Cited by 331Musculoskeletal pain and rehabilitationPain Management and TreatmentPain Management and Placebo Effect

The DOI matches its Crossref record; 75 of the 82 references it cites were found in a registry or an index, and 2 are not checked yet.

Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial

Open access

Ashar, Yoni K., Gordon, Alan, Schubiner, Howard, Uipi, Christie, Knight, Karen, Anderson, Zachary, Carlisle, Judith, Polisky, Laurie, Geuter, Stephan, Flood, Thomas F., Kragel, Philip A., Dimidjian, Sona, Lumley, Mark A., Wager, Tor D.·2022·JAMA Psychiatry

DOI 10.1001/jamapsychiatry.2021.2669PMC PMC8482298

Open this paper in CoChat — free account Open PDF

Abstract

Importance: Chronic back pain (CBP) is a leading cause of disability, and treatment is often ineffective. Approximately 85% of cases are primary CBP, for which peripheral etiology cannot be identified, and maintenance factors include fear, avoidance, and beliefs that pain indicates injury. Objective: To test whether a psychological treatment (pain reprocessing therapy [PRT]) aiming to shift patients' beliefs about the causes and threat value of pain provides substantial and durable pain relief from primary CBP and to investigate treatment mechanisms. Design, Setting, and Participants: This randomized clinical trial with longitudinal functional magnetic resonance imaging (fMRI) and 1-year follow-up assessment was conducted in a university research setting from November 2017 to August 2018, with 1-year follow-up completed by November 2019. Clinical and fMRI data were analyzed from January 2019 to August 2020. The study compared PRT with an open-label placebo treatment and with usual care in a community sample. Interventions: Participants randomized to PRT participated in 1 telehealth session with a physician and 8 psychological treatment sessions over 4 weeks. Treatment aimed to help patients reconceptualize their pain as due to nondangerous brain activity rather than peripheral tissue injury, using a combination of cognitive, somatic, and exposure-based techniques. Participants randomized to placebo received an open-label subcutaneous saline injection in the back; participants randomized to usual care continued their routine, ongoing care. Main Outcomes and Measures: One-week mean back pain intensity score (0 to 10) at posttreatment, pain beliefs, and fMRI measures of evoked pain and resting connectivity. Results: At baseline, 151 adults (54% female; mean [SD] age, 41.1 [15.6] years) reported mean (SD) pain of low to moderate severity (mean [SD] pain intensity, 4.10 [1.26] of 10; mean [SD] disability, 23.34 [10.12] of 100) and mean (SD) pain duration of 10.0 (8.9) years. Large group differences in pain were observed at posttreatment, with a mean (SD) pain score of 1.18 (1.24) in the PRT group, 2.84 (1.64) in the placebo group, and 3.13 (1.45) in the usual care group. Hedges g was -1.14 for PRT vs placebo and -1.74 for PRT vs usual care (P < .001). Of 151 total participants, 33 of 50 participants (66%) randomized to PRT were pain-free or nearly pain-free at posttreatment (reporting a pain intensity score of 0 or 1 of 10), compared with 10 of 51 participants (20%) randomized to placebo and 5 of 50 participants (10%) randomized to usual care. Treatment effects were maintained at 1-year follow-up, with a mean (SD) pain score of 1.51 (1.59) in the PRT group, 2.79 (1.78) in the placebo group, and 3.00 (1.77) in the usual care group. Hedges g was -0.70 for PRT vs placebo (P = .001) and -1.05 for PRT vs usual care (P < .001) at 1-year follow-up. Longitudinal fMRI showed (1) reduced responses to evoked back pain in the anterior midcingulate and the anterior prefrontal cortex for PRT vs placebo; (2) reduced responses in the anterior insula for PRT vs usual care; (3) increased resting connectivity from the anterior prefrontal cortex and the anterior insula to the primary somatosensory cortex for PRT vs both control groups; and (4) increased connectivity from the anterior midcingulate to the precuneus for PRT vs usual care. Conclusions and Relevance: Psychological treatment centered on changing patients' beliefs about the causes and threat value of pain may provide substantial and durable pain relief for people with CBP. Trial Registration: ClinicalTrials.gov Identifier: NCT03294148.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1001/jamapsychiatry.2021.2669

Cites

75 of 77 references verified0 citation errors · 0 not checkable

Statistics

Figure 1. CONSORT Participant Flow Diagram MRI indicates magnetic resonance imaging.CC BY · PubMed Central

Figure 2. Clinical Outcomes A, Shading indicates standard error. B, Dots represent individual participants; thick lines represent the group mean. C, Percentage of patients reporting pain scores of 0 or 1 of 10 (ie, pain-free or nearly pain-free) at posttreatment and at 1-year follow-up. PRT indicates pain reprocessing therapy.CC BY · PubMed Central

Figure 3. Effects of Treatment on Evoked and Spontaneous Back Pain and Related Brain Function A, Error bars show standard error. B, Coordinates and statistics for activations provided in eTable 7 in Supplement 2; analyses conducted within a mask of regions of interest; eFigure 1 in Supplement 2. C, Decreased evoked pain-related activity was observed in anterior midcingulate (aMCC) and anterior prefrontal regions for PRT vs placebo and left anterior insula for PRT vs usual care. D, Error bars show standard error. E, PRT vs control conditions increased aPFC-seeded (red clusters) and aIns-seeded (green clusters) connectivity with primary somatosensory cortex (permutation test, P < .05). Inset shows seed regions, derived from evoked pain analyses; magenta outlines, PRT vs placebo; black outlines, PRT vs usual care. F, PRT vs usual care increased connectivity between an aMCC seed (yellow; derived from evoked back pain analyses) and the precuneus (orange). Connectivity analyses were conducted within primary somatosensory cortex and medial default mode network masks. aP < .001. bP < .05.CC BY · PubMed Central

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

How do you feel — now? The anterior insula and human awareness
(Bud) Craig, A. D. (2009) · Nature Reviews Neuroscience · doi:10.1038/nrn2555 · Cited by 6,657
Relationship of subjective and objective social status with psychological and physiological functioning: Preliminary data in healthy, White women.
Adler, N. E., Epel, E. S., Castellazzo, G., & Ickovics, J. R. (2000) · Health Psychology · doi:10.1037/0278-6133.19.6.586 · Cited by 5,080
Central sensitization: implications for the diagnosis and treatment of pain
Woolf, C. J. (2011) · Pain · doi:10.1016/j.pain.2010.09.030 · Cited by 4,771
What low back pain is and why we need to pay attention
Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., Hoy, D., Karppinen, J., Pransky, G., Sieper, J., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)30480-x · Cited by 4,652
Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016
Dahlhamer, J., Lucas, J., Zelaya, Nahin, R., Mackey, S., DeBar, L., Kerns, R., Von Korff, M., Porter, L., & Helmick, C. (2018) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6736a2 · Cited by 2,598
Non-specific low back pain
Maher, C., Underwood, M., & Buchbinder, R. (2017) · The Lancet · doi:10.1016/s0140-6736(16)30970-9 · Cited by 2,535 · cited 5×
“Techniques included (1) providing personalized evidence for centralized pain; (2) guided reappraisal of pain sensations while seated and while engaging in feared postures or movements; (3) techniques addressing psychosocial threats (eg, difficult emotions) potentially amplifying pain; and (4) techniques to increase po…”
BackgroundMethodInfluential
The brain basis of emotion: a meta-analytic review
Lindquist, K. A., Wager, T. D., Kober, H., Bliss-Moreau, E., & Barrett, L. F. (2012) · Behavioral and Brain Sciences · doi:10.1017/s0140525x11000446 · Cited by 2,320
Self-citation
RELIEVING PAIN IN AMERICA: A BLUEPRINT FOR TRANSFORMING PREVENTION, CARE, EDUCATION, AND RESEARCH
Simon, L. S. (2012) · Journal of Pain & Palliative Care Pharmacotherapy · doi:10.3109/15360288.2012.678473 · Cited by 2,200
Cognitive and emotional control of pain and its disruption in chronic pain
Bushnell, M. C., Čeko, M., & Low, L. A. (2013) · Nature Reviews Neuroscience · doi:10.1038/nrn3516 · Cited by 2,076 · cited 1×
“Full-time (>30 h/wk) 33 (66) 26 (51) 28 (56)”
Interoceptive predictions in the brain
Barrett, L. F., & Simmons, W. K. (2015) · Nature Reviews Neuroscience · doi:10.1038/nrn3950 · Cited by 1,766 · cited 1×
“Part-time (5-30 h/wk) 10 (20) 12 (24) 13 (26)”

Show all 82 references

Research works printed but not linked: 1

Schubiner, 2010, Unlearn Your Pain

Sorted by citations

Items 101–200 of 330

The neuroscience of itch in relation to transdiagnostic psychological approaches
Kim, J. J., & Day, M. A. (2024) · Scientific Reports · doi:10.1038/s41598-024-69973-5 · Cited by 7
“…is included as a treatment rational in educational interventions 76 , cognitive-behavioural therapy 77 , and mindfulness-based cognitive therapy 78 , and emerging research is showing how changes in brain function during such treatment are driven by change in psychological processes (e.g., 79,80 ).”
Background
Pain can’t be carved at the joints: defining function-based pain profiles and their relevance to chronic disease management in healthcare delivery design
Barron, D. S., Saltoun, K., Kiesow, H., Fu, M., Cohen-Tanugi, J., Geha, P., Scheinost, D., Isaac, Z., Silbersweig, D., & Bzdok, D. (2024) · BMC Medicine · doi:10.1186/s12916-024-03807-z · Cited by 6
Neural and molecular changes during a mind-body reconceptualization, meditation, and open label placebo healing retreat: an observational study
Jinich‐Diamant, A., Simpson, S., Zuniga-Hertz, J. P., Chitteti, R., Schilling, J. M., Bonds, J. A., Case, L. K., Chernov, A. V., Dispenza, J., Maree, J., et al. (2025) · Communications Biology · doi:10.1038/s42003-025-09088-3 · Cited by 11
Clin‐STAR corner: 2021 update in musculoskeletal pain in older adults with a focus on osteoarthritis‐related pain
Adogwa, O., Reid, M. C., Chilakapati, S. S., & Makris, U. E. (2023) · Journal of the American Geriatrics Society · doi:10.1111/jgs.18369 · Cited by 6
Chronic Pain Psychology in Neurology Practice
Serdarević, M. (2024) · Continuum · doi:10.1212/con.0000000000001471 · Cited by 4
Hippocampal functional connectivity after whiplash injury is linked to the development of chronic pain
Branco, P., Bosak, N., Vigotsky, A. D., Granovsky, Y., Yarnitsky, D., & Apkarian, A. V. (2024) · Nature Mental Health · doi:10.1038/s44220-024-00329-8 · Cited by 6
“…cognitive processes, including fear avoidance, kinesiopho-bia, and pain catastrophizing, are risk factors for the development of chronic pain in several pain conditions 36 , and their resolution through, for example, pain reprocessing therapy, shows promise for the treat-ment of chronic pain 37 .”
Injection of hyaluronic acid versus platelet rich plasma for treatment of vulvovaginal atrophy in post-menopausal females
Ragy, S., Kahky, H. M. E., Zuelfakkar, N. M., Nassar, S. A., & Elhusseiny, R. M. (2025) · Archives of Dermatological Research · doi:10.1007/s00403-025-03820-z · Cited by 6
The Role of Glia Underlying Acupuncture Analgesia in Animal Pain Models: A Systematic Review and Meta-Analysis
Yan, B., Tang, S., Zhang, Y., & Xiao, X. (2022) · Pain Medicine · doi:10.1093/pm/pnac115 · Cited by 6
MASSAG model: Towards an integrative neuroscience framework linking emotional trauma, pain, and mechanisms of force-based manipulations
Jinich‐Diamant, A., Albinni, B., Fishbein, J. N., Jacobson, E., Abraira, V. E., Hong, S., Korgan, A. C., Mazzieri, A. M., & Case, L. K. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106517 · Cited by 5
Intrusive Mental Imagery in Chronic Pain: Prevalence and Associations with Common Comorbidities
Watts, J. M., Blackwell, S. E., & Daniels, J. (2024) · Cognitive Therapy and Research · doi:10.1007/s10608-024-10480-2 · Cited by 5
“These sub-optimal outcomes have led not only to development of new psychological treatment approaches, such as pain reprocessing therapy (Ashar et al., 2022), but also further calls for a better understanding of the factors underlying the maintenance and treatment of chronic pain (Crofford, 2015;…”
Independent effects of transcranial direct current stimulation and social influence on pain
Dehghani, A., Bango, C. I., Murphy, E. K., Halter, R. J., & Wager, T. D. (2024) · Pain · doi:10.1097/j.pain.0000000000003338 · Cited by 5
Self-citation
A Tai chi and qigong mind-body program for low back pain: A virtually delivered randomized control trial
Yang, Y., McCluskey, S. T., Bydon, M., Singh, J. R., Sheeler, R. D., Nathani, K. R., Krieger, A. C., Mehta, N. D., Weaver, J., Jia, L., et al. (2024) · North American Spine Society Journal (NASSJ) · doi:10.1016/j.xnsj.2024.100557 · Cited by 7
Sham treatment? Should it be redefined for its use in manual therapy clinical studies?
Hage, R., Demoulin, C., Puentedura, E. J., & Brismée, J. (2025) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2025.2448921 · Cited by 5
Open label placebo for chronic low back pain: a systematic review and meta-analysis of randomized controlled trials
Flávio‐Reis, V. H. P., Pessoa‐Gonçalves, Y. M., Diaz, C. A. V., Lamoglia, A. S. A., Desidério, C. S., & Oliveira, C. J. F. (2025) · Pain Management · doi:10.1080/17581869.2025.2467025 · Cited by 5
Efficacy of cognitive functional therapy for pain intensity and disability in patients with non-specific chronic low back pain: a randomised sham-controlled trial
de Lira, M. R., Meziat‐Filho, N., Silva, G. Z. M., Castro, J., Fernandez, J., Guirro, R. R. D. J., Pereira, R. B. R., & Chaves, T. C. (2025) · British Journal of Sports Medicine · doi:10.1136/bjsports-2024-109012 · Cited by 5
Pains Revisited
Loeser, J. D., & Ballantyne, J. C. (2024) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000001224 · Cited by 6
Medically unexplained symptoms explained
Rème, S. E. (2024) · The Lancet · doi:10.1016/s0140-6736(24)01138-3 · Cited by 5
‘The Second Arrow’: A Collaborative Autoethnographic Exploration of What Can Be Learned From One Long COVID Journey
Belton, S., & Sheridan, K. (2025) · Health Expectations · doi:10.1111/hex.70227 · Cited by 4
Persistent Altered States: Psychological Treatment of Psychedelic Adverse Effects
Holmøy, B., & Andersen, K. A. A. (2025) · Tidsskrift for Norsk psykologforening · doi:10.52734/hgsn7664 · Cited by 4
Pain catastrophizing is associated with reduced neural response to monetary reward
Cooke, M. E., Edwards, R. R., Wheeler, G. L., Schmitt, W. A., Nielsen, L., Streck, J. M., Schuster, R. M., Potter, K. W., Evins, A. E., & Gilman, J. M. (2023) · Frontiers in Pain Research · doi:10.3389/fpain.2023.1129353 · Cited by 4
Depression and Pain
Miller-Matero, L. R. (2024) · Oxford University Press eBooks · doi:10.1093/9780197675250.003.0005 · Cited by 4
Multisite pain among United States Veterans with posttraumatic stress disorder: Prevalence, predictors, and associations with symptom clusters
Fishbein, J. N., Malaktaris, A. L., Afari, N., & Herbert, M. S. (2024) · Journal of Pain · doi:10.1016/j.jpain.2024.104763 · Cited by 4
Efficacy and Safety of the Combination of Diclofenac and Thiocolchicoside in the Treatment of Low Back Pain and Other Conditions: Systematic Review of the Literature
Oikonomou, I., & Akinosoglou, K. (2025) · Healthcare · doi:10.3390/healthcare13060677 · Cited by 7
“CLBP requires a more multidisciplinary approach, often integrating physical therapy [23], exercise [24], and cognitive-behavioral therapy [25,26] to address physical and psychosocial contributors to pain.”
Education about pain and experience with cognitive-based interventions do not reduce healthcare professionals’ chronic pain
Weisman, A., Yona, T., & Masharawi, Y. (2025) · PeerJ · doi:10.7717/peerj.19448 · Cited by 4
Construction and Application Effect Analysis of Orthopedic Pain Care Ward under Multi-Disciplinary Cooperation Model
Xiao, T., Wang, Y., Zhou, C., & Yan, P. (2024) · British Journal of Hospital Medicine · doi:10.12968/hmed.2024.0450 · Cited by 4
Multimodal hypersensitivity and somatic symptoms predict adolescent postmenarchal widespread pain
Osborne, N. R., Hellman, K. M., Burda, E. M., Darnell, S. E., Singh, L., Schrepf, A., Walker, L. S., & Tu, F. F. (2025) · Pain · doi:10.1097/j.pain.0000000000003597 · Cited by 5
Preliminary study: quantification of chronic pain from physiological data
Cheng, Z., Ly, F. S., Santander, T., Turki, E., Zhao, Y., Yoo, J., Lonergan, K., Gray, J., Li, C. H., Yang, H. T. Y., et al. (2022) · PAIN Reports · doi:10.1097/pr9.0000000000001039 · Cited by 4
Emerging evidence for emotion-focused psychotherapy in patients with somatic symptom disorders and chronic pain
Frisch, S., & Gündel, H. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.111132 · Cited by 4
Trauma and Behavioral Health Care for Patients with Chronic Pain
Salahuddin, D., & Conti, T. (2022) · Primary Care - Clinics in Office Practice · doi:10.1016/j.pop.2022.04.001 · Cited by 3
The influence of low back pain-related attitudes and beliefs on the clinical decision making of physical therapists
Rufa, A., Brooks, G., Adams, K. R., & Dolphin, M. (2024) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2024.2346973 · Cited by 3
“She reports no change in symptoms in her lower extremity or low back with forward or backward bending. psychologically aimed interventions and was significantly more effective than standard care and placebo treatment for up to one year [46].”
Depression as an Independent Predictor of Incident Pain: Longitudinal Evidence From CHARLS
Song, W., Wang, S., Cao, Z., & Lin, J. (2025) · Journal of Pain Research · doi:10.2147/jpr.s551970 · Cited by 3
Exposure-based Interventions for Chronic Pain and Bodily Symptoms: A Special Interest Meeting Report
Schemer, L., Glogan, E., Sjouwerman, R., Ahm, R., Ashar, Y. K., Boddez, Y., Boersma, K., Cañeiro, J. P., Cima, R. F. F., den Hollander, M., et al. (2026) · Behaviour Research and Therapy · doi:10.1016/j.brat.2026.104998 · Cited by 3
“…placebo, and care as usual, 66% of individuals randomized to PRT were pain-free or nearly so at post-treatment, versus fewer than 20% in the control groups, with benefits largely maintained through 1-year follow-up (Ashar et al., 2022) and still evident at 5-years follow-up (Ashar et al., 2025).”
Self-citation
Pediatric Neural Changes to Physical and Emotional Pain After Intensive Interdisciplinary Pain Treatment
Lepping, R. J., Hoffart, C. M., Bruce, A. S., Taylor, J. M., Mardis, N., Lim, S.-L., & Wallace, D. P. (2024) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000001237 · Cited by 4
“This ﬁ nding is in line with previous studies that found greater changes in the descending pain pathway following behavioral and pharmacological treatment 39-41 and may indicate a change in the top-down modulation of the stimulation from painful to nonpainful.”
Brain plasticity following lumbar disc herniation treatment with spinal manipulation therapy based on resting-state functional magnetic resonance imaging
Du, H.-G., Wen, Y., Dong, J.-X., Chen, S., Jin, X., Liu, C., Ling, D.-Y., & Lv, L. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e37703 · Cited by 3
“There is currently no universally agreed upon method for determining the sample size in the field of fMRI research [16 – 18].”
Method
Brain Morphological and Functional Changes in Adenomyosis with Pain: A Resting State Functional Magnetic Resonance Imaging Study
Jiao, X., Yuan, M., Li, Q., Huang, Y., Ji, M., Li, J., Yan, S., Sun, H., Wang, X., Pan, Z., et al. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11185286 · Cited by 3
“As a cortical convergence region, the insula participates in various processes, from somatic perception to emotional conflict, receiving information directly from the spinothalamic tract [32,33].”
Background
Cognitive Science Below the Neck: Toward an Integrative Account of Consciousness in the Body
Christov‐Moore, L., Jinich‐Diamant, A., Safron, A., Lynch, C., & Reggente, N. (2023) · Cognitive Science · doi:10.1111/cogs.13264 · Cited by 3
“…rather than physical injury nearly eliminated chronic back pain in 66% of sufferers, versus 20% (open-label placebo) and 10% (usual care) (Ashar et al., 2022), demonstrating that approaches targeting belief structures themselves may be more effective than open-label placebo (von…”
Background
Italian versions of the Neurophysiology of Pain Questionnaire (NPQ): psychometric properties and an investigation on the understanding of pain neurophysiology in physical therapists
Esposto, M., Pellicciari, L., Cecchetto, S., Chiarotto, A., Testa, M., Turolla, A., & Polli, A. (2024) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2024.102957 · Cited by 3
Chronic pain is specifically associated with updating working memory: a longitudinal twin study
Rader, L., Wager, T. D., & Friedman, N. P. (2024) · Pain · doi:10.1097/j.pain.0000000000003347 · Cited by 3
Self-citation
Pain Catastrophizing: Features and Profiles in Chronic Migraine
Grazzi, L., Rizzoli, P. B., & Telesca, A. (2024) · Springer eBooks · doi:10.1007/978-3-031-32046-0_52-1 · Cited by 2
Patient and staff perspectives on pain treatment experiences in a community clinic serving under-resourced older adults
Brewer, J. R., McDermott, K. A., Greenberg, J., Presciutti, A., Camera, D. L., Ritchie, C. S., & Vranceanu, A. (2024) · Pain Management · doi:10.1080/17581869.2024.2432852 · Cited by 3
Risk-stratified Care Improves Pain-related Knowledge and Reduces Psychological Distress for Low Back Pain: A Secondary Analysis of a Randomized Trial
Greenlee, T. A., George, S. Z., Pickens, B., & Rhon, D. I. (2025) · Clinical Orthopaedics and Related Research · doi:10.1097/corr.0000000000003351 · Cited by 3
“Arguably, there is value in using this risk-strati ﬁ ed approach to improve patient well-being because changes in pain beliefs have been associated with reduced psychological distress, pain, and disability in patients with LBP [1, 36, 45].”
Pain Acceptance in Adolescent Chronic Pain
Dowling, E. J., Simons, L. E., Crum, A. J., Pate, J., Chilcot, J., Laycock, H. C., Scott, W., & Heathcote, L. C. (2025) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000001307 · Cited by 3
“63 Finally, the sample was recruited from a single center and mainly comprised females.”
The imaginary divide between mental and “physical” health: Dismantling dualism and reductionism to address a monumental mistake in medicine
Fabiano, N., Solmi, M., Kroenke, K., Stubbs, B., Firth, J., Gaughran, F., Machaczek, K. K., Palmer, C., & Fiedorowicz, J. G. (2026) · JCPP Advances · doi:10.1002/jcv2.70123 · Cited by 3
“…for back pain are efficacious, while psychological treatment (via pain reprocessing therapy) has demonstrated significant pain improvement, with functional MRI correlates of reduced responses to evoked back pain in the anterior midcingulate and the anterior prefrontal cortex (Ashar et al., 2022).”
Home-Use and Portable Biofeedback Lowers Anxiety and Pain in Chronic Pain Subjects
Ly, F. S., Santander, T., Pavlov, S., Zhao, J., Zhang, M., Arroyo, D., Sokolovskiy, S., Iyer, A., Yankauskas, Y., Chen, J. L., et al. (2023) · American Journal of Lifestyle Medicine · doi:10.1177/15598276231221112 · Cited by 3
Osteopathic diagnosis and treatment of the spine in patients with chronic back pain through the lens of medical infrared thermography: A randomized controlled pilot study
Bohlen, L., Biester, A., Rapp, O., Wentzel, J., Liem, T., Cerritelli, F., & Schmidt, T. (2025) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2025.101999 · Cited by 2
Alterations in Functional Connectivity Density in Patients With Phantom Limb Pain
Liao, Y., Sang, L., Wang, Q., Li, P., Wang, L., Zhang, Y., Qiu, M., & Zhang, J. (2025) · The Journal of Comparative Neurology · doi:10.1002/cne.70058 · Cited by 2
“For example, effective psychological treatments for chronic back pain enhance connectivity from the anterior midcingulate to the PCUN (Ashar et al. 2022).”
Cardiac Vagal Control and Emotional Awareness Associated With Pain Among Breast Cancer Survivors
Harel, K., Czamanski‐Cohen, J., Cohen, M. W., Lane, R. D., Allen, J. J. B., Caspi, O., & Weihs, K. L. (2025) · Psychophysiology · doi:10.1111/psyp.70086 · Cited by 2
“…with the aim to enhance bodily interoceptive awareness and foster EA, facilitating the interpretation of bodily sensations associated with complex emotions, may be beneficial in reducing pain symptoms (Ashar et al. 2022; Calsius et al. 2016; Majore-Dusele et al. 2021; Payne and Brooks 2019).”
Pain Reprocessing Therapy for migraine: A case series
Fishbein, J. N., Schuster, N. M., Anders, A., Portera, A. M., & Herbert, M. S. (2025) · Headache The Journal of Head and Face Pain · doi:10.1111/head.15043 · Cited by 2
“14,15 Systematic investigation is needed to clarify the relationship between PRT techniques, mechanisms, and outcomes in migraine and chronic pain conditions.”
Effect Modifiers of Graded Sensorimotor Retraining for Chronic Low Back Pain
Venter, M., McAuley, J. H., Hansford, H. J., Ryan, M. L., Bagg, M. K., Wand, B. M., & Cashin, A. G. (2026) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.52787 · Cited by 2
An alternative “Port”? Rationale and development process for POts Reprocessing Therapy (PORT), a brain–body therapy for postural tachycardic syndrome (POTS)
Crouch, T. B., Nguyen, M., Wells, M., Redman, T., Ashar, Y., Schubiner, H., Westcott, G., Kinser, P., Maxwell, M., Chelimsky, G., et al. (2026) · Clinical Autonomic Research · doi:10.1007/s10286-026-01189-1 · Cited by 4
Self-citation
The impact of coping strategies on treatment outcomes in older patients with degenerative dorsopathies
Gulyaev, D. A., Курносов, И. А., Godanyuk, D. S., Manukovsky, V. A., & Ostrovsky, V. V. (2022) · Genij Ortopedii · doi:10.18019/1028-4427-2022-28-3-410-416 · Cited by 2
Retrospektive Auswertung elektronisch erhobener Patientenfragebögen einer universitären Schmerzambulanz mit dem painDETECT®-Fragebogen
Foadi, N., Winkelmann, I., Rhein, M., & Karst, M. (2022) · Der Schmerz · doi:10.1007/s00482-022-00677-3 · Cited by 2
“Dabei können schon relativ kurze Interventionen zu therapeutisch relevanten Veränderungen führen [23, 24].”
Background
Injury, illness, and emotion: A review of the motivational continuum from trauma through recovery from an ecological perspective
Harvey, A. R. (2023) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2022.100586 · Cited by 4
Change in Pain-Related Anxiety Mediates the Effects of Psychophysiologic Symptom Relief Therapy (PSRT) on Pain Disability for Chronic Back Pain: Secondary Results from a Randomized Controlled Trial
Pester, B., Yamin, J. B., Cabrera, M. J., Mehta, S. M., Silverman, J. M., Grossestreuer, A. V., Howard, P., Edwards, R. R., & Donnino, M. W. (2023) · Journal of Pain Research · doi:10.2147/jpr.s416305 · Cited by 2
Neurophysiology of Pain
Marchand, S. (2024) · Springer eBooks · doi:10.1007/978-3-031-56541-0_3 · Cited by 2
Tailoring Interoceptive Exposure for Patients With Medical Comorbidities
Farris, S. G., Kibbey, M. M., Derby, L., Keller, B., Hoyt, D. L., Brinkman, H. R., Alderman, B. L., & Leyro, T. M. (2024) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2024.11.001 · Cited by 2
Systematic Review on Noninvasive Nonpharmacological Treatments for Chronic Pain: Surveillance Report 3
Skelly, A. C., Brodt, E., Kantner, S. N., Diulio-Nakamura, A., Mauer, K., & Shetty, K. D. (2022) · doi:10.23970/ahrqepcnoninvasivenonpharmasurveillance3 · Cited by 1
Systematic Review on Noninvasive Nonpharmacological Treatment for Chronic Pain: Surveillance Report 2
Skelly, A. C., Brodt, E., Kantner, S. N., Diulio-Nakamura, A., Mauer, K., & Shetty, K. D. (2022) · doi:10.23970/ahrqepcsurveillance2noninvasivenonpharma · Cited by 2
Rethinking chronic plantar heel pain management: moving beyond mechanical models
Rosa, M. A. B. M. V., PERSIANE, A. S., & Yi, L. C. (2025) · British Journal of Sports Medicine · doi:10.1136/bjsports-2024-109348 · Cited by 2
“6 7 This shift will help address plantar heel pain more comprehensively and mitigate negative beliefs associated with pain.”
Mindfulness-Based Interventions for Psychiatry
Ivkovic, A., Evans, S., Mirsky, P., Ashar, Y. K., & Muskin, P. R. (2024) · Tasman’s Psychiatry · doi:10.1007/978-3-030-51366-5_159 · Cited by 1
Self-citation
A functional problem—on a linguistic ambiguity in dentistry
Herpel, C., Schwindling, F. S., Rammelsberg, P., & Tesarz, J. (2023) · Journal of Oral Rehabilitation · doi:10.1111/joor.13518 · Cited by 1
Boosting open-label placebo effects in acute induced pain in healthy adults (BOLPAP-study): study protocol of a randomized controlled trial
de Leeuw, M., Laager, M., Gaab, J., Ruppen, W., & Schneider, T. (2024) · Frontiers in Medicine · doi:10.3389/fmed.2024.1238878 · Cited by 1
Paradigms matter: why persistent pain is different and how dentists can help
Penlington, C., Durham, J., & Beecroft, E. V. (2024) · BDJ · doi:10.1038/s41415-024-7283-1 · Cited by 1
Kognitive Verhaltenstherapie mit Herzratenvariabilitäts-Biofeedback bei chronischen Schmerzen
Wünsche, S., Krempel, L., & Martin, A. (2024) · Die Psychotherapie · doi:10.1007/s00278-024-00732-7 · Cited by 1
Looking Beyond Tissue Damage
Sullivan, M. D. (2024) · Oxford University Press eBooks · doi:10.1093/9780197675250.003.0003 · Cited by 1
Demographics, Clinical Characteristics, and Outcomes of a Post-Coronavirus-19 Sample After Cognitive Rehabilitation: A Case Series
Farr, E. M., Esterov, D., Kassmeyer, B. A., Lennon, R. J., & Bergquist, T. F. (2024) · Archives of Rehabilitation Research and Clinical Translation · doi:10.1016/j.arrct.2024.100409 · Cited by 1
Examining the use of interoceptive exposure exercises in people with and without a history of chronic physical health problems
Farris, S. G., Zvolensky, M. J., Garey, L., & Businelle, M. S. (2025) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2024.2447722 · Cited by 1
“…studies of IE exclude individuals with chronic medical conditions (e.g. cardio-pulmonary conditions) or require medical evaluation and/or clearance (Ashar et al., 2022; Farris & Kibbey, 2022; Ljótsson, Atterlöf, et al., 2014; Oser et al., 2021; Särnholm et al., 2017, 2021; Smith et al., 1998;…”
A Systematic Review and Meta-Analysis of the Association Between Pain-Related Fear and Pain Intensity in Experimental Pain Models
Kutash, L. A., Sayer, M. A., & Delahanty, D. L. (2025) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001359 · Cited by 1
“This phenomenon, grounded in neuromatrix theory, lays the foundation for contemporary interventions including pain reprocessing therapy (26) and pain neuroscience education (27), which are designed to reduce the threat value of pain.”
Patterns of Shared Genetic Risk Between Chronic Pain, Psychopathologies, and Neuroticism
Zorina-Lichtenwalter, K., Bango, C. I., Čeko, M., Ashar, Y. K., Keller, M. C., Wager, T. D., & Friedman, N. P. (2025) · Clinical Psychological Science · doi:10.1177/21677026251317431 · Cited by 3
Self-citation
Intensive psychodynamische Kurzzeittherapie chronischer Schmerzen
Michal, M., Emmenegger, P.-A., & Brehm, M. (2025) · Der Schmerz · doi:10.1007/s00482-025-00884-8 · Cited by 1
Pain Reprocessing Therapy – Schmerz neu denken
Kallweit, A., & Schubiner, H. H. (2025) · Der Schmerz · doi:10.1007/s00482-025-00889-3 · Cited by 1
Self-citation
Effects of visual input on contralateral foot touch and postural stability during one-leg standing in older adults with chronic low back pain
Sung, P. S., & Lee, D. (2025) · European Spine Journal · doi:10.1007/s00586-025-09083-6 · Cited by 1
Understanding pain as threat or challenge: predictive roles of resilience, attachment, and sensory sensitivity
Lajaunie, A. M., Smythe, D., Zhu, G., Sturgeon, J. A., & Pierce, J. M. (2025) · Pain Medicine · doi:10.1093/pm/pnaf091 · Cited by 1
Trunk Laterality Judgement in Chronic Low Back Pain: Influence of Low Back Pain History, Task Complexity, and Clinical Correlates
Matheve, T., Janssens, L., Timmermans, A. A. A., Goossens, N., Danneels, L. A., Meirezonne, H., Brandt, M., & Baets, L. D. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14155328 · Cited by 1
Dyspareunia: a novel clinical approach for diagnosis based on pain mechanisms
Reichman, O., Sahar, T., & Ashar, Y. K. (2025) · Pain · doi:10.1097/j.pain.0000000000003807 · Cited by 1
Self-citation
Pain Catastrophizing: Features and Profiles in Chronic Migraine
Grazzi, L., Rizzoli, P. B., & Telesca, A. (2025) · Springer eBooks · doi:10.1007/978-3-031-73363-5_52 · Cited by 1
Disrupted functional network topology in tension-type headache: A cross-sectional magnetoencephalography study
Xiong, Z., Qiu, D., Liang, J., Li, X., Guo, Z., Zhang, M., Liu, G., Gao, T., & Wang, Y. (2025) · Cephalalgia · doi:10.1177/03331024251386425 · Cited by 1
“The insula, particularly its anterior portion, plays a critical role in pain perception, emotional salience and intero-ception (35) and has been repeatedly implicated in migraine and chronic pain conditions (36,37).”
A dual-database bibliometric analysis of music-based interventions and pain from 2004 to 2024
Zou, X., Jin, Z., & Zeng, W. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2025.1671234 · Cited by 1
Management of non-specific low back pain without drugs
Jones, C. M. P., Underwood, M. R., Basnet, R., Trewern, L., & Lin, C. C. (2025) · BMJ · doi:10.1136/bmj-2025-086052 · Cited by 2
Embedding expectation effects on the management of cancer pain and related symptoms: A focus review
Moss, A., Terhune, J. H., Tkaczuk, K. H. R., & Colloca, L. (2025) · Journal of Pain · doi:10.1016/j.jpain.2025.105586 · Cited by 1
Psykologisk behandling av vedvarende vansker etter bruk av psykedelika
Holmøy, B., & Andersen, K. A. A. (2025) · Tidsskrift for Norsk psykologforening · doi:10.52734/qaow7353 · Cited by 1
Caudal Granular Insular Cortex to Somatosensory Cortex I: A Critical Pathway for the Transition of Acute to Chronic Pain
Ball, J. B., Finch, M. R., Taylor, J. A., Smith, Z. Z., Rocha, I. R. C., Green‐Fulgham, S. M., Rowe, E. B., Dragavon, J. M., McNulty, C. J., Dreher, R. A., et al. (2025) · Journal of Neuroscience · doi:10.1523/jneurosci.1306-25.2025 · Cited by 1
Treating chronic pain with low dose ketamine and adjunct therapies within a biopsychosocial approach: a case series
Almog, S., Weiner, M. D., Howarth, J., Becerra, J., Fux, J., & Berry, M. S. (2026) · Frontiers in Pain Research · doi:10.3389/fpain.2025.1675821 · Cited by 1
“Coaching sessions consist of a combination of methods, including Somatic Tracking within Pain Reprocessing therapy (30), Internal Family Systems therapy (31), Eye Movement Desensitization and Reprocessing [EMDR (32)], breathwork, and mindfulness meditation.”
Prediction error coding as the computational basis for nocifensive and nocifensive-like behaviors
Batsunov, A., Tugin, S., Kirasirova, L., Skobeleva, K., & Sagalajev, B. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1758337 · Cited by 1
Improving Assessment of Sexual Concerns in Interdisciplinary Chronic Pain Settings
Meltzer, K. J., & Poupore‐King, H. (2026) · Journal of Health Service Psychology · doi:10.1007/s42843-025-00141-7 · Cited by 1
“…for these presentations have used the term mind-body symptoms (Lumley & Schubiner, 2019), tension myositis or tension myoneural syndrome (first proposed by John Sarno, MD) (Sarno, 1991), and also neuroplastic pain (Ashar et al., 2022; Gordon & Ziv, 2022) to describe similar presentations.”
“Noticing the Way that I’m Noticing Pain”: A Qualitative Analysis of Therapeutic Progression in Mindfulness-Oriented Recovery Enhancement for Patients with Lumbosacral Radicular Pain
Wexler, R. S., Balsamo, W., Fox, D. J., ZuZero, D., Parikshak, A., Kwin, S., Ramirez, J., Thompson, A. R., Carlson, H. L., Kern, T., et al. (2026) · Mindfulness · doi:10.1007/s12671-026-02782-1 · Cited by 1
“Instead, it involves a sophisticated re-evaluation of the pain experience, consistent with previous research (Ashar et al., 2022; Schütze et al., 2010).”
Effectiveness of resistance training and pain reprocessing therapy in female flight attendants with chronic low back pain: a study protocol for a randomized controlled trial
Zolfaghari, N., Letafatkar, A., Rossettini, G., Villafañe, J. H., Ayed, K., Laher, I., Coso, J. D., Granacher, U., & Zouhal, H. (2026) · Pain Management · doi:10.1080/17581869.2026.2643332 · Cited by 1
Recent highlights in low back pain research, Part II: Prevention and management
Saragiotto, B. T., Shaheed, C. A., Overton, M., Hayden, J. A., Hartvigsen, J., & Pinto, R. Z. (2026) · Journal of physiotherapy · doi:10.1016/j.jphys.2026.03.002 · Cited by 1
Brain-Centered Interventions for Nociplastic Pain: From Symptom Management to Pain Resolution
Thérond, A., Yuan, C., Aiyer, R., Hasoon, J. J., Yong, R. J., Stark‐Inbar, A., Starnino, L., Kulich, R. J., & Robinson, C. L. (2026) · Current Pain and Headache Reports · doi:10.1007/s11916-026-01489-1 · Cited by 1
“PRT consists of four integrated components delivered over approximately eight sessions [ 14 ].”
Influential
The new generation of psychological treatments for pain: characteristics and critical appraisal
McDermott, K. A., & Keefe, F. J. (2026) · Pain · doi:10.1097/j.pain.0000000000003993 · Cited by 2
Pain reprocessing therapy in adults with chronic widespread pain: A pilot randomized clinical trial
Sit, R. W. S., Chan, C. Y.-K., Fong, H. P.-Y., Fung, C. L.-C., & Wong, S. Y. S. (2026) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2026.112688 · Cited by 1
Exploring the link between anxiety, depression and somatization with pain severity in chronic low back pain patients: a survey at a tertiary care hospital
Zaka, M., Mirza, U. B., Bibi, M., Bibi, A., Sheikh, A., Dars, J. A., & Raza, A. A. (2026) · Pain Management · doi:10.1080/17581869.2026.2674766 · Cited by 1
Symptom-Level Comorbidity of Fibromyalgia and Depression: A Network Approach within a Large Clinical Sample
Reichert, J., Drusko, A., Beiner, E., Hermes, M., Papaioannou, V., Häuser, W., Eich, W., & Tesarz, J. (2026) · Psychotherapy and Psychosomatics · doi:10.1159/000551679 · Cited by 1
The body and the brain keep the score: a data-driven conceptual model linking trauma and postural tachycardia syndrome
Crouch, T. B., Chelimsky, G. G., Boylan, L. E., Maxwell, M., Westcott, G., Chase, S. O., Redman, T., Burch, J., Gharbo, R. S., Wells, M. J., et al. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1829434 · Cited by 1
“This approach, which we have termed POTS Reprocessing Therapy (PORT), was adapted from Pain Reprocessing Therapy (PRT), an evidence-based treatment for centralized pain conditions, given our hypothesis that POTS represents a different manifestation of a similar functional dysregulation in the nervous system (Crouch et…”
Influential
Innateness in Mind
Carruthers, P. (2026) · Cambridge University Press eBooks · doi:10.1017/9781009506076 · Cited by 1
Differential patterns of brain connectivity alterations in patients with back pain chronification versus recovery: A resting-state FMRI study
Wunderlich, S., López, J. E., Stoecklein, V. M., Ringel, F. A., Ricke, J., Schulz, E., & Stoecklein, S. (2026) · Journal of Pain · doi:10.1016/j.jpain.2026.106347 · Cited by 1
Psychotherapeutische Arbeit mit Angehörigen und Paaren bei psychischen und körperlichen Erkrankungen
Zimmermann, T., Wuttke, A., & Ditzen, B. (2023) · PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie · doi:10.1055/a-1841-3289 · Cited by 1
“Gerade der Fokus auf katastrophisierende Gedanken in einer „pain reprocessing therapy“ (PRT) konnte die Schmerzen bei Rückenschmerzpatient*innen deutlich reduzieren [21].”
Background
Ärztliche Gesprächsführung und psychologische Beratung bei Endometriose
Wischmann, T. H., & Ditzen, B. (2024) · Die Gynäkologie · doi:10.1007/s00129-024-05201-5 · Cited by 1
One-year Results of Minimally Invasive Sutured Fixation of the Slipped Ribs in the Pediatric Population
Polycarpou, A., Chopko, T. C., Glasgow, A. E., McCarthy, S. R. B., Hilliker, D. R., Wilder, R. T., & Klinkner, D. B. (2024) · Journal of Pediatric Surgery · doi:10.1016/j.jpedsurg.2024.02.027 · Cited by 1
Influence of Depression on Pain and Disability in Patients with Chronic Low Back Pain after Physical Therapy: A Secondary Analysis of a Randomized Controlled Trial
Wang, R., Peng, M.-S., Wang, Y.-Z., Chen, P.-J., & Wang, X.-Q. (2024) · Depression and Anxiety · doi:10.1155/2024/9065325 · Cited by 1

Authors: Ashar, Y. K., Gordon, A., Schubiner, H., Uipi, C., Knight, K., Anderson, Z., Carlisle, J., Polisky, L., Geuter, S., Flood, T. F., Kragel, P. A., Dimidjian, S., Lumley, M. A., & Wager, T. D.
Affiliations: University of Colorado Boulder (US)
Pain Psychology Center, Los Angeles, California
Ascension Providence Hospital (US)
Panorama Orthopedics and Spine Center, Golden, Colorado
Northwestern University (US)
Johns Hopkins University (US)
Brigham and Women's Hospital (US)
Emory University (US)
Wayne State University (US)
Dartmouth College (US)
Corresponding author: Ashar, Yoni K.
Wager, Tor D.
ORCID: Ashar, Yoni K.
Schubiner, Howard
Uipi, Christie
Anderson, Zachary
Carlisle, Judith
Geuter, Stephan
Flood, Thomas F.
Kragel, Philip A.
Dimidjian, Sona
Lumley, Mark A.
Wager, Tor D.
Venue: JAMA Psychiatry
Publisher: American Medical Association (AMA)
Published: 2022-01-01
Volume: 79
Issue: 1
Pages: 13
ISSN: 2168-622X (ISSN-L)
DOI: 10.1001/jamapsychiatry.2021.2669
PMC: PMC8482298
OpenAlex: W3204387157
Cited by: 331
References: 82
Citations by year: 2026: 87 · 2025: 80 · 2024: 85 · 2023: 45 · 2022: 32
FWCI: 23.94
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
Locations: JAMA Psychiatry (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Funders: Deutsche Forschungsgemeinschaft
National Institutes of Health (TL1TR002386)
National Institute of Mental Health (R01MH076136)
National Institute on Drug Abuse (R01DA035484)
National Center for Advancing Translational Sciences
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Keywords: chronic back pain, pain beliefs, fear avoidance, placebo effect, psychological intervention, telemedicine, evoked pain, resting-state functional connectivity, therapeutic mechanisms, pain intensity, disability, treatment durability, fear-avoidance beliefs, pain catastrophizing, pain-related guilt, pain-related shame, pain-related hopelessness
MeSH terms: Adult, Back Pain, Disability Evaluation, Female, Humans, Male, Middle Aged, Pain, Treatment Outcome, Pain Management

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial

Abstract

Overview

Integrity signals

Figures

Verification

Claims the paper makes

Claims other papers make about this one

Self-check

Citations

Cites

Cited by

Related

Metadata

Record

About these checks