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The Boulder Back Pain Study – 5 Years Later

In 2021, a randomized clinical study was conducted to assess the response of individuals with chronic low back pain to a treatment called Pain Reprocessing Therapy (PRT).1 

PRT is a psychological intervention that emphasizes that the brain can create pain in the absence of tissue damage and that teaches the participant to reappraise their thoughts about pain, thus decreasing the perceived threat of the sensation.

This blog about the Boulder Back Pain Study discusses the initial study – the study participants had chronic low back pain (for a mean of 10 years) and after 4 weeks of PRT treatment, 73% of the patients were pain-free or nearly pain-free. These results were largely maintained at the one-year follow up.

In 2025, the study authors published a 5-year follow up on the results, which revealed the following:2

  • Five years later, over 50% of patients who received PRT remained pain-free or nearly pain-free.
  • These participants also had better improvements than placebo and usual care in pain interference, depression, anger, mind-brain attributions, and fearful beliefs about movement.

The five-year follow up results show that the initial effect of the PRT treatment on these individuals with chronic low back pain was not transient.

These results reinforce the great news that our brains and nervous systems have high plasticity (adaptable and able to change) even after many years of pain!

If you have back pain or other chronic symptoms, you may benefit from individualized physical therapy with Dr. Sarah Burkhardt. 

Schedule Now

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!

  1. Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79(1):13–23. doi:10.1001/jamapsychiatry.2021.2669 ↩︎
  2. Ashar YK, Low EL, Knight K, et al. Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: 5-Year Follow-Up of a Randomized Clinical Trial. JAMA Psychiatry. 2025;82(10):1049-1051. doi:10.1001/jamapsychiatry.2025.1844 ↩︎