PRIVATE PSYCHOLOGIST OSLO

Pain Reprocessing Therapy (PRT)

Pain Reprocessing Therapy (PRT) is the form of treatment that has demonstrated strong and persistent effects on the treatment of chronic pain (Ashar et al, 2021). Traditionally, therapy has been aimed at helping patients live with pain, but in PRT the goal is to get rid of the pain through therapeutic work.

The psychologist helps the client distinguish between what is pain caused by physical damage (structural pain) and what is pain caused by psychological causes (neuroplastic pain). In working with chronic pain, traditional pain management (medicines, surgery, exercise, etc.) shows little effect over time. Researchers are now leaning more towards the fact that chronic pain may have a psychological cause, and should be treated psychologically.

That the pain is psychologically conditioned or neuroplastic does not mean that the pain is imagined, but that it is no longer a physical injury that is the main cause of the pain. By working with the psychological factors that maintain and partly create pain, the client will learn powerful techniques and tools that they can use during and between classes, and be able to overcome the pain.

Sources:

Ashar, YK, Gordon, A., Schubiner, H., et al. (2021). Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: A randomized clinical trial. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2021.2669 

Dahlhamer, James, Jacqueline Lucas, Carla Zelaya, Richard Nahin, Sean Mackey, Lynn DeBar, Robert Kerns, Michael Von Korff, Linda Porter, and Charles Helmick. "Prevalence of chronic pain and high-impact chronic pain among adults—United States, 2016." Morbidity and Mortality Weekly Report 67, no. 36 (2018): 1001. 

Gureje, Oye, Michael Von Korff, Gregory E. Simon, and Richard Gater. "Persistent pain and well-being: a World Health Organization study in primary care." Jama 280, no. 2 (1998): 147-151. 

Ferrari, Robert, and Anthony S. Russell. "Epidemiology of whiplash: an international dilemma." Annals of the rheumatic diseases 58, no. 1 (1999): 1-5. 

Obelieniene, Diana, Harald Schrader, Gunnar Bovim, Irena Misevičiene, and Trond Sand. "Pain after whiplash: a prospective controlled conception cohort study." Journal of Neurology, Neurosurgery & Psychiatry 66, no. 3 (1999): 279-283. 

Castro, WHM, SJ Meyer, MER Becke, CG Nentwig, MF Hein, BI Ercan, S. Thomann, U. Wessels, and AE Du Chesne. "No stress–no whiplash?" International journal of legal medicine 114, no. 6 (2001): 316-322. 

Fisher JP, Hassan DT, O'Connor N. Minerva. BMJ. 1995 Jan 7;310(70). 

Bayer, Timothy L., Paul E. Baer, and Charles Early. "Situational and psychophysiological factors in psychologically induced pain." Pain 44, no. 1 (1991): 45-50. 

Derbyshire, Stuart WG, Matthew G. Whalley, V. Andrew Stenger, and David A. Oakley. "Cerebral activation during hypnotically induced and imagined pain." Neuroimage 23, no. 1 (2004): 392-401. 

Jensen, Maureen C., Michael N. Brant-Zawadzki, Nancy Obuchowski, Michael T. Modic, Dennis Malkasian, and Jeffrey S. Ross. "Magnetic resonance imaging of the lumbar spine in people without back pain." New England Journal of Medicine 331, no. 2 (1994): 69-73. 

Kleinstück, Frank, Jiri Dvorak, and Anne F. Mannion. "Are "structural abnormalities" on magnetic resonance imaging a contraindication to the successful conservative treatment of chronic nonspecific low back pain?." Spine 31, no. 19 (2006): 2250-2257. 

Brinjikji et al (2015a, 2015b). Am J Neuroradiology 

Moseley JB, O'Malley K, Petersen NJ, Menke TJ, Brody BA, Kuykendall DH, Hollingsworth JC, Ashton CM, Wray NP. A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med. 2002 Jul 11;347(2):81-8. doi: 10.1056/NEJMoa013259. PMID: 12110735. 

Chan, Chin-wern, and Philip Peng. "Failed back surgery syndrome." Pain Medicine 12, no. 4 (2011): 577-606. 

Louw, Adriaan, Ina Diener, César Fernández-de-las-Peñas, and Emilio J. Puentedura. "Sham surgery in orthopedics: a systematic review of the literature." Pain Medicine 18, no. 4 (2017): 736-750. 

Mirza, Sohail K., and Richard A. Deyo. "Systematic review of randomized trials comparing lumbar fusion surgery to nonoperative care for treatment of chronic back pain." Spine 32, no. 7 (2007): 816-823. 

Brox, Jens Ivar, Øystein P. Nygaard, Inger Holm, Anne Keller, Tor Ingebrigtsen, and Olav Reikerås. "Four-year follow-up of surgical versus non-surgical therapy for chronic low back pain." Annals of the rheumatic diseases 69, no. 9 (2010): 1643-1648. 

Marwan N., Bogdan Petre, Souraya Torbey, Kristina M. Herrmann, Lejian Huang, Thomas J. Schnitzer, Howard L. Fields, and A. Vania Apkarian. "Corticostriatal functional connectivity predicts transition to chronic back pain." Nature neuroscience 15, no. 8 (2012): 1117-1119. 

Hashmi, Javeria A., Marwan N. Baliki, Lejian Huang, Alex T. Baria, Souraya Torbey, Kristina M. Hermann, Thomas J. Schnitzer, and A. Vania Apkarian. "Shape shifting pain: chronicity of back pain shifts brain representation from nociceptive to emotional circuits." Brain 136, no. 9 (2013): 2751-2768. 

Kirwilliam, SS, and SWG Derbyshire. «Increased bias to report heat or pain following emotional priming of pain-related fear.» PAIN 137, no. 1 (2008): 60-65. 

Picavet, H. Susan J., Johan WS Vlaeyen, and Jan SAG Schouten. "Pain astrophizing and kinesiophobia: predictors of chronic low back pain." American journal of epidemiology 156, no. 11 (2002): 1028-1034. 

Cherkin DC, Anderson ML, Sherman KJ, et al. Two-Year Follow-up of a Randomized Clinical Trial of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care for Chronic Low Back Pain. JAMA. 2017;317(6):642–644. doi:10.1001/jama.2016.17814 

Doménech, Julio, Vicente Sanchis-Alfonso, and Begona Espejo. "Changes in astrophizing and kinesiophobia are predictive of changes in disability and pain after treatment in patients with anterior knee pain." Knee surgery, sports traumatology, arthroscopy 22, no. 10 (2014): 2295-2300. 

Cai, Libai, Huanhuan Gao, Huiping Xu, Yanyan Wang, Peihua Lyu, and Yanjin Liu. "Does a program based on cognitive behavioral therapy affect kinesiophobia in patients following total knee arthroplasty? A randomized, controlled trial with a 6-month follow-up.” The Journal of arthroplasty 33, no. 3 (2018): 704-710. 

Guck, Thomas P., Raymond V. Burke, Christopher Rainville, Dreylana Hill-Taylor, and Dustin P. Wallace. "A brief primary care intervention to reduce fear of movement in chronic low back pain patients." Translational behavioral medicine 5, no. 1 (2015): 113-121. 

25Smeets, Rob JEM, Johan WS Vlaeyen, Arnold DM Kester, and J. André Knottnerus. "Reduction of pain catastrophizing mediates the outcome of both physical and cognitive-behavioral treatment in chronic 

low back pain.” The Journal of Pain 7, no. 4 (2006): 261-271. 

de Jong, Jeroen R., Karoline Vangronsveld, Madelon L. Peters, Mariëlle EJB Goossens, Patrick Onghena, Isis Bulté, and Johan WS Vlaeyen. "Reduction of pain-related fear and disability in post-traumatic neck pain: a replicated single-case experimental study of exposure in vivo." The Journal of Pain 9, no. 12 (2008): 1123-1134.