of people experiencing chronic back pain. The full text of the research paper is available for free, here.
  • Sturgeon et al. (2025) are beginning to test a “brief” PRT approach, delivered via telehealth, to reduce pain for people with fibromyalgia. The abstract for this article can be viewed here. 
  • A preliminary research study by Fishbein, et. al (2025) looked at three people’s experiences (referred to as “cases”) with PRT to treat migraine headaches. The abstract can be viewed here. 
  • More studies are surely forthcoming!
• Read The Way Out, a book about PRT, written by the developer of PRT, Alan Gordon, LCSW (Gordon & Ziv, 2021). You can learn more about the book here.
• While Taproot Therapy does not currently have clinicians certified in PRT, we do have clinicians who work with chronic illness and chronic pain through other therapeutic models. We also highly recommend our colleague, Jess Freedman, LMSW, who is a  certified advanced practitioner of PRT. 

 




References


Ashar, Y. K., Gordon, A., Schubiner, H., Uipi, C., Knight, K., Anderson, Z., Carlisle, J., Polisky, 
L., Geuter, S., Flood, T. F., Kragel, P. A., Dimidjian, S., Lumley, M. A., & Wager, T. D. (2021). Effect of Pain Reprocessing Therapy vs placebo and usual care for patients with chronic back pain: A randomized clinical trial. JAMA Psychiatry, 79(1), 13–23. https://doi.org/10.1001/jamapsychiatry.2021.2669

Fishbein, J. N., Schuster, N. M., Anders, A., Portera, A. M., & Herbert, M. S. (2025). Pain 
Reprocessing Therapy for migraine: A case series. Headache: The Journal of Head and Face Pain, 65(9), 1660-1665. https://doi.org/10.1111/head.15043

Gordon, A., & Ziv, A. (2021). The way out: A revolutionary, scientifically proven approach to 
healing chronic pain. Vermilion.

Pain Reprocessing Therapy Center. (n.d.-a). Free recovery resources. 
https://www.painreprocessingtherapy.com/free-resources/

Pain Reprocessing Therapy Center. (n.d.-b). Neuroplastic pain. Retrieved October 9, 2025, from 
https://www.painreprocessingtherapy.com/neuroplastic-pain/

Pain Reprocessing Therapy Center. (n.d.-c). Pain Reprocessing Therapy. Retrieved October 9, 
2025, from https://www.painreprocessingtherapy.com/

Pain Reprocessing Therapy Center. (2021). Treatment outline for Pain Reprocessing Therapy. 
https://www.painreprocessingtherapy.com/wp-content/uploads/2021/03/PRT-Supplementary-Materials-for-Site.pdf

Sturgeon, J., Trost, Z., Ashar, Y. K., Lumley, M. A., Schubiner, H., Clauw, D., & Hassett, A. L. 
(2025). Brief pain reprocessing therapy for fibromyalgia: A feasibility, acceptability, and preliminary efficacy pilot. Regional Anesthesia & Pain Medicine. Advance online publication. https://doi.org/10.1136/rapm-2025-107076

Tankha, H., Lumley, M. A., Gordon, A., Schubiner, H., Uipi, C., Harris, J., Wager, T. D., Ashar, Y. 
K. (2023). “I don't have chronic back pain anymore”: Patient experiences in Pain Reprocessing Therapy for chronic back pain. The Journal of Pain, 24(9), 1582-1593. https://doi.org/10.1016/j.jpain.2023.04.006