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Our Approach

Pain is complex, and so is recovery.

Rather than focusing only on where it hurts, we take the time to understand the whole person so we can better understand your condition and help guide your recovery.

1. Understanding You

  • We Listen First

Before examining your condition, we first take the time to listen, understand your story, and learn what matters most to you. Building a meaningful partnership starts with understanding you—not just your symptoms.

  • Whole-person Care

Every person is more than a diagnosis. Understanding your symptoms starts with understanding you—not just your painful body part. We consider the many factors that may influence your health, symptoms, and recovery because every person experiences pain differently.

2. Putting The Pieces Together

  • We Understand The Bigger Picture

Pain and recovery are rarely influenced by a single factor. Instead, biological, psychological, and social factors often interact to shape your individual experienceOur role is to put those pieces together to better understand your condition and guide the most appropriate care.

  • Examples only. Many factors can influence pain and recovery

  • Clinical Reasoning

Like putting together a puzzle, every piece of information tells part of your story. Clinical reasoning helps us connect those pieces to better understand the factors most likely influencing your condition and recovery.

3. Making Sense Of Your Pain

  • We Help You Understand Your Pain

Pain is always real. However, it does not always reflect the amount of tissue damage present.
Your nervous system continually evaluates information from your body, mind, and environment before producing pain as a protective response
By helping you better understand your symptoms, we aim to reduce unnecessary fear and uncertainty, build confidence in movement, and support your recovery.

Positive Response to Pain
Negative Response to Pain
  • The Modern Understanding Of Pain

Pain is not a damage detector. It's a sensitivity alarm from your brain 

"

"Pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage." 

- International Association for the Study of Pain (IASP) - 

You can have pain without damage and have damage without pain. Imaging is not always fully able to explain your pain

4. Making Decisions Together

  • We Sets Goals Together

Recovery is a journey, and every person's journey is different. Together, we set goals that are meaningful, realistic, and personally relevant. These goals help us tailor your treatment plan, track your progress, and work together towards the outcomes that matter most to you.

  • Shared Decision Making

The best decisions are made together. Every person has different goals, values, preferences, and life circumstances. Rather than applying the same treatment to everyone, we work together to develop a management plan that reflects what matters most to you.​

Reference

Arrigoni, A., Rossettini, G., Palese, A., Thacker, M. and Esteves, J.E. (2024) Exploring the role of therapeutic alliance and biobehavioural synchrony in musculoskeletal care: Insights from a qualitative study. Musculoskeletal Science and Practice, 73, 103164.

 

Belton, J., Birkinshaw, H. and Pincus, T. (2022) Patient-centred consultations for persons with musculoskeletal conditions. Chiropractic & Manual Therapies, 30, 53.

 

Carmona, C., Crutwell, J., Burnham, M. and Polak, L. (2021) Shared decision-making: Summary of NICE guidance. BMJ, 373, n1430.

 

Cholewicki, J., Breen, A., Popovich, J.M., Reeves, N.P., Sahrmann, S.A., Van Dillen, L.R., Vleeming, A. and Hodges, P.W. (2019) Can biomechanics research lead to more effective treatment of low back pain? A point–counterpoint debate. Journal of Orthopaedic & Sports Physical Therapy, 49(6), pp.425–436.

 

Cook, C.E. and Keter, D.L. (2026) Musculoskeletal Treatment Mechanisms: A Puzzle That May Never Be Fully Solved. Journal of Orthopaedic & Sports Physical Therapy.

 

Fanuscu, A., Meuwissen, I. and Meeus, M. (2025) The Past, Present, and Future of the Biopsychosocial Approach to Nonspecific Chronic Low Back Pain in Research and Clinical Practice Based on a Bibliometric Analysis. Pain Physician, 28, pp.397–416.

Gliedt, J.A., Schneider, M.J., Evans, M.W., King, J. and Eubanks, J.E. (2017) The biopsychosocial model and chiropractic: A commentary with recommendations for the chiropractic profession. Chiropractic & Manual Therapies, 25, 16.

 

Hutting, N., Caneiro, J.P., Ong’wen, O.M., Miciak, M. and Roberts, L. (2022) Patient-centered care in musculoskeletal practice: Key elements to support clinicians to focus on the person. Musculoskeletal Science and Practice, 57, 102434.

 

Keter, D., Hutting, N., Vogsland, R. and Cook, C.E. (2024) Integrating Person-Centered Concepts and Modern Manual Therapy. JOSPT Open, 2(1), pp.60–70.

 

Kinney, M., Seider, J., Beaty, A.F., Coughlin, K., Dyal, M. and Clewley, D. (2018) The impact of therapeutic alliance in physical therapy for chronic musculoskeletal pain: A systematic review of the literature. Physiotherapy Theory and Practice.

 

Leake, H.B., Moseley, G.L., Murphy, L.K., Murray, C.B., Palermo, T.M. and Heathcote, L.C. (2023) How does pain work? A qualitative analysis of how young adults with chronic pain conceptualize the biology of pain. European Journal of Pain, 27(3), pp.424–437.

 

Leininger, B., Evans, R., Greco, C.M., Hanson, L., Schulz, C., Schneider, M., Connett, J., Keefe, F., Glick, R.M. and Bronfort, G. (2025) Supported biopsychosocial self-management for back-related leg pain: A randomized feasibility study integrating a whole-person perspective. Chiropractic & Manual Therapies, 33, 6.

 

Linton, S.J., O'Sullivan, P.B., Zetterberg, H.E. and Vlaeyen, J.W.S. (2024) The "Future" Pain Clinician: Competencies Needed to Provide Psychologically Informed Care. Scandinavian Journal of Pain, 24.

 

Moore, B.E., Schleidgen, L., Hang, C.P., Rabey, M., Ng, L., Chai, K.E.K., Melton, P., Cowen, G., Beales, D. and Moloney, N. (2026) Protection from Chronic Musculoskeletal Pain: A Scoping Review. European Journal of Pain, 30, e70273.

 

Moseley, G.L., Leake, H.B., Beetsma, A.J., Watson, J.A., Butler, D.S., van der Mee, A., Stinson, J.N., Harvie, D., Palermo, T.M., Meeus, M. and Ryan, C.G. (2024) Teaching Patients About Pain: The Emergence of Pain Science Education, its Learning Frameworks and Delivery Strategies. The Journal of Pain, 25(5), 104425.

 

Nijs, J., Lahousse, A. and Malfliet, A. (2023) A Paradigm Shift from a Tissue- and Disease-Based Approach Towards Multimodal Lifestyle Interventions for Chronic Pain: 5 Steps to Guide Clinical Reasoning. Brazilian Journal of Physical Therapy, 27, 100556.

 

Shepherd, M.H., McDevitt, A., Keter, D., Albers, N., Clewley, D. and Cook, C.E. (2025) The Person-Centered Hypothesis Framework: Advancing Clinical Reasoning in Musculoskeletal Pain Management. Musculoskeletal Science and Practice, 80, 103395.

 

Slater, H., Jordan, J.E., O’Sullivan, P.B., Schütze, R., Goucke, R., Chua, J., Browne, A., Horgan, B., De Morgan, S. and Briggs, A.M. (2022) "Listen to me, learn from me": A priority setting partnership for shaping interdisciplinary pain training to strengthen chronic pain care. PAIN, 163(11), e1145–e1163.

 

Stilwell, P. and Harman, K. (2019) An Enactive Approach to Pain: Beyond the Biopsychosocial Model. Phenomenology and the Cognitive Sciences.

 

Swann, C., Buchan, J., Calleja, E.A., Goddard, S.G., Clarke, M.M., Hawkins, R.M., Jackman,P.C., Schweickle, M.J., Vella, S.A. and Rosenbaum, S. (2026) Goal Setting in Exercise and Physical Activity: An Expert Statement on Behalf of Exercise and Sports Science Australia. Sports Medicine.

 

Unsgaard-Tøndel, M. and Søderstrøm, S. (2021) Therapeutic Alliance: Patients’ Expectations Before and Experiences After Physical Therapy for Low Back Pain—A Qualitative Study With 6-Month Follow-Up. Physical Therapy, 101, pzab187.

 

Wand, B.M., Cashin, A.G., McAuley, J.H., Bagg, M.K., Orange, G.M. and Moseley, G.L. (2023) The Fit-for-Purpose Model: Conceptualizing and Managing Chronic Nonspecific Low Back Pain as an Information Problem. Physical Therapy, 103(2).

Looking for a more personalised approach to pain care?

If you're experiencing pain, stiffness, movement limitations, or recurring symptoms, we're here to help you

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