Can EMDR Help Chronic Pain?

At a glance

EMDR is being investigated for chronic pain, with promising but uneven evidence. A 2025 systematic review included nine studies, seven of them randomized trials. The studies differed in pain conditions, treatment protocols, and outcome measures. The authors described potential benefit while noting that EMDR has not been established as routine pain-management practice. ^[1]

That is a reason to discuss an emerging option carefully. It is not a reason to promise that processing a memory will remove a physical condition or make medical treatment unnecessary.

Psychological treatment does not make pain imaginary

A referral for psychological care should not be explained as “nothing is physically wrong.” Our editorial position is that pain deserves to be taken seriously whether or not a particular examination provides a complete explanation. The purpose of a psychological consultation should be stated clearly, without asking the person to prove that their suffering is real.

For example, a hypothetical client may want help with the distress surrounding an accident, fear about movement, or the disruption pain has brought to daily life. These are possible treatment goals to assess, not assumptions about the cause of every pain condition.

If EMDR is proposed, the clinician should explain which difficulty they intend to address and how it relates to the broader care plan. “We will work on the distress associated with this experience” is more precise than “your pain is stored trauma.”

A closer look at one pilot trial

A randomized pilot study by Gerhardt and colleagues involved forty people with nonspecific chronic back pain and psychological trauma. It compared EMDR added to usual care with usual care alone. The results were encouraging, but the small pilot was not designed to settle effectiveness definitively and did not include an active psychotherapy comparison. ^[2]

The sample matters. Research in people selected for both chronic back pain and trauma cannot simply be generalized to every person with migraine, arthritis, neuropathy, or another pain condition. A promising result should lead to a better-targeted question, not an unlimited claim.

Separate pain intensity from the impact of pain

When reading a study or discussing treatment, ask which outcome is improving. Pain intensity, emotional distress, physical functioning, and quality of life are related but different. The chronic-pain review found variation across the measures and effects reported by individual studies. ^[1]

Our practical recommendation is to choose goals that matter to the person and review them separately. A hypothetical client may still report pain but be more able to attend a family event. Another may feel calmer about a memory while their physical limitations remain unchanged. Both observations are worth recording accurately.

Reducing distress is not a failure because it is not a cure. At the same time, reduced distress should not be advertised as the disappearance of a medical problem.

What would make EMDR relevant?

The answer should come from assessment, not the presence of pain alone. A history involving frightening medical events or other distressing memories might be relevant to a formulation. It does not establish that all symptoms arise from those memories or that EMDR is automatically the most appropriate first step.

The broader EMDR literature distinguishes stronger evidence for PTSD from preliminary work in other conditions. That distinction should remain visible when clinicians discuss pain-related applications. ^[3]

We recommend asking the clinician to identify both the proposed benefit and its limits. What outcome is realistic to evaluate? What other treatments should continue? What would lead the clinician to recommend a different approach? These questions make consent more specific than a general statement that the method “works with the nervous system.”

Keep medical decisions in the appropriate care setting

This article is not advice to change medication, postpone an examination, or reinterpret new symptoms as emotional. Changes in pain or other physical symptoms may need medical assessment. Decisions about medical treatment belong with the appropriate treating professionals, not with a newsletter or a stimulation application.

For coordinated care, our recommendation is to clarify roles. Who monitors the physical condition? Who addresses trauma-related symptoms? What information can be shared with consent? Who should the client contact about an unexpected change? A clear division of responsibility can prevent the person from receiving contradictory messages.

A useful way to discuss progress

Imagine a client whose goal is to resume a meaningful activity within the limits agreed with their medical team. The therapist and client could review whether distress about the activity has changed, whether participation has changed, and whether the physical symptoms need reassessment. These are suggested discussion points, not a self-directed exposure or rehabilitation program.

The value of this approach is that no single rating has to stand for everything. It also avoids pressuring the client to report less pain in order to demonstrate that therapy is working.

What not to promise

Avoid claims that EMDR reliably cures chronic pain, removes pain memories from the body, or works better than all other pain treatments. The studies reviewed here do not justify those conclusions. They support further investigation and cautious, individualized use rather than replacing established care. ^{[1] [2]}

Bottom line

EMDR may have a role for some people with chronic pain, particularly when a careful assessment identifies relevant psychological difficulties. The evidence remains developing. A responsible discussion protects medical care, names the treatment target, and evaluates meaningful outcomes without implying that pain is imaginary or that improvement must mean a complete cure.