Chronic pain is a lifelong burden for millions. New research shows three non-drug therapies—cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and pain reprocessing therapy (PRT)—can meaningfully reduce pain and improve quality of life. Telehealth is helping bring these options to patients in rural and underserved areas.
Global estimates show chronic pain persisting for three months or more, affecting about 8% to 11% of people, with higher rates in developed countries. In Thai clinics, back pain, headaches, and muscle problems are among the most common complaints. Beyond physical discomfort, chronic pain often disrupts sleep, mood, and daily routines. Traditional approaches rely heavily on medications, but these treatments can lose effectiveness over time and carry risks of overuse and side effects.
Evidence now supports CBT, ACT, and PRT as ways to retrain the brain’s response to pain. A 2025 JAMA trial demonstrated that telehealth-delivered CBT skills training can serve as a first-line nonpharmacologic option, expanding access where in-person care is limited. A senior clinician at a Bangkok hospital notes that addressing fear, stress, and negative thinking can substantially improve patients’ lives.
CBT is the most studied method. It helps patients identify distorted thoughts that magnify pain and disability. By reducing catastrophizing and encouraging gradual activity and relaxation techniques, CBT can break the cycle of fear, inactivity, and social withdrawal that often accompanies chronic pain.
ACT promotes accepting pain while focusing on living a meaningful life. Mindfulness and values-driven actions help people create space for discomfort and pursue goals even when pain persists. ACT draws from broader behavioral traditions and has been adapted into brief sessions and ongoing programs.
PRT targets the brain’s interpretation of pain signals. Instead of avoiding pain or becoming hypervigilant, PRT helps patients reinterpret pain as less threatening, supporting daily activities and a positive self-view. International guidelines increasingly favor integrating psychological therapies with appropriate physical activity and social support, tailored to each patient’s beliefs and resources.
For Thailand, these approaches address a growing burden of pain linked to diabetes, osteoarthritis, and injuries from road traffic incidents. Access to pain specialists remains uneven outside major cities. Telehealth and online CBT interventions show promise for high-impact chronic pain, aligning with Thailand’s push toward digital health and scalable care.
Thai health authorities are incorporating mindfulness elements from ACT into public hospital programs, drawing on local meditation traditions. A senior psychologist at a rehabilitation center in the north notes that many Thais already practice mindfulness; formalizing it within therapy respects culture while advancing science.
While some critics doubt whether psychological therapies fully relieve pain, many leading organizations view them as complementary to medical care. Reducing reliance on medications aligns with global efforts to curb overprescription and opioid misuse, a concern in Southeast Asia as well.
Looking forward, increasing awareness and reducing stigma around pain psychology are essential to help more Thais access these tools. Educational campaigns in cities and rural provinces can normalize discussions about pain and the value of psychological well-being as part of comprehensive care.
Practical steps for readers:
- Seek multidisciplinary pain clinics that offer both medical and psychological support.
- Ask your provider about online or telehealth CBT or ACT options, especially where local services are scarce.
- Use trusted Thai health portals to learn self-management strategies.
- Engage community organizations that provide resources in local languages and dialects.
In summary, recent science confirms that relief from chronic pain can come from the mind as well as the body. By blending global evidence with Thai cultural strengths, healthcare in Thailand can move toward more holistic, person-centered care. Persistent pain does not have to define life; informed, accessible therapies can restore function, hope, and dignity.