Processing therapy works on the basis of retraining the brain to interpret signals from the body’s tissues in a neutral, safe way.

All the signals the brain receives can be interpreted through either a lens of safety or a lens of danger. In chronic pain, these neutral, safe signals from the body’s tissues are often perceived through a lens of danger, which leads the brain to trigger a painful experience.

The therapy is designed to help retrain the brain to view these safe, neutral, non-dangerous signals through a lens of safety instead.

It is an evidence-based talking therapy — a psychological approach rather than a physical or hands-on treatment.

Sessions are designed to help identify the underlying causes of these changes within the brain, and to give patients the tools to retrain their own response, ultimately reducing the experience of pain.

People who can benefit from pain reprocessing therapy are generally those with long-standing pain that has persisted for many months or years. It is not typically suitable for people whose pain is clearly driven by an ongoing structural problem.

In many cases, this type of chronic pain is not caused by an active tissue injury anymore. Instead, it arises because the brain is no longer processing normal, neutral signals from the body in the usual way.

These neutral, non-dangerous signals can become amplified, leading to a persistent pain experience even in the absence of ongoing tissue damage. This is thought to relate to changes in activity within the central nervous system that help perpetuate the pain.

Pain reprocessing therapy may also help with the anxiety associated with pain, which can further contribute to how strongly the brain generates the pain experience.

Pain reprocessing therapy is different from other pain management approaches because it takes, in my view, a more holistic approach to pain. It looks at a person beyond just the physical domain.

It considers the affective, social, and even spiritual aspects of a person’s life. When someone experiences chronic pain, all of these different domains are affected in some way, and they all influence each other.

Understanding what is happening across those areas — and what may be fuelling the chronic pain process — is a key part of what pain reprocessing therapy aims to address.

That’s why I think it’s quite unique among pain management therapies. Its approach is more holistic and very patient-centred, rather than being condition-centred or disease-centred.

A pain reprocessing therapy programme is delivered over a number of sessions. Initially, when the patient comes to see me, the first session is focused on making sure the patient is experiencing a neuropathic pain presentation rather than a structural pain presentation, because the diagnosis needs to be correct for the therapy to work.

That first session involves discussing the patient’s pain experience, including the characteristics and behaviour of the pain, what they’ve tried previously, and any diagnoses they may have been given.

From there, the work moves into more focused, self-directed, mindfulness-based activities. These are designed to help the patient engage with the pain while also retraining the brain to view it through a lens of safety.

The overall goal is to equip patients as quickly as possible with the tools they need to manage their own pain, rather than relying on ongoing or endless sessions with a practitioner.

A question often asked by patients is how they will know whether pain reprocessing therapy is the right approach for them.

The diagnostic criteria we use looks at features such as the characteristics of the pain. For example, does the pain change in character, or move location? Does it present in unusual ways — sometimes on one side, sometimes on both, or shifting between areas like an arm on one day and the other arm the next?

We also look at whether the pain is influenced by stress. For instance, some people notice their pain disappears while on holiday for a couple of weeks, only to return when they come back to work. These kinds of patterns can be indicators that the pain is neuroplastic in nature.