Bring on the Pain Revolution!

When it comes to health, rural communities take more than their fair share of the burden of disease and disability. Chronic pain is no exception to this rule – stats would suggest that these problems are bigger in rural communities than they are in the cities. The prevalence of persistent disabling pain, pain-related opioid dependency and opioid-related death and disability, lost productivity due to pain, early departure from the workforce due to pain, pain-related physical and social withdrawal, depression and suicide hit rural communities harder.  And make no mistake – unless we act now, these problems will get worse. We really can’t wait for our research discoveries to trickle down to what we in Australia call “The Bush”. We need to get it out there now.

Of course, all these problems are not unique to The Bush, but they are arguably more pressing and harder to get at than they are in The City.  I only really began to appreciate this in the last couple of years, thanks mainly to courageous and committed people making it known to me at conferences and via emails and phone calls. At first I was a bit intimidated by the enormity of the challenge, but it didn’t take long for things to make sense. These were the things I was mulling around….

We actually know a fair amount about how best to prevent and treat persistent pain.

We know that expectations and worry are more predictive of recovery than scan results and type of injury.

We know that understanding pain biology, learning and implementing active self-management strategies and adhering to a truly biopsychosocial approach, are good things to do.

We know we can teach people about pain biology (although, of course, we could get a lot better at it!), how to reduce worry, alter expectations and facilitate active self-management.

We know that rural health professionals are the heartbeat of their community. They cope with demands we in the city can’t imagine, with limited resources and very little support.

Finally, rural communities are exactly that – communities – and considering that persistent pain is a bio psycho SOCIAL phenomenon, that wonderful community spirit might just be a key player in making a real difference.

This is where Pain Revolution comes in. I have gathered another 23 willing cyclists to ride 870km, run 12 public and professional engagement events, take a travelling research lab on the road and raise more than $75,000 while we are at it.

We are going to do this:

  1. Create Conversation. We need tongues wagging in the communities we visit. We need tongues wagging all over the world. We need to get onto the radio and into the local paper. We need to work closely with local champions and clinicians.
  1. Get people to re-engage with pain. Dr Tasha Stanton and Dr Daniel Harvie will be taking The Brain Bus – a mobile illusion van that will fascinate and inspire people to learn more about the amazing science of pain. I will try to convince anyone who will listen that pain is actually fascinating and there is surprisingly a whole lot of hope when it comes to preventing and overcoming it.
  1. Share our knowledge and expertise. The peloton includes pain scientists (such as the Spider Venom guyProfessor Glenn King), doctors and physios. The education team includes Dr YH Yau, internationally renowned neurosurgeon/spinal surgeon and pain fellow, the world-famous and indefatigable David Butler, anaethetist and former president of the Australian Pain Society Dr Malcolm Hogg, pain physicians and specialist pain physios. We will be running public seminars and health professional workshops at each town en route.
  1. Learn. We will listen to rural clinicians and consumers; and we will work together to identify the most pressing problems and how to overcome them.
  1. Raise funds. Our aim is to train and support Rural Pain Educators who will be highly trained in pain biology education and self-management strategies. They will work on the ground to support patients and clinicians as they journey to recovery. Of course we will evaluate the impact of our initiative on real world outcomes – work, function and wellbeing.

This grand vision won’t come off without support and I am very grateful indeed to our major sponsor, University of South Australia. Their international reputation as an innovative, community-facing university at the leading edge of clinical pain science research made this sponsorship even more significant, and we thank them enormously for their ongoing help.

A big shout out also to our Silver sponsors. The International Spine Centre, led by the amazing YH Yau, has joined the Revolution. The centre is a world leader in pain education and training for medical and allied health practitioners. Thanks also to our two Silver sponsors fully committed to reducing the burden of workplace injury and getting people back to work – Gallagher Bassett and Employers Mutual Limited.

We round off that support with bronze sponsorship from the Australian Physiotherapy Association, the Australian Pain Society, NOI, Giant Bicycles and the Port Adelaide Football Club, so we are feeling very supported indeed!

This support has enabled us to get on the road, and we need your help to spread the Revolution far and wide.

You can contribute to the Revolution, and setting up our Rural Pain Educator network by tax-deductible donation HERE. Please share our Everyday Hero page on Facebook, via email, Twitter or however you communicate!  Our Facebook page will be the primary way we’re sharing the story, so follow us on Facebook for regular updates and news (including where to meet us along the road!). Let’s share this with the world, come and join the Revolution!

About Lorimer Moseley

Lorimer Moseley Body In MindLorimer is Foundation Chair in Physiotherapy and Professor of Clinical Neurosciences at the University of South Australia, and Senior Principal Research Fellow at Neuroscience Research Australia. He has published 300 scholarly works. His H-index is 59. He leads the Body in Mind Research Group, which investigates the role of the brain and mind in chronic pain.  For full bio, go here.


  1. As a part of my “plan” to survive and thrive<once I realized pain was becoming so manifest as to revolutionize my life-
    see permanent disability early-retirement from my work as a educator,
    loss of spouse and other significant personal relations due to disruption of paradigm shifts contingent on health and a pain-free existence,
    significant impact to my personal finances as the result of the prior pain-directed "lifestyle shifts" indicators, etc., etc.,
    ~ I made the decision to move to a distant rural community near the Canadian border.

    It may seem an odd choice for pain management however it was founded upon the need to lessen the daily stressors of life in the big city ( expense, traffic, lack of community, etc),
    a great Love of nature and art supported by the joys of living in a small town known for its outdoor activity ( ski resort, lake, countless biking and hiking trails) & it's art community ( I am an artist myself so the move held the promise of a new career in a inspirational environment).
    There was a pain Doctor & a very supportive, knowledgeable and creative Pharmacist in town. I found a darling (and amazingly cheap) cabin in the woods and off I went…
    To begin my new life… the one chronic pain had created for me. In a town named, literally, Hope.

    Moving north, and rural, seemed like the best individualized pain management plan for me.

    And it was…
    For a time.
    Right up until my condition, Degenerative Disc Disease, took a turn for the worse. I was now out of my new Pain Doctor's league. The 1 of only 2 spinal surgeons within a (unendurable, naturally, because of my pain) 4 hour round-trip drive thought the solution was a complete fusion I.e. a cage for my lumbar spine. There was only one other opinion to go to.

    It was time to move back to the big city to get more experienced and reputable eyes and minds on the latest "bump in the road" of my journey with pain.

    Long story short- although I loved living in a rural area~ the sense of community support and connection there is a phenomenal experience, especially for this big city girl~ if you have a chronic pain condition that is rooted in a significant and/or severe and/or unusual medical condition you absolutely must have access to sophisticated medical care i.e. medical care associated with Universities and research, as well as to experienced surgeons who are usually found in or near busy aka city hospitals.

    So yes, I am a living witness and can testify to the research you have done in respect to pain and rural areas.

    As a footnote here…
    My continuing journey with pain and learning to live with it has lead me to create and maintain a web-site that is meant to act as a daily mental, emotional and spiritual resource for those living in pain:

    Note the article on all of Dr, Moseley's wonderful ( life-changing~ Thank You Very Much!) books.

    Good Luck on the Ride!
    You all there are the living-breathing embodiment of The Pain Revolution in my eyes.
    Carry on!

    With great gratitude, dawn

    Lorimer Reply:

    Now that’s what I’m talking’ about! Very chuffed to read this.
    from Lorimer

  2. Gerry Daly says

    I live in London, a busy metropolis obviously, and I’ve often longed for the relative non-distractive peacefulness of a rural existence. On the other hand, reading this article, I can appreciate that chronic pain and an even semi-isolated lifestyle may not be ideal bedfellows. Perhaps too much free time to dwell on subjective matters negatively in the rural setting, as compared to too much exposure to negative judgement in the city which only serves to pressurize mostly unachievable expectations. Uninterrupted thinking time is very important for the pain patient, just to enhance a greater familiarity with the dynamics of any chronic pain condition, especially where the science might be lagging behind the everyday reality. I’ve found it helpful to have a couple of quiet hours of ‘befriending’ the condition early in the morning, and then pay little attention to it for the rest of the day…if possible. AS W C Fields used to say….’ When I get up in the morning, I like to smile….get it over with’ ! Perhaps something of a compromise evolved from need….. an imposed city lifestyle, with a little ‘country’ thrown in.

    Good luck with the trip. Looks like a good idea.