Reprocessing Pain Therapy (TRD): What It Is and How It Works

Many people around the world suffer from chronic pain. This disorder manifests itself in very different forms, such as headaches, back pain, neck pain, wrist pain… but they all have in common that we do not know what the organic cause is.

Although the physical cause of these ailments is unknown, most treatments focus on treating the suspected organic cause, or at least reducing the perception of pain with the help of drugs such as opiates.

But … what if the problem was in the brain? Is it possible to change the perception of pain? These are some of the questions that Pain Reprocessing Therapy not only answers, but works on. improve the quality of life of people with chronic pain. Learn more about this interesting psychotherapy.

    What is Pain Retreatment Therapy?

    Chronic pain is a reality for many people. It’s not hard to find someone in a hurry who has a pain in their back, neck, head, or who feels like they have repetitive strain injuries, a discomfort that kicks in every time they have to. doing some activities easy and painless for the most part, but that for such patients can become a great suffering.

    There aren’t a few people who feel their body hurts for no apparent organic reason after doing a mundane task. For example, there are people who start hurting their back when walking for a while, their neck after sitting for several hours at the desk, or their wrist while typing on the keyboard.

    These same people went to various specialists who all answered the same thing: they cannot find the organic cause. Of course, the treatment is organic, using both occupational therapy and drugs.

    Corn… What if the key to chronic pain was not physical but psychological? After all, pain is nothing more than a cerebral interpretation of the signals it receives from different parts of the body. It is the body’s warning sign that alerts the brain that there are damaged tissues or organs.

    However, in the case of chronic pain, this signal is a misinterpretation of the brain by a signal that it perceives as painful when it should not.. This pain is called neuroplastic pain and is the result of mistakes the brain makes in interpreting safe messages from the body.

    Although the origin of this pain is psychological, this does not mean that neuroplastic pain is imaginary. In fact, neuroimaging techniques that have been used to treat what’s going on in the brains of patients with chronic pain show that the pain is real. Some recent research has shown that pain is often the result of learned neural pathways in the brain. But just as pain can be ‘learned’, so can it be ‘unlearned’.

    That chronic back pain, neck pain, fibromyalgia symptoms, repetitive strain injuries, headaches and other forms of chronic pain are not the result of structural causes, but psychophysiological processes were already suspected. Following new research and the approach of a new psychological therapy specifically targeted at patients with chronic pain, it has been found that this type of pain can be reversed. This is where pain retreatment therapy comes in

      How is it used in patients?

      Alan Gordon’s group has developed a treatment called Pain Reprocessing Therapy (PRT). Assuming that chronic pain is the result of abnormal brain connections that are seen as painful and safe signals from the body, the goal of this therapy is to “remove” these connections with the intention of deactivating neuroplastic pain.. Just as the brain learns to associate a signal with pain, it can be unlearned using appropriate techniques.

      Pain Reprocessing Therapy includes various psychological techniques that retrain the patient’s brain to respond appropriately to safe bodily signals and thus successfully break the cycle of chronic pain.

      These techniques include somatic tracking., which combines mindfulness, reassessing safety, and inducing positive affects. The purpose of somatic tracking is to help patients see their pain sensation through a different and safer view, and thus try to turn off the pain signal.

      As discussed previously, patients with chronic pain often develop conditioned responses. That is, your brain makes associations between certain physical activities and the onset of pain (e.g. walking causes back pain, writing causes wrist pain, back pain when sitting …). Another component of TRD is helping patients break these associations so that they can do the activities on their own without feeling pain.

        Scientific evidence for its effectiveness

        A study conducted by the University of Colorado Boulder, USA, and published in the prestigious JAMA Psychiatry provided scientific evidence for the effectiveness of retreatment therapy for pain.

        This study, conducted by the group of Yoni K. Ashar, Alan Gordon, Tor D. Wager and their colleagues, found that approximately two-thirds of patients with chronic back pain who underwent four-week psychological treatment based on this therapy they felt little or no pain after receiving this treatment. And the amazing thing is that most of them kept the relief for a year.

        The same researchers note in their study that chronic pain has long been thought to be mainly due to unfamiliar bodily problems, an idea upon which most treatments to reduce this pain are based. Unlike conventional treatments, aimed at reducing the supposed source of pain, TRD is based on the premise that the brain can generate pain in the absence of an injury or after it has healed., and that people can unlearn this pain.

        Virtually most patients with chronic back pain (85%) suffer from what is called “primary pain”, which means that medical tests cannot identify a clear bodily source, such as tissue damage. .

        As we have already mentioned, abnormal neural pathways are thought to be responsible for the perception of this pain. Several regions of the brain, including those related to reward and fear, are activated more during episodes of chronic pain than during those of acute pain.

        In his study, Wager and his colleagues they recruited 151 men and women who had suffered from back pain for at least six months with an intensity of at least four on a scale of zero to ten. These participants were divided into three groups: TRD therapy, placebo, and non-therapy, and the subjects’ brains were assessed before and after treatment, particularly using functional magnetic resonance imaging (fMRI) to measure the brain’s reaction to a stimulus. mild pain.

        After treatment, 66% of patients in the treatment group experienced little or no pain, compared to 20% in the placebo group and 10% in the group without treatment. When people in the PRT group have been exposed to pain and evaluated by neuroimaging after treatment, regions of the brain associated with pain treatment, including the anterior insula and the anterior middle nerve, had significantly bypassed.

        This study is considered to be one of the strongest evidence that psychological therapy can improve the quality of life of patients with chronic pain, yielding results that have not been seen in other treatments, with durability and an extent of pain reduction that they are very rarely observed in trials with other treatment techniques for Chronic Pain.

        It should be noted, however, that the authors of this study and those who have proposed retreatment therapy for pain do not consider it effective for what is called secondary pain, which has its origin in acute injury or illness. . Wager’s study focused specifically on retreatment pain therapy for chronic back pain, so larger studies will be needed to determine if results as good as those seen in these patients are achieved.

        In any case, both this study and the still rare but promising clinical practice of TRD attest to the fact that it is about a good therapeutic tool to improve the quality of life of people suffering from chronic pain and even eliminate it. See this pain from a new perspective, understand that it is a false alarm signal and that all is well in the body, understand that it should not be seen as a danger signal and unlearn pain is a good tool to improve the quality of patients. Lives.

        Pain retreatment therapy shows great promise as a potentially powerful option for people with chronic pain who want to live free from this discomfort.

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