Echoes in the Nervous System Trauma’s Influence on Pain Pathways

Chronic pain exists along a continuum from acute injury to long-standing, centralized pain shaped by neuroplastic changes, trauma, and stress-related learning in the brain and body. Advances in neuroscience and epigenetics show how adverse experiences can alter pain processing and gene expression over time, helping explain why pain may persist even after tissue healing. Accurate identification of pain type is essential for selecting appropriate treatments, including pharmacologic options, while also recognizing the risks associated with long-term opioid therapy, complex persistent opioid dependence, and opioid use disorder. This program will look at current evidence to build integrated, patient-centered strategies that address pain, trauma, and opioid-related risk together. This presentation explores how pain and trauma are encoded in the brain and body, highlighting the neuroscience of threat learning, prediction, and neuroplasticity alongside epigenetic mechanisms that shape stress and pain responses over time. We will examine how adverse experiences can alter gene expression and neural circuits involved in pain, and how these processes remain reversible. The role of Pain Reprocessing Therapy (PRT) will be discussed as an evidence-based approach that targets maladaptive brain predictions to reduce chronic pain and trauma-related symptoms.

Objectives:

-Explain key neurobiological and epigenetic mechanisms underlying chronic pain and trauma, including learning, memory, and stress regulation.

-Describe how pain becomes centralized and maintained by brain-based predictive processes.

-Understand how Pain Reprocessing Therapy leverages neuroplasticity to reverse maladaptive pain and trauma responses.

Continuing education credits available: Nursing Home Administrator and Social Worker

If you have any questions about this presentation or are interested in individualized educational sessions on pain management or substance use disorders, please contact Loretta Bryan (loretta.bryan@sdaho.org) for more information. For those interested in training for pain reprocessing therapy (PRT), here are some recommendations from Dr Ball…

• The most well-known is from Pain Reprocessing Therapy at painreprocessingtherapy.com. (The trainings include 21 hours of CE and cost $990.) They do have a free 1-hr CE. They accept the following types of practitioners in their directory (doctors, nurses, healthcare providers, pharmacists, psychotherapists, counselors, mental health professionals, health life and pain coaches, PT, OT, chiropractor, massage therapists, and hands-on healers).

• The Arizona Trauma Institute have several different certifications there, although not specific to pain reprocessing therapy (PRT).

Presenter: Dr. Jennifer Ball, PharmD, BCGP, Minnesota Direct Care and Treatment 

Presented: March 9, 2026