Can TRE help chronic pain? How Trauma Release Exercises effect the nervous system
The first time I tried TRE, I wasn’t exactly sure what to expect. I knew the theory, had done a lot of reading and I’d watched some videos. It seemed strange- releasing an inbuilt tremor response? That we all have, but most of us don’t know it? And then I tried it for myself.
That experience changed how I understood chronic pain.
Because what TRE does is it gives the nervous system permission to complete something it has been holding in suspension, sometimes for years. And for people living with chronic pain, that unfinished business in the nervous system is often one of the main factors keeping them in pain.
What is TRE?
TRE stands for Trauma and Tension Release Exercises. It was developed by Dr David Berceli, a somatic trauma therapist who spent years working in conflict zones and noticed something consistent: people who had been through extreme stress, whether natural disasters or war, would often begin to shake and tremble spontaneously after the danger had passed. This tremoring appeared to be the body's own mechanism for discharging the fight/ flight energy mobilised during a threat response.
Berceli began to notice the same pattern in animals. You may have seen it yourself- think of a deer that has been chased by a predator and escaped- it will typically stop, shake vigorously for a few minutes, and then return to grazing as if nothing happened. The deer has completed that stress cycle and reset its nervous system to a baseline of relaxation.
Humans do this as well- or we would, if we didn't so often suppress it. We tense up against the shaking. We tell ourselves to pull it together. We hold it all in. Then we wonder why we can’t switch off at the end of a long day, or sleep though the night. And over time, that held tension accumulates in the body as chronic bracing, vigilance, and for many people, chronic pain.
TRE uses a simple sequence of exercises , practiced in a safe environment, to gently fatigue specific muscles in the legs and hips, creating the conditions for the body's natural tremoring response to begin. Once it does, the person simply allows it- resting on the floor, breathing, noticing what arises. The tremoring then moves through the body, releasing tension that has been held, sometimes for decades.
It sounds unusual. The results are often profound.
The nervous system, tension, and chronic pain
To understand why TRE can help with chronic pain, it helps to understand what chronic pain actually is.
As I wrote in my guide to why chronic pain persists, pain is not simply a signal from damaged tissue. It is a protective output generated by the nervous system- the brain's best guess at how much danger you are in, based on all available information. When the nervous system becomes sensitised- through injury, ongoing stress, trauma, unmet needs, hormonal shifts, or cumulative overload- that alarm system can get stuck in the ‘on’ position, producing pain even when there is no ongoing tissue damage to explain it.
This is called central sensitisation. And one of the key drivers of central sensitisation is chronic muscular tension.
When we experience threat, the body mobilises. Muscles brace. The breath shortens. The jaw, the shoulders, the hips, the psoas muscle all contract in preparation for fight, flight or freeze. This is supposed to happen- its brilliant, adaptive, and exactly what the body is designed to do.
The problem is that in chronic stress, the threat never fully resolves. The muscles never fully release. The body remains in a low-level state of bracing, often below conscious awareness. that keeps the nervous system in a state of vigilance and the pain system in a state of readiness.
The esteemed bodyworker Moshe Feldenkrais named this ‘parasitic tension’ - tension that we have no conscious control over, or sometimes even awareness of, which zaps your energy, causing tiredness and discomfort.
This is where TRE comes in.
By facilitating the release of that deep muscular holding- particularly in the psoas and hip flexors, (which are sometimes called the ‘fight or flight muscles’ because they help you kick and run) TRE helps the body complete stress cycles that have been interrupted. Tension that has been stored in the muscles begins to discharge. The nervous system receives a powerful signal: the threat has passed. It is safe to release and settle down.
As that deep holding releases, pain sensitivity often begins to reduce.
What I see in clients
I have been using TRE with clients for several years now, and what I observe consistently is this-people arrive braced. It is visible in how they hold their shoulders, how they breathe, how they sit. I can see the patterns, even through my computer screen, before they describe them to me. Often they don't know they are doing it. It has simply become their normal.
In the first TRE session, the tremoring is sometimes tentative. I can begin as small movements in the legs, a slight vibration in the hips. Some people feel warmth spreading through the body. Others notice an almost immediate sense of release, as their body starts to let go.
The second session is to explore different movements that help guide the tremors to relevant stuck or constricted parts - the abdomen, chest, shoulders, arms and neck, if there is stored tension there.
By the end of a session, most clients describe feeling much more able to relax their bodies, and also being able to quiet the mental chatter. One client with longstanding fibromyalgia described it as ‘finally putting down something very heavy that I didn't know I was carrying.’
Over time- and TRE works cumulatively, with each session building on the last- clients with chronic pain often notice:
A reduction in baseline pain levels
Fewer flare-ups, or flare-ups that settle more quickly
Improved sleep, as the body stops bracing through the night
Reduced anxiety around symptoms
Greater body awareness and trust
A general sense of feeling more at home in themselves
TRE and trauma- the connection to chronic pain
One of the things that makes TRE particularly valuable in a chronic pain context is its capacity to work with trauma without requiring verbal processing.
Many people with chronic pain have a history of adverse experiences, whether childhood stress, difficult relationships, medical trauma, accidents, or years of struggling with a body that feels unreliable. These experiences don't just live in memory. They persist in the body as patterns of tension, vigilance, and protective bracing that the nervous system has never fully released.
Cognitive Hypnotherapy can reach the subconscious patterns maintaining those responses. Somatic work can bring awareness to where they live in the body. But TRE offers something uniquely direct: a bottom-up route to releasing what is held physically, without needing to talk about it, analyse it, or even consciously identify it.
For people who find talking therapies difficult, or who have processed their history cognitively but still find it living in their body- TRE can be the missing piece.
I know this from my own experience. When I was recovering from a serious spinal injury several years ago, TRE was one of the most significant parts of my recovery. I was worried it may make my back worse, but I had nothing to worry about. Actually I started too feel better straight away. Not because it fixed the structure- it didn't need to- but because it helped my nervous system stop bracing around an injury that had long since healed. My body had learned to protect that area as if the threat were still present. TRE, alongside other work, helped my body learn something new, update its understanding of safety vs threat, and respond differently.
What to expect in a TRE session
I teach TRE entirely online, and once learned, it can be practised independently wherever you are in the world. This is one of its great advantages- it becomes a self-regulation tool that you carry with you, anywhere you are.
A typical session begins with a simple series of exercises designed to gently load and fatigue the muscles of the legs, hips and lower back. The exercises can be adapted to your mobility levels and any physical restrictions you may have. You then lie on the floor, knees bent, and allow whatever happens to happen. For most people, tremoring begins within a few minutes, starting in the legs and sometimes moving up through the body.
I’m there to help you stay within your window of tolerance- to slow things down if the process becomes too intense, or to encourage the body to go a little further if it is holding back. The goal is always regulation and to avoid overwhelm.
Sessions last 60 minutes. Most people feel deeply relaxed afterwards as if something that has been wound tight for a very long time has finally been allowed to unwind. Its a combination of effortless relaxation, stillness and relief.
Is TRE right for you?
TRE is generally safe and well-tolerated. It is typically avoided in the immediate aftermath of surgery and approached with additional care during pregnancy. It is not a substitute for medical care, and if you are living with a complex pain condition, it is always worth discussing new approaches with your GP or medical team.
TRE works as a standalone practice, but also particularly well as part of an integrated approach- alongside Pain Neuroscience Education to reduce fear, Cognitive Hypnotherapy to address subconscious patterns, and Buteyko Breathing to stabilise the physiological foundations of the stress response.
This is exactly the combination I use in my work with clients experiencing chronic pain. We address the nervous system from every angle, rather than relying on one single approach.
If you recognise yourself in this article- if you feel chronically braced, if your body has been holding tension for longer than you can remember, if pain has become a persistent and confusing presence in your life- TRE may be worth exploring.
You don't have to keep carrying what the body has been holding. There are ways to put it down.
If you'd like to find out more about TRE for chronic pain, or explore whether working together might be the right fit, you can book a free clarity call here.
You can also read more about TRE, chronic pain, and the Breath Body Mind Method.
About Ella Matthews
Ella Matthews is a Cognitive Hypnotherapist, Certified TRE Provider, Pain Neuroscience Educator and Buteyko Breathing Instructor with over 20 years of therapeutic experience. She specialises in working with women living with chronic pain, stress, anxiety and trauma, online across the UK.
