As physiotherapists, we are often asked about pain, what causes it, how best to manage it and why so many people continue to suffer despite advances in care. 

Pain is one of Australia’s most pressing health challenges, affecting one in five adults and costing the economy an estimated $139 billion annually. 

Over 100,000 hospitalisations involve chronic pain, with low back pain and osteoarthritis among the top contributors to disability and health spending. 

Physiotherapy is central to addressing this challenge. 

Musculoskeletal pain remains one of the most common and costly burdens, accounting for $15.9 billion in health spending in 2022–23, including $3.9 billion for back pain and $4.9 billion for osteoarthritis. 

Despite this, the system still leans heavily on surgery and medications, often more invasive and expensive, while under utilising proven, conservative approaches like physiotherapy. 

We know physiotherapy works. 

Early access can speed recovery, prevent long-term complications and reduce reliance on opioids. 

For persistent pain, our biopsychosocial approach focuses on restoring function, supporting self-management and improving quality of life. 

Structured programs, such as those for osteoarthritis and low back pain, can delay or even prevent surgery. 

In fact, studies show that up to 90 per cent of people with knee osteoarthritis can manage their condition effectively through physiotherapy, potentially saving the health system $100 million annually. 

The APA has long advocated for pain reform. 

We’ve called for publicly funded first contact physiotherapy so patients can see us directly in primary care, without delay or out-of-pocket costs. 

We support new pain care pathways that recognise physiotherapy as a first-line treatment and continue to push for key scope of practice reforms, including direct referrals to orthopaedic specialists and improved digital integration. 

We’ve seen this work overseas. Countries like the UK, Norway and New Zealand have shown how embedding physiotherapy into primary care reduces costs, improves access and eases GP pressure. 

It’s time Australia followed suit. 

Encouragingly, we’ve begun early discussions with the Royal Australian College of General Practitioners about joint advocacy for better pain care. 

There’s a clear appetite for team-based models supported by blended funding, where physiotherapists, GPs, psychologists and pharmacists collaborate as one care team. 

We also support the Australian Pain Society’s strong advocacy for multidisciplinary, biopsychosocial pain care. 

The Australian Pain Society has long emphasised that chronic pain is best managed through coordinated input from physiotherapists, psychologists, nurses and medical specialists. 

Its National Pain Strategy highlights the need to embed team-based care across primary and tertiary settings, ensuring that patients are supported with consistent and effective treatment, not just prescriptions or surgical procedures. 

To support this, the APA is also working with the Physiotherapy Board of Australia and Ahpra to develop national guidance on physiotherapy prescribing. 

Allowing physiotherapists to prescribe within a defined scope could streamline care, reduce opioid reliance and embed conservative pain management earlier in the patient journey. Pain reform is both urgent and achievable. 

The APA’s 2025 federal election statement, which will drive our advocacy activity over 2025, outlines a clear, evidence-based road map focused on access, equity and multidisciplinary care. 

Physiotherapy must be seen as essential, not optional, in Australia’s health response to pain. 

We’ll continue working with government, health insurers, primary health networks and our health sector colleagues to remove barriers to timely, effective care. 

Pain is complex but accessing high-value care shouldn’t be. Let’s help more Australians live with less pain and greater possibility.

>>Rik Dawson APAM MACP
APA Titled Gerontological Physiotherapist
APA National President