Pain Reprocessing Therapy: FAQs and My Story
- Jan 31
- 6 min read
Updated: Feb 19
In this article, you’ll find:
My story
By my mid 20s, everything hurt. I had searing pain from my neck to my fingers that prevented me from working. I could not walk more than 10 minutes without foot and knee pain. I had done thousands of dollars’ worth of physical therapy, saw countless orthopedic and neurology specialists, and tried traditional remedies from acupuncture to Tibetan medicine. Nobody had a good explanation for my pain, and nothing worked to fully relieve it.
My friends were out hiking, dancing, and building their careers, but I could not live the life of a typical 27 year old. My pain seemed invisible to others, and it was embarrassing to explain. I felt deeply isolated, sad, and afraid. What would the rest of my life be like?
One day, a comment under an article about chronic pain changed my life. The poster mentioned that nothing had worked for them except Pain Reprocessing Therapy (PRT). Intrigued, I started googling. I was shocked to find I lived only a few miles from the center that had founded this evidence-based method to relieve chronic pain.
I started weekly appointments in the hopes of addressing my hand pain, since that seemed the most pressing. Although we were focusing on my hands in each session, miraculously, my foot and knee pain subsided and disappeared within 2 months. I could suddenly walk longer distances and go to the gym again.
The breakthrough with my hands happened a little later. One day, I was feeling pretty good overall, with minimal hand pain. I joined my PRT appointment by Zoom, and my PRT practitioner asked me to turn and simply look closely at my keyboard, monitor, and mouse. As I stared intently at them without touching, searing pain started creeping down my arms and into my fingers. This was the clearest evidence I had so far that I had neuroplastic pain, i.e. pain which occurs when the brain mistakes safe nerve signals from the body as dangerous. Through continued sessions, we managed to alleviate my hand pain completely and I even returned to a full-time office job.
My journey with PRT was so transformative that I decided to get certified. The techniques I've learned have allowed me to live life with more rest and ease, and even helped me better manage normal but challenging physical sensations -- all the way from stubbing a toe to labor contractions.
The science: why does PRT work?
Pain warns us that something is wrong. If you pick up a dish that is too hot, pain tells you that you ought to drop it, in order to prevent more injury. However, sometimes, our brains and bodies can activate these warning signals even when there is no threat of harm, or after an injury has healed.
If we quiet down, we can feel sensations all over our body. Close your eyes and take a moment to feel the sensations somewhere that you don’t have pain - perhaps a thigh, an elbow, or part of your back. You can feel something - maybe buzzing, tingles, or the light pressure of your clothes against your skin. The brain interprets these sensations as safe and neutral. If, however, the brain is “stuck” in fear-pain mode, it might misinterpret such neutral sensations as dangerous, or it might amplify the feeling of pain disproportionately beyond the level of injury. A good analogy is a rescue dog who starts barking at the rustle of a mailman outside because it's always on high alert.
PRT is an evidence-based approach to help people retrain how their brains interpret bodily sensations when there is such a mismatch.
Research shows that stress can exacerbate pain symptoms, too. As a PRT practitioner, I specialize in working with people who are constantly on edge, prone to ruminating, or under stress. I teach clients how to feel safe resting and listening to their bodies. The physical sensations that come with being in a heightened state can sometimes become so familiar, that – ironically – being on high alert subconsciously feels more comfortable than being relaxed. However, the more relaxed we are, the less our experience of pain. I help people learn to let go and live life day-to-day more restfully.
It is important to note: PRT is not simply positive thinking or a denial of genuine medical issues. I strongly encourage everybody to do their due diligence on any medical issue and see doctors as needed. PRT is a structured process to shift your relationship to pain and create a sense of safety so that the brain no longer misinterprets safe signals as dangerous.
Medical imaging showed I have a physical injury and diagnosis. Could I still be a candidate for PRT?
Good question. I, too, had MRIs and received diagnoses for all of my issues - plantar fasciitis, patellar femoral syndrome, chronic tendonitis and tenosynovitis, and neuropathic pain. What gave me really longlasting relief was PRT and a shift in my relationship with my body.
A landmark study also found that 64% of people with no back pain at all actually had abnormal spinal findings (e.g. disc bulges, degeneration, etc) when they received MRIs. This means that sometimes, people can have abnormal imaging without it being the cause of pain.
I am not a medical doctor and I can’t guarantee that your experience will be the same as mine. But if you feel like you’ve tried everything and are looking for a non-invasive option, PRT could still be right for you. If you and your doctor don’t think there’s any harm in the cornerstones of PRT – reflective conversation, mindfulness, slowing down, and body awareness building – book a free intro call today. Further below, I describe what a typical PRT program looks like.
What should I expect a PRT session to look like?
PRT is a supportive, conversational, and slightly meditative process. Here’s what to expect.
Free intro call: I’ll ask you more about your journey with chronic pain and answer any questions. This time is really for you to decide if I’m a good fit. If you decide you’d like to work together, I’ll send over some paperwork to be completed before our first session.
Session 1: We’ll do a detailed intake of your history with chronic pain, how it is preventing you from daily activities, and your current priorities in life. I’ll recap the science of PRT and preview what sessions will look like. We’ll also start getting into some of the PRT practices, time permitting.
Session 2 and beyond: There is some variation based on your needs and interests, but PRT sessions involve a combination of the following:
Somatic tracking, where we gently bring our awareness to different parts of the body. This includes the parts that feel pain, and parts that feel neutral or safe. By repeatedly bringing our attention near to & onto the parts that feel pain in a manner that is neutral and curious, we teach the brain that sensations there may be safe.
Resourcing: using our body awareness, 5 senses, external space, and body movements, we build “resources” that feel safe. This is especially important for people who live in a constant state of high alert.
Emotional conversation: we may talk about current sources of stress, historical tendencies towards self-criticism or perfectionism and where they originated, and emotions like fear, sadness, and anger stored in the body. We work to restore compassion and empathy for ourselves and process what it has felt like to live with chronic pain. This aspect is not a replacement for psychotherapy.
Conversations with the body & visualization: it can be useful to actually talk to or personify parts of the body that feel pain or tension. When clients have long held resentment or frustration towards the body, it takes time and effort to repair the relationship.
Self-awareness, reappraisal, and habit formation: we need to recognize the habit and thought patterns we engage in that tend to trigger the pain or being in a state of high alert. We reframe and replace counterproductive habits and thoughts with ones that generate safety and calm, in order to shift the fear-pain cycle for good.
I usually give clients a simple, optional “homework” task to do on their own – something like noticing the sensations in their body when they do a particular activity, or a meditation. I find that continuing the work outside of session is more likely to see longlasting results.
What distinguishes Anoma as a PRT practitioner?
Above all, being a PRT patient across multiple issues created a strong foundation for me as a practitioner. I know exactly what it feels like to feel frustrated, hopeless, and alone in your pain.
I have an innate intuition for guiding clients through somatic tracking due to my 17 years of meditation experience and time I’ve spent teaching meditation pro bono. My internship in clinical pastoral education at Cedars Sinai Medical Center also taught me how to interact sensitively with vulnerable populations experiencing medical issues and chronic pain.
All this said, it's incredibly important that you choose a PRT practitioner that you feel comfortable with and who understands you well. I won't take it personally if that's not me. In fact, I'll even help you find another PRT practitioner, because I believe so strongly in the methodology.
Book a free, no obligation intro call to get started.