I was pleased to read Dr Quintner’s contribution in our national publication (‘Philosophical hurdles for musculoskeletal pain’, InMotion February 2020). Any discussion that promotes best practice physiotherapy is valuable.

The author has reminded us of the complexities of pain—both acute and chronic—and has presented iterations of frameworks and models, based on pain science, that have contributed to our understanding of either the construction of pain or its management in a contemporary, evidence-based manner.

The APA has acknowledged the challenges that progress in painrelevant sciences has presented to the traditional biomedical model of pain and treatment. The APA Pain Group commenced in 2013 in order to promote the integration of contemporary pain science into care, to improve our pain management for the one in five Australians who are challenged by chronic pain.

We have grown rapidly with the development of a Level 1 Pain course, a generic pain module to be integrated across professional development courses, a career pathway in pain leading to pain titling and specialisation, and the commencement of the inaugural training program towards specialisation in pain. We are under no illusions that we have learnt all there is to learn.

To the contrary, we remain committed to continuing the clinical translation and implementation of rapidly progressing knowledge in the pain field.

Dr Quintner’s observations and critique are timely. Like him, we are aware of hurdles in musculoskeletal pain management—in fact  they do not stop at musculoskeletal pain. In this rapidly evolving area, we are excited that the APA has recognised the need for a specialist field so that we can continue to stay abreast of developments in the management of pain generally.

Our titled pain physiotherapists and soon-to-be specialist pain physiotherapists will continue to lead our profession in this challenging, rapidly changing space. They will also remain in the vanguard of vigorous and collaborative advocacy and lobbying efforts.

This is an important time in the pain field, with growing attention given to the National Strategic Action Plan for Pain Management and education, and physiotherapy accepts the responsibility and challenge of being  a key player in this important space.

Dr Quintner’s encouragement to do better and to offer alternative perspectives are also timely. Physiotherapy researchers have been at the leading edge internationally of developing, testing and implementing better strategies to prevent and treat persistent pain​ for some time.

It is clear that clinical physiotherapists belong at the frontline of pain care and it is exciting to see that the profession is building the skills and knowledge to match the opportunity we have to make a large impact on public health. The opportunity to reflect on our theoretical models and frameworks—on what we do and how we do it—is an important part of our journey.

Dr Quintner’s letter, published in our member publication, reflects a maturity within our profession that should help to keep us at the leading edge of this field, to keep pushing for better consumer outcomes as our highest priority.

I know many of us share my gratitude for Dr Quintner’s interest in our work and his encouragement to keep positioning ourselves to meet the challenges of this complex, rapidly evolving and very important area.