Priorities challenges and opportunities of physical therapists who work with people that experience persistent pain

BACKGROUND: Persistent pain is a complex condition that places substantial demands on physical therapists and healthcare systems. Understanding how clinicians experience and navigate these complexities is essential for improving care. OBJECTIVE: To investigate the challenges, priorities, and opportunities from the perspective physical therapists who work with people experiencing persistent pain. METHODS: We conducted focus groups with physical therapists working in pain management settings. Participants responded to four open-ended discussion questions in written and verbal formats. Data were analyzed using systematic text condensation to identify themes. RESULTS: Sixty-six physical therapists across eight focus groups participated. An overarching theme of "complexity of pain" emerged, reflecting its influence across all aspects of care. Eleven interrelated subthemes were identified: clinical skills and education; funding models; professional networking and referral pathways; health professional awareness of evidence-based pain management; community awareness of evidence-based pain management; access to care; physical therapy advocacy and leadership; patient engagement and expectations; clinical time; clinician and patient emotional wellbeing; and clinical and social complexity. CONCLUSION: From the perspectives of Australian physical therapists, the complexities of managing persistent pain are deeply interrelated and extend across the healthcare system. These challenges are not attributable to pain complexity alone but reflect systemic issues spanning education, funding, access, and advocacy. Addressing these challenges requires coordinated action at individual, organizational, and societal levels.