Steve Nairn, MSc PT.
As physiotherapists, the most common concern we hear from our clients is pain. It is striking that, despite advances in medication, surgical techniques, and access to health information, we are experiencing more pain than ever before. In Canada, approximately 1 in 5 people—nearly 8 million individuals—live with chronic pain. This raises an important question: what are we missing, and how can we be more effective in treating persistent pain?
I believe a key part of the answer lies in stress. Modern life, despite its many conveniences, exposes us to unprecedented levels of pressure and distraction. Constant notifications, social media, and ongoing access to work can overwhelm our nervous systems, creating a sense that there is always too much to do and not enough time. To the primitive brain, this is perceived as a threat. Unlike in the past, these stress signals can persist for days, weeks, or even years without relief. Over time, this can leave the nervous system in a prolonged state of high alert, often referred to as a fight-or-flight response. While this response is helpful in short bursts, when it becomes chronic it can contribute to burnout and increase the likelihood of experiencing pain.
This is where Pain Reprocessing Therapy (PRT) can play an important role. PRT uses evidence-based psychological techniques to help retrain the brain and reduce chronic pain and other persistent symptoms. It is based on the understanding that pain is influenced not only by physical factors, but also by our beliefs, emotions, past experiences, and trauma. By changing how we interpret and respond to pain, we can harness the brain’s ability to adapt and reduce symptoms.
At the core of this approach is neuroplasticity, the brain’s remarkable ability to rewire and change. Just as the brain can become conditioned to remain in a heightened state of alert, it can also learn to shift toward a state of safety and ease. I speak from both professional and personal experience. I have faced persistent pain and lived with a nervous system in a prolonged state of high alert. In the past, I placed significant pressure on myself to perform in my career, in sports, and in my roles as a husband, father, and friend. While well intentioned, this pattern left me more vulnerable to pain.
My experience eventually required me to step away from work and regular activities on multiple occasions while I sought treatment. I came to realize that conventional physiotherapy and medication alone were not enough for my recovery. My path expanded to include learning how to regulate my nervous system and cultivate a genuine sense of calm and safety within my body. This concept was entirely new to me, yet it was exactly what my system needed. Over time, this allowed my brain to rewire and my nervous system to settle.
As I gradually returned to movement, respecting my limits and reframing my symptoms through a lens of safety rather than danger, I began to improve. I came to understand that my persistent symptoms were no longer driven by structural injury, but by neural patterns in the brain that had become overprotective.
Over the past decade, I have integrated these principles into both my personal life and clinical practice. I now see pain reprocessing and nervous system regulation as essential components in the treatment of persistent pain. These approaches offer clients not only a path toward recovery, but also a meaningful sense of understanding and control over their symptoms.
