Can Pain Reprocessing Therapy Help Fibromyalgia?
Understanding the connection between pain, the brain & the nervous system
Your pain is real. Your symptoms are real. And your nervous system may be playing an important role in keeping those symptoms going.
Fibromyalgia is increasingly understood as a nociplastic pain condition. This means that changes in the way the nervous system processes and amplifies sensory information can contribute to ongoing pain—even when there is not ongoing tissue damage that fully explains the intensity of the symptoms.
This does not mean the pain is “all in your head.”
It means that the brain and nervous system are part of the pain system—and that system can sometimes become overprotective.
🧠 Why might PRT be helpful for fibromyalgia?
Think of your nervous system as an alarm system.
When the brain repeatedly receives signals of danger—whether from pain, illness, stress, trauma, inflammation, injury, or other experiences—it can become increasingly sensitive to potential threats.
Over time, the alarm may begin responding to sensations that are uncomfortable but not necessarily dangerous.
Fibromyalgia can involve increased sensitivity to pain and other sensory information. Research also suggests that people with fibromyalgia may have heightened threat responses and changes in the way the brain learns and predicts pain.
PRT works with this pain–danger system.
Rather than fighting your body or pushing through pain, PRT helps you learn to:
Understand how the brain and nervous system contribute to persistent pain
Recognize the difference between pain and danger
Approach sensations with curiosity rather than fear
Reduce fear and threat responses around symptoms
Safely notice physical sensations without automatically interpreting them as harmful
Retrain the brain's prediction and alarm systems
Gradually return to activities that pain may have caused you to avoid
🌿 What does the research show?
A 2025 University of Michigan pilot study specifically examined a brief, telehealth version of Pain Reprocessing Therapy in 35 adults with fibromyalgia.
Participants completed three weekly sessions. Among those who completed treatment, researchers found significant reductions in:
Pain intensity
Pain interference with daily life
Fear related to pain
At the 3-month follow-up, 42.3% of participants described themselves as “much improved” or “very much improved.” About 31% reported at least a 50% reduction in pain intensity at that time point.
While this was a small-scale study, the findings are encouraging—particularly because the treatment was specifically designed around the mechanisms believed to contribute to nociplastic pain such as fibromyalgia.
❤️ You don't have to choose between “physical” and “psychological.”
Fibromyalgia involves complex interactions between the body, brain, nervous system, emotions, stress, sleep, movement, and environment.
PRT doesn't ask you to believe that your symptoms aren't physical.
Instead, it offers another possibility:
What if your nervous system has learned to protect you a little too much—and can learn something new?
The goal isn't to convince yourself that you aren't hurting.
The goal is to help your brain and nervous system feel safer with sensations that have become associated with danger.
And sometimes, when the brain feels safer, the alarm doesn't have to be quite so loud.
Pain Reprocessing Therapy is not a replacement for appropriate medical care. It can be used alongside medical treatment, physical therapy, movement, sleep support, and other approaches that are appropriate for you.
Learn more about PRT:
Undivided Heart Counseling — Pain Reprocessing Therapy Group
Research: Sturgeon JA, Trost Z, Ashar YK, et al. Brief Pain Reprocessing Therapy for Fibromyalgia: A Feasibility, Acceptability, and Preliminary Efficacy Pilot. Regional Anesthesia & Pain Medicine, 2025.