Some people come to Sea to Summit Physical Therapy in South Boulder because of persistent pain and dizziness. In fact, you are likely to know someone who experiences chronic pain as it affects approximately 21% of adults in the United States.1
Pain Reprocessing Therapy (PRT) is a treatment for chronic pain (and other symptoms) that is not due to current tissue damage.2 Chronic pain is pain that persists past the tissue healing timeframe (usually 3-6 months). This happens due to the way the brain changes to interpret sensations.
Pain is a danger signal – it is supposed to let you know there is a problem. However, the brain sometimes misinterprets safe signals/sensations as if they’re dangerous. (These false alarms are just as loud as real ones!). This is called neuroplastic pain and is a common cause or component of chronic pain. (This misinterpretation of sensations can also result in other symptoms including dizziness, GI distress, and fatigue.)
For more information about whether your symptoms are neuroplastic, read this list.
PRT is a treatment that decreases fear (because fear causes pain) and re-maps the brain to understand a sensation is indeed safe. It works holistically with the following aspects:
- Cognitive – education about symptoms and the brain results in decreased fear
- Somatic – Somatic tracking is an important part of PRT (See below)
- Behavioral – Graded Exposure to movements/activities that used to feel scary teaches the brain that these are safe
- Emotional – Sometimes it is the fear or suppression of an emotion that is driving the symptoms, more than the sensation itself. Learning to recognize and express emotions can decrease symptoms.
Somatic Tracking is a technique to retrain your brain to interpret signals from your body correctly, which ultimately turns off the pain/symptom. The goal with somatic tracking is to help you feel safe with your symptoms. There are three components to somatic tracking:
- Mindfulness: Attend to sensations with curiosity. Observing the sensation without fear disrupts the pain-fear cycle.
- Safety Reappraisal: (This step may come first if the sensation feels to threatening to observe with curiosity)
- Gather evidence that your symptoms are neuroplastic: physical therapy or doctor exam, diagnostic tests and measures, and this assessment list.
- Reinforce safety, health, and the brain’s role in producing symptoms.
- Positive Affect Induction: Keep it light, not intense! Use humor, stories, relaxing imagery. Take the pressure off the process so the brain can feel safe while it re-learns how to interpret sensations.
If you are experiencing chronic symptoms, you may benefit from individualized physical therapy with Dr. Sarah Burkhardt.
or email sarah@seatosummitpt.com with any questions!
For more about pain and the brain, see this blog About Pain, and this one about a variety of symptoms and the Autonomic Nervous System. To learn more about the ability to function without pain, even in the presence of MRI pathology, read about these rock climbers here!
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(Photo Credit: Meg Kies)