‘Pain Physiotherapy Level 2’ is designed for physiotherapists seeking to deepen their expertise in the assessment and management of complex pain presentations. 

Building on the foundations established in the APA Level 1 course, this program integrates modern pain science with practical applications in real-world settings. 

The course, underpinned by advanced clinical reasoning, offers participants practical opportunities of reflection and the integration of complex clinical findings into a pain recovery pathway. 

What does the course cover? 

At its core, the Level 2 course offers an advanced overview of pain science and the biopsychosocial model as it applies to clientcentred physiotherapy practice. 

Participants explore detailed concepts in neurophysiology, neuroimmunology, neuroplasticity and the role of the nervous, immune and endocrine systems in pain. 

Topics such as the hypothalamic-pituitary-adrenal axis, central sensitisation and the International Association for the Study of Pain’s emerging definition of nociplastic pain are examined in depth, alongside the clinical implications. 

The course addresses pain classification systems and the spectrum of pain presentations – from acute and episodic conditions to persistent and complex chronic pain states. 

Conditions associated with nociplastic pain mechanisms, such as fibromyalgia, irritable bowel syndrome, chronic low back pain, tension-type headaches and temporomandibular disorders, are discussed in relation to central sensitisation and altered sensory processing. 

A significant focus is placed on psychosocial factors contributing to pain and non-recovery. 

Participants will be exposed to the identification, measurement and management of risk factors such as maladaptive beliefs, fear-avoidance behaviours, distress and reduced self-efficacy. 

The use of validated questionnaires and outcome measures is incorporated into clinical reasoning and management planning. 

The course responds to participant feedback, emphasising the need for practical application. 

Through case studies (written and video), small group workshops and, where possible, a live patient assessment, participants will practise their subjective and objective assessment skills. 

The physical examination is framed around patient-valued functional activities, aligning assessment with the patient’s goals and expectations. 

Reflective breakout sessions allow clinicians to unpack complex cases, integrate biopsychosocial factors and refine their reasoning processes. 

Psychologically informed practice is a cornerstone of the program. Introductory training in motivational interviewing, counselling strategies and therapeutic alliance building equips physiotherapists to better support behaviour change. 

Participants explore strategies such as graded motor imagery, graded exposure, motor control retraining, sensory and perceptual training, goal setting and exercise prescription within a recovery-oriented framework. 

What skills will participants have upon completing the course? 

This course exposes participants to a number of advanced competencies aligned with the APA Clinical Competence Framework at Milestone Level 3 (advanced performance level). 

Upon completing the course, participants will be able to: 

• analyse and interpret subjective and objective findings through a biopsychosocial lens
• demonstrate understanding of the neurophysiological and neuroimmune mechanisms underpinning pain
• identify risk factors for persistent pain and non-recovery and integrate these into a comprehensive management plan
• formulate and communicate pain explanations that align with patients’ learning styles, values and expectations
• apply psychologically informed practice skills, including introductory motivational interviewing techniques
• assess and address maladaptive behaviours, sensory and perceptual alterations and maladaptive motor patterns
• develop person-centred management plans that promote patient ownership and self-management
• manage patients presenting with moderate to high complexity, including those who are distressed, resistant or strongly oriented toward biomedical solutions. 

Participants will leave with a practical clinical ‘toolkit’ for unpacking complex pain states, integrating pharmacological and psychological considerations into physiotherapy reasoning, and facilitating adaptive neuroplastic change through education and graded activity. 

Why should physiotherapists undertake this course?

 Physiotherapists frequently encounter individuals experiencing persistent or complex pain. 

However, many clinicians – particularly those early in their careers – report feeling challenged when applying evidence-based care in chronic pain contexts. 

Traditional biomedical models, reinforced by some medical pathways and by employer and patient expectations, can make implementation of a biopsychosocial approach difficult. 

This course directly addresses that gap. 

It provides disciplinespecific, practically oriented training that bridges theory and clinical application across musculoskeletal, sports, women’s health and broader pain domains. 

Unlike many theoretical pain courses, Level 2 prioritises hands-on learning, case-based reasoning and communication skill development. 

The program empowers physiotherapists to confidently navigate the ‘critical interface’ between clinician and patient – where communication, belief reconceptualisation and behaviour change determine outcomes. 

By strengthening therapeutic alliance skills and providing structured frameworks for managing distress and complexity, the course enhances both clinical effectiveness and professional confidence.

Contemporary evidence supports the efficacy of pain education and collaborative, person-centred care in improving pain behaviours and recovery trajectories. 

By embedding these principles into everyday practice, physiotherapists can deliver care that aligns with current scientific understanding and best practice standards. 

Are there any prerequisites? 

The Level 2 course is designed for experienced physiotherapists who have completed ‘Pain Physiotherapy Level 1’ or have equivalent foundational knowledge. 

Participants should have clinical experience in musculoskeletal, orthopaedic, sports, women’s health, neurological or other relevant painrelated fields. 

The course is particularly suited to clinicians who wish to advance their skills in managing moderate to highly complex pain presentations and who are seeking greater depth in clinical reasoning and psychologically informed practice. 

By integrating advanced pain science with hands-on clinical application, the program equips practitioners to deliver confident, compassionate and effective care across the spectrum of pain presentations.

This course was initiated and developed by Lester Jones MACP, Dr Alastair Flett FACP and Dr Peter Roberts FACP in 2016. Alastair and Peter continue to develop and conduct the course, which receives highly rated feedback from participants. 

‘Pain Physiotherapy Level 2’ will run on 30–31 May in Coconut Grove, Northern Territory. To register, visit australian.physio/pd/ pd-product?id=13406

Dr Peter Roberts FACP is a Specialist Musculoskeletal Physiotherapist (as awarded by the Australian College of Physiotherapists in 2007) and an APA Titled Musculoskeletal, Pain and Sports and Exercise Physiotherapist. 

He is a visiting lecturer at Adelaide University and has 20 years of experience in the clinical management of people with complex pain problems. 

He runs a private practice and is passionate about helping patients with complicated pain issues to discover and embrace recovery pathways.