Patient Guides · Mind-Body Approaches

Your Pain Is Real.
Your Brain Can Help Turn It Down.

All pain is produced by the brain. That doesn't mean it's imagined. After an injury heals, the nervous system can stay on high alert, like a smoke detector that keeps going off after the fire is out.

A surgeon's perspective

Sometimes the best treatment isn't another procedure

I see it every week: patients with severe pain whose imaging doesn't explain it, or whose pain continues after a technically successful operation. For many of them, the most powerful treatment is retraining the nervous system.

Signs your nervous system may be driving the pain

It started during a stressful time, or without a clear injury
It moves around, spreads or changes sides
It varies with stress, mood or time of day
It has lasted long past normal healing time
Your imaging doesn't match how bad it is

These are clues, not a diagnosis. A thorough evaluation comes first.

Pain reprocessing therapy

Teaching the brain that the body is safe

Usually 8 to 12 sessions with a trained therapist. PRT combines education about how pain works, somatic tracking (noticing sensations with curiosity instead of fear), and lowering the fear that keeps the alarm turned up.

66%

of people with chronic back pain were pain-free or nearly pain-free after PRT, versus 20% with placebo and 10% with no new treatment.

Randomized trial of 151 adults, JAMA Psychiatry, 2022. Most kept their improvement for a year.

Where to begin