Chronic Pain Physiotherapy: A Modern Approach to Persistent Pain

Chronic pain — defined as pain persisting beyond 3 months — affects approximately 3.4 million Australians and is the leading cause of disability in the country. Many people with chronic pain have been told there is nothing that can be done, have tried multiple treatments without success, or have been dismissed as exaggerating. Modern pain science tells a very different story — and physiotherapy plays a central role in treatment.

Understanding Chronic Pain

Acute pain — from a fresh injury — serves an important protective function, warning us of tissue damage. Chronic pain is fundamentally different. When pain persists beyond normal tissue healing times (typically 3–6 months), it often reflects changes in the nervous system rather than ongoing tissue damage.

Central sensitisation is the key mechanism: the nervous system becomes sensitised and amplifies pain signals, like a car alarm calibrated too sensitively. Pain can persist and spread even after the original injury has fully healed. This is not psychological weakness — it is a measurable neurological process with real physiological changes.

Conditions We Treat

• Chronic lower back pain (the most common presentation)
• Fibromyalgia — widespread pain, fatigue, and sensitivity
• Complex regional pain syndrome (CRPS)
• Chronic neck pain
• Persistent post-surgical pain
• Chronic widespread musculoskeletal pain
• Chronic headaches and migraines with a musculoskeletal component

The Modern Physiotherapy Approach to Chronic Pain

Effective chronic pain management goes well beyond passive treatment. At Better Physiotherapy Bundoora, we use an evidence-based biopsychosocial approach:

• Pain education (Pain Neuroscience Education): Understanding how chronic pain works — the role of central sensitisation, the difference between hurt and harm — reduces fear, catastrophising, and disability. Research shows pain education alone significantly reduces pain and improves function.
• Graded exercise therapy: Starting at a very manageable baseline and progressing gradually, building the body's tolerance to activity over time. The goal is to increase function, not wait until pain is zero before moving.
• Pacing strategies: Learning to balance activity and rest appropriately — avoiding the boom-bust cycle of overdoing it on good days and being incapacitated on bad ones.
• Manual therapy: Targeted treatment of specific musculoskeletal contributors to pain, where appropriate
• Sleep and lifestyle: Poor sleep amplifies pain significantly. Addressing sleep hygiene, stress, and lifestyle factors is an important part of chronic pain management.
• Goal-setting: Defining meaningful function goals — returning to gardening, playing with grandchildren, working — and working systematically toward them

Medicare Access for Chronic Pain

Chronic pain conditions qualify for Medicare EPC (Enhanced Primary Care) referrals. Ask your GP about a GP Management Plan — this gives you access to up to 5 bulk-billed physiotherapy sessions per year at no cost.