Transforming Women’s Pain: Pain Reprocessing Therapy

If you are here, someone has probably already told you the scans look fine.

That sentence is meant to be reassuring and almost never is. It leaves you with pain that is unmistakably real and an explanation that does not fit it. Here is what the evidence actually says about pain in women, about why it gets waved off, and about one approach that takes a different route into the problem.

Why do women have more chronic pain?

Start with the plain numbers. In 2023 the CDC found that 25.4 percent of women reported chronic pain in the previous three months, against 23.2 percent of men. A modest gap across the whole population, and a much wider one inside specific conditions.

Migraine is the clearest example. A life-span study of United States prevalence put migraine at 17.5 percent in females and 8.6 percent in males, roughly double. Fibromyalgia runs the same direction, and the National Institute of Arthritis and Musculoskeletal and Skin Diseases states simply that more women get it than men. Add chronic pelvic pain, and the picture is not subtle.

Nobody has a single clean explanation. Hormonal cycling, differences in central pain processing, and a long history of women being under-represented in pain research all show up in the literature. What matters for you is less the mechanism than the consequence.

What happens when your pain is not believed

This is the part patients raise first and doctors write about last.

In 2024, researchers analysed 21,851 emergency department discharge notes across the United States and Israel and found that female patients were less likely than male patients to be prescribed any analgesic, opioid or not, for comparable presentations. Not a survey of how women felt about their care. Records of what was actually prescribed.

That belongs in an article about treatment, not just an article about grievance. Being repeatedly told a sensation is not really there teaches you to argue with your own body. You learn to brace, to prove the pain, to treat every twinge as evidence you have to defend. That posture is the opposite of what the approach below asks of you, which is why the history is worth naming before anyone starts the work.

What is Pain Reprocessing Therapy, and what does the evidence show?

Pain Reprocessing Therapy works from a specific idea: pain is produced by the brain, and in some long-standing pain the brain has learned to generate a danger signal that no longer matches injury in the tissue. The therapy targets that learned judgement rather than the tissue.

A 2022 randomised controlled trial of Pain Reprocessing Therapy for chronic back pain enrolled 151 adults, 54 percent of them women, who had lived with pain for an average of ten years, and randomised them to PRT, an open-label placebo injection, or usual care. At the end of treatment, 33 of the 50 people in the PRT group, that is 66 percent, reported pain of 0 or 1 out of 10. In the placebo group it was 20 percent. In usual care, 10 percent. The difference was still there a year later (Ashar et al., 2022).

So what can be said honestly? That a mind-body approach produced large, durable results in one well-controlled trial in one condition, and that related work has held up elsewhere. A cluster-randomised trial of 230 adults with fibromyalgia, a condition that affects more women than men, found an emotion-focused therapy outperformed a fibromyalgia education programme on overall symptoms, widespread pain and physical functioning. Encouraging. Not the same thing as proof that it will work for you.

What somatic tracking actually asks you to do

The central practice is called somatic tracking, and it is less mystical than it sounds.

You turn your attention toward a sensation you have spent years turning away from. You watch it, deliberately and without bracing, curious about it rather than afraid of it. Where does it sit. Does it move. Does it change while you are looking. The aim is not to force it away. It is to let your nervous system gather evidence that attending to this sensation does not lead to harm, until the alarm attached to it settles.

That is why the dismissal history matters. If your pain has been minimised for years, calm attention is genuinely hard to produce. Most people arrive braced, and learning to unbrace usually takes longer than the technique itself.

It has real limits too. Somatic tracking is appropriate for pain the brain has learned to generate, not for pain with an active structural or inflammatory cause. Sorting one from the other is a medical assessment, not a self-diagnosis, and that is where a physician-led version of this work differs from an app.

What about mothers and caregivers?

This work is harder when you cannot stop.

Caring for young children rarely leaves you the thing most pain advice quietly assumes you have: rest, quiet, and room to pay attention to what your body is doing. That matters here more than usual, because the practice depends on noticing a sensation without alarm. Watching a feeling calmly in a still room is one exercise. Doing it during a school run, or at three in the morning with a toddler, is a different one.

The practical adaptation is not to hunt for longer sessions. It is to use shorter ones, more often. A minute of unhurried attention to a sensation, several times across a day, does more than the half hour you keep postponing until the house goes quiet. It does not go quiet.

There is a second reason this comes up. If your pain has ever been put down to stress, or hormones, or simply the demands of having children, that experience is directly relevant. Being told the pain is not really there teaches you to distrust your own body. This approach asks the opposite of you: take the sensation seriously enough to look straight at it, while learning that it is not evidence of damage.

If you are managing pain alongside caring for other people, say so at the first appointment. It changes what a realistic plan looks like.

How this differs from cognitive behavioural therapy

Cognitive behavioural therapy is what most people with chronic pain are offered first, and it works by helping you challenge unhelpful thoughts about the pain.

Pain Reprocessing Therapy starts somewhere else. Rather than disputing the thought, it works on the brain’s judgement of whether the sensation is actually dangerous. Dr. Vaid pairs PRT with Motivational Interviewing, which draws out your own reasons for testing a belief instead of telling you the belief is wrong.

She does not provide CBT in-house. If CBT is what you are looking for, or another clinician has recommended it, she can refer you to a provider who does.

What working with Dr. Vaid looks like

You see Dr. Vaid herself at every visit. Savera is a solo practice, not a rotating team, which is the point of it. She is board certified in Internal Medicine, Infectious Disease and Addiction Medicine, with advanced training in Pain Reprocessing Therapy, and consults in English, Punjabi and Hindi. She is a physician, and she delivers PRT herself as part of medical care rather than referring it out.

A first appointment covers your pain history, what has been tried, and what has been ruled out, because deciding whether this approach fits your pain is a medical question that comes before any technique. Savera is out of network by design, so visits stay unhurried and your record stays private. HSA and FSA are accepted, and cost is discussed openly on the first call.

For the wider picture, start with Pain Reprocessing Therapy, or read about PRT for fibromyalgia if that is the diagnosis you are carrying.