 Chronic stress leading to chronic pain Chronic pain is often thought of as a purely physical problem, but emerging research suggests that the brain plays a significant role in how pain is experienced. Pain Reprocessing Therapy (PRT) is a groundbreaking approach that aims to retrain the brain’s response to pain, particularly in cases where chronic stress and emotional factors contribute to persistent discomfort.
The Brain’s Role in Chronic Pain Pain serves as a protective mechanism, alerting us to injury or danger. However, when pain persists long after an injury has healed—or arises without clear physical damage—it often becomes a problem of misfiring neural pathways rather than ongoing tissue damage. Neuroscientist Dr. Tor Wager explains: “Pain is not just something that happens to us—it’s something the brain constructs based on a variety of inputs, including past experiences, emotions, and expectations.” When chronic stress heightens the nervous system’s sensitivity, the brain can misinterpret normal sensations as pain. PRT works by helping individuals recognize and change these misinterpretations. How Pain Reprocessing Therapy Works PRT is based on the idea that chronic pain is often the result of learned neural patterns rather than structural damage. By changing the way the brain perceives pain, people can significantly reduce their discomfort. Dr. Yoni Ashar, a clinical psychologist and researcher, explains: “Pain Reprocessing Therapy helps people understand that their pain is coming from the brain, not the body. When they learn to view their pain as non-threatening, their brain stops generating it.” PRT involves five key steps: 1. Educating the Mind – Learning that chronic pain is often due to the brain’s misinterpretation of danger signals. 2. Shifting Beliefs About Pain – Recognizing pain as a reversible condition rather than a permanent disorder. 3. Reducing Fear and Avoidance – Engaging in normal movement and activities to rewire the brain’s pain response. 4. Using Mindfulness and Somatic Techniques – Practicing relaxation and awareness to calm the nervous system. 5. Reinforcing Positive Outcomes – Noticing and celebrating pain reduction to further retrain the brain. Scientific Support for PRT A 2021 study published in JAMA Psychiatry found that PRT significantly reduced chronic back pain in participants, with many experiencing lasting relief. As Dr. Ashar, one of the study’s lead researchers, noted: “Two-thirds of participants in our study were pain-free or nearly pain-free after just four weeks of Pain Reprocessing Therapy.” This offers hope to the millions of people suffering from chronic pain linked to stress and emotional factors. The Connection Between Chronic Stress and Pain Chronic stress activates the body’s fight-or-flight response, leading to muscle tension, inflammation, and heightened pain sensitivity. Dr. Howard Schubiner, a physician specializing in mind-body medicine, states: *“When we’re under stress, our brains create pain as a distraction from emotional distress. But when we address these emotions, the pain often fades.” PRT teaches individuals to recognize and process these emotional triggers, breaking the cycle of stress-induced pain. A New Path to Healing For those struggling with chronic pain, PRT offers a new perspective—one that shifts the focus from endless medical treatments to the power of the mind-body connection. While not a quick fix, retraining the brain’s pain response can be a transformative process. As Dr. Schubiner emphasizes: “The pain is real—but so is recovery.” By understanding the brain’s role in chronic pain and applying techniques from Pain Reprocessing Therapy, many individuals can find relief and reclaim their lives. Final Thoughts Chronic pain can feel like an inescapable cycle, but new research is proving that healing is possible. If stress and emotional factors contribute to your pain, exploring PRT might be the key to lasting relief. Instead of focusing solely on physical treatments, addressing the brain’s role in pain could be the breakthrough you’ve been looking for. In May 2025, I will be getting certified in Pain Reprocessing Therapy. Please fill out the contact form, under contact me, if you are interested in seeing if this model could help you. Resources The Pain Reprocessing Podcast The Way Out: A revolutionary, scientifically proven approach to healing chronic pain. Alan Gordon, Alon Ziv. (2021).
3 Comments
The point about reducing fear and avoidance - engaging in normal movement to rewire the brain's pain response - really resonates. It aligns with what research increasingly shows about perceived threat shaping pain signals more than tissue damage alone. The JAMA Psychiatry finding that two-thirds of participants were pain-free after just four weeks is striking and gives real hope to people who've been told their pain is simply a structural problem with no end in sight. 7/4/2026 10:23:35 am
Chronic pain management continues to evolve as new approaches explore the connection between physical symptoms and neurological processes. Expanding awareness of different treatment options may help more people find effective relief strategies. Which patients tend to benefit most from pain reprocessing therapy techniques?
Debra Eng, LCSW
7/7/2026 01:19:25 pm
People who respond well to pain reprocessing therapy (PRT) tend to share a few characteristics. They typically have chronic pain without a clear ongoing structural or tissue-based cause—or pain that's disproportionate to any identifiable damage—suggesting the nervous system has learned to generate pain signals even after the body has healed. They're often open to the idea that the brain can generate real, physical pain in the absence of injury, and willing to consider that fear, stress, and hypervigilance about their symptoms may be reinforcing the pain cycle. People who notice their pain fluctuates with emotional state, stress, or context (rather than being constant and predictable) tend to be especially good candidates, since this variability is a hallmark of centralized or neuroplastic pain. Psychological flexibility also helps—those willing to gently approach rather than avoid movement or sensations, to test predictions about their pain, and to engage in some degree of self-reflection about emotional contributors (past or present stressors, perfectionism, self-criticism) generally see stronger results. Conversely, people who are firmly wedded to a purely structural explanation for their pain, or who feel dismissed by a mind-body framing, often need more groundwork before PRT will land well. Your comment will be posted after it is approved.
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Debra Eng, MSW, LCSWShe has over 20 years of experience with a wide range of issues. She currently focuses on aging, caregiving, developmental trauma and chronic health and pain conditions. Archives
July 2026
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