A landmark international review published in The Lancet shows how treatments used in specialised centres could be used in primary care when pain first emerges.

For the first time it is possible to show how psychological therapies can work in the brain, physically changing how the brain processes pain and suffering, offering new hope to millions living with long-term conditions.

Led by Professor Lene Vase from Aarhus University, Denmark, alongside the senior author Professor Christopher Eccleston from the University of Bath and Professor Tor Wager from Dartmouth College, USA, the study presents a comprehensive roadmap to scale up access to effective psychological treatments - through frontline healthcare and digital tools.

The review synthesises evidence across multiple studies, showing that therapies like cognitive behavioural therapy (CBT) reduce the emotional burden of pain and make measurable changes in brain activity. These changes occur in the brain’s ’default mode network’, a region associated with emotion and pain regulation.

Chronic pain — defined as pain lasting more than three months — affects 150 million people in Europe, including 13.6 million in the UK. Yet specialist psychological care is available to only a small minority.

The research team identified the key components of successful treatment and repackaged them for use by GPs, nurses, and physiotherapists, enabling earlier and more equitable patient access.

Professor Christopher Eccleston, from the Centre for Pain Research at the University of Bath, said

Expert pain psychology is a luxury good for which demand massively outstrips supply. We must work hard to automate successful treatments and share skills with the healthcare professionals who meet patients earliest.

With only a limited number of trained specialists, the researchers see huge potential in digital health solutions, including CBT-based mobile apps. Though over 500 apps already exist for psychological pain relief, few are backed by rigorous evidence.

To make lasting impact, the authors call for a UK National Pain Institute to drive national strategy and innovation.

Professor Eccleston added:

We need coordinated and energetic leadership to deliver high-quality, evidence-based interventions at scale.

Patient advocate Ian Taverner, who has lived with chronic pain, added:

These approaches can be life-changing, but very few people ever get access to them. Bringing this knowledge and these skills to patients earlier—when they first ask for help—is an exciting research direction.