Priorities challenges and opportunities of physical therapists who work with people that experience persistent pain.
David S Kennedy, Tania Gardner, Sophie Shephard and 1 others
Physical therapists managing persistent pain report their biggest gaps are in pain science training and psychologically informed techniques, while funding structures reward heat and massage over active management.
Patients expect to be 'fixed,' not managed.
Key findings
1Physical therapists describe a perceived inadequacy of training in pain science, psychologically informed techniques (motivational interviewing, counselling, trauma skills), and communication skills, with undergraduate programmes seen as insufficient for managing persistent pain.
2Funding structures and clinical guidelines reward low-value passive modalities such as heat and massage rather than active, functional treatments, and consultation times are insufficient for the complexity of persistent pain cases.
3Patients frequently expect to be 'fixed' by their physical therapist or to receive specific modalities, which conflicts with evidence-based management approaches and can lead to disengagement from care.
Still to come
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Participants were recruited from a PT-specific Pain Day event, so they self-selected and likely had a high pre-existing interest in persistent pain; the authors acknowledge the sample is not representative of the whole profession. Almost all participants were metropolitan (61 of 66); rural and remote PTs, who face different access and resourcing challenges, are barely represented. Data were collected in December 2019, before the pandemic reshaped telehealth, surgical backlogs, and long-COVID care; the authors note these perspectives may not reflect current practice. No audio or video recording was made; all data depend on what a single scribe in each group chose to write down, which the authors acknowledge may limit narrative depth. The authors are themselves PTs who specialise in pain management and hold academic roles in the field; they acknowledge this shared professional background may have shaped the questions, the group dynamics, and the interpretation.
Declared interests
The authors declare no competing interest.
The easy way to misread this
Do not read the eleven themes as evidence that any particular intervention works or fails — this is a qualitative study of what 66 PTs felt and reported at one forum, not a test of treatment outcomes. The sample was self-selected from a pain-specific event and almost entirely metropolitan, so the challenges described may be more intense than what a PT in a general practice or a rural clinic experiences. The themes are perceptions and suggestions, not measured effects.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →