Mandy Mercuri: An Introduction to Pain Reprocessing Therapy and Somatic Tracking

Guest blog by Mandy Mercuri Mindfulness & Pain Recovery Coach & My Health Story Advisory Member

If you’re living with ongoing musculoskeletal pain, it’s completely understandable to feel frustrated, confused, or even hopeless at times. Many of us spend years being told to “manage” pain rather than understanding the root cause of why it’s happening or how to help it change.

The good news? Pain can change. And today, I’d love to introduce you to two approaches that have helped me and many others: Pain Reprocessing Therapy (PRT) and Somatic Tracking.

What Is Pain Reprocessing Therapy (PRT)?

Pain Reprocessing Therapy is a science-backed approach designed to help retrain the brain and nervous system when pain has become persistent.

When an injury has healed, or when there’s no clear structural damage, pain can continue because the brain has become overprotective. It’s a bit like a smoke alarm that’s become too sensitive, going off even when there’s no real danger. Or a software glitch when there are no hardware processing issues.

A landmark 2021 clinical trial published in JAMA Psychiatry found that nearly two-thirds of people with chronic back pain who received PRT became pain-free or nearly pain-free, compared with only about 10% in the placebo group. Even better—the improvements lasted for at least a year. This shows us something powerful: the pain system can change, even after years of discomfort.

So why does this matter?

Because chronic or “nociplastic” pain is often linked to how the brain interprets signals from the body. The pain is absolutely real…but the alarm system is firing too loudly. PRT helps us understand why this happens and teaches the brain new messages of safety so that it can turn the volume down.

PRT has been shown to help many kinds of pain, including:

• Persistent back or neck pain
• Sciatica
• Carpal tunnel or nerve-related pain
• Fibromyalgia
• Tension headaches
• IBS
• And many other forms of musculoskeletal pain

If your pain system is stuck in protection mode, PRT is worth exploring, regardless of your diagnosis.

What Is Somatic Tracking?

Somatic Tracking is one of the core skills used in PRT. Think of it as a gentle mindfulness practice that helps you pay attention to sensations in the body with curiosity rather than fear.

It has three simple parts:

1. Mindful awareness

You observe what you’re feeling—warm, tight, buzzing, shifting—without judging or trying to fix anything.
You’re simply noticing, like a curious scientist.

2. Safety

You gently remind yourself that the sensations, even uncomfortable ones, are not dangerous.
This is how the brain learns, “I don’t need to sound the alarm.”

You might quietly say,
“This is safe. I’m okay.”

3. Lightness and kindness

Rather than concentrating hard or trying to “do it right,” you bring a soft, friendly attitude.
Maybe even a touch of playfulness.

Trying too hard can make pain louder.
Gentleness helps the nervous system settle.

You might be thinking, “Hang on, turning toward pain sounds scary…”

This is such a common reaction and completely understandable. Many people have spent years avoiding sensations that feel threatening.

But here’s the key:
Somatic Tracking is not about forcing yourself into discomfort.
It’s about showing your nervous system, slowly, safely, repeatedly, that these sensations aren’t dangerous.

This creates what psychologists call a corrective experience. The brain learns:
“I can feel this… and I’m still safe.”

These safe moments begin to rewire old fear-based pathways, allowing pain to ease over time.

PRT and other forms of danger

Pain neuroscience tells us that pain doesn’t exist in isolation – its complex and complicated.
The brain interprets many different experiences as “danger,” including:

• Stress
• Difficulty sleeping
• Emotions we tend to push away
• Fear, worry, or catastrophic thoughts
• Old habits of bracing, tensing, or overprotecting the body

Part of PRT is also to gently explore these experiences too—not to fix them instantly, but to understand how they influence your nervous system.

When your brain learns to feel more safe overall, pain has space to change.

How to Begin Somatic Tracking

If you’re curious to try it, here are a few simple guidelines:

• Start with neutral or pleasant sensations, like the breath or the feeling of your hands resting.
• Gradually explore sensations that are mildly uncomfortable, and only for short moments.
• Keep the emphasis on safety, ease, and curiosity—not effort.
• If things feel overwhelming, pause. Ground yourself in something steady like your breath, sounds, or the feeling of the chair beneath you.

Every time you notice a sensation with calm curiosity, you’re teaching your brain a powerful message:
My body is safe. I don’t need to fight or flee.

It’s all an experiment, right?

If you are willing to try a different approach, why not give somatic tracking a try….you’ll find a variety of Somatic Tracking practices on my Insight Timer page with some focused on bodily sensations, some on emotions, some on movement, and some on breath. Each one is an opportunity to build safety, confidence, and trust in your body again.

Some final tips:

Go gently.
Practice when you can.
You’re not forcing, fixing, figuring out…you’re teaching your nervous system, moment by moment, that you are safe and that recovery is possible.

And it is.