A Clinician's Guide to PRT vs. PNE
A hallmark of Modern Manual Therapy and The Eclectic Approach has always been Pain Neuroscience Education, or PNE. Recently, a colleague introduced me to Pain Reprocessing Therapy. As a PT, it's a great way to take the PNE message, but giving the patient an objective program to follow with concrete steps. I made a handy Clinician's Guide to highlight the differences. Lmk what you think and please share!
A Clinician's Guide to
PRT vs. PNE
Understanding the key differences between Pain Reprocessing Therapy and Pain Neuroscience Education.
Pain Neuroscience Education (PNE)
Core Concept: Pain Education
Focuses on reconceptualizing pain by explaining its underlying neurophysiology. It shifts the patient's view from a structural/mechanical problem to an overprotective nervous system, providing the "what" and "why" of their pain experience (Louw et al., 2016).
Method: Primarily Educational
Delivered through explanations, metaphors (e.g., "overactive alarm system"), and pictures to explain concepts like central sensitization. It's typically an adjunct to other physical therapy interventions like manual therapy and exercise.
Outcome Focus: Understanding & Enablement
Aims to decrease pain catastrophizing and fear-avoidance, thereby enabling the patient to more confidently engage in active therapies. It prepares them for movement by changing their conceptual model of pain.
Pain Reprocessing Therapy (PRT)
Core Concept: Pain Reappraisal & Extinction
A systematic psychological therapy focused on helping patients reattribute primary (nociplastic) pain to reversible brain processes, not tissue damage. It provides the "how" to unlearn the pain response (Ashar et al., 2022).
Method: Systematic Protocol
A structured, multi-component system with objective steps. Its core technique, somatic tracking, gives patients an active tool to use during a pain experience: mindfully observing sensations through a lens of safety to create a corrective experience and extinguish fear (Gordon & Ziv, 2021).
Outcome Focus: Pain Reduction & Elimination
Aims for substantial and durable pain relief, with the goal of pain elimination. The landmark study showed 66% of PRT patients became pain-free or nearly pain-free, an outcome rarely seen in other psychological interventions for chronic pain (Ashar et al., 2022).
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