Pain reprocessing therapy in adults with chronic widespread pain: A pilot randomized clinical trial.

INTRODUCTION

Chronic Widespread Pain (CWP) is a disabling condition with no established cure. As a nociplastic pain condition without active tissue damage, it is considered potentially reversible. Pain Reprocessing Therapy (PRT) is a mechanism-based psychological intervention shown to reduce or eliminate pain in chronic low back pain but has not been tested in CWP.

METHODS

This 12-week, two-arm pilot randomized clinical trial enrolled 53 participants with CWP, randomized 1:1 to PRT (n = 27) or psychoeducation control (n = 26). The PRT group received one health evaluation and education session, followed by eight weekly 1-h individual PRT sessions; the control group received four bi-weekly 1-h group psychoeducation sessions. Primary outcomes assessed feasibility, including recruitment, randomization, adherence, dropout, and adverse events. Secondary outcomes evaluated pain intensity, pain interference, anxiety, depression, kinesiophobia, myalgia, fatigue, and health-related quality of life.

RESULTS

Over 13 months, 416 individuals were screened, and 53 were enrolled. The PRT group attended a mean of 7.8 sessions. Dropout occurred in 3 (11.1%) PRT and 7 (27.0%) control. Data retention was 85% at 8 weeks and 79% at 12 weeks. Favourable trends for PRT were observed in all secondary outcomes at 12 weeks.

CONCLUSION

Preliminary evidence suggested that PRT is feasible and acceptable for patients with CWP, with favourable trends observed in pain reduction, functional outcomes, and psychological well-being. Findings from this pilot study provide practical insights to inform the design of a future large-scale randomized controlled trial, including considerations for sample size, study design, outcome selection, and intervention delivery.

TRIAL REGISTRATION: This research study is registered under the Chinese Clinical Trial Registry (Trial Registration Number: ChiCTR2400081418) on 29th Feb, 2024.