Maintaining activity and fitness is another challenge. Many people on a “good” day will revert to previous activity levels and over do activity, resulting in a flare of pain and prolonged underactivity. This cycle of over and under-doing activity is confusing, distressing, and over time tends to make people worse. It is not until people living with pain learn to pace themselves to maintain a small but ever increasing level of activity on good and also bad.

CPA: How is Australia dealing with chronic pain differently than other places in the world?

CW: Australia has a National Pain Strategy, which was agreed in 2011 but is not fully funded federally. There is, however, local state-based support for the strategy, particularly in New South Wales (NSW), Australia’s most populous state. There is a growing trend to include people who require pain services to be invited to collaborate in the development, delivery and evaluation of services. For example, in NSW, the Agency for Clinical Innovation (ACI), funded by NSW Health, facilitated the development and implementation of a comprehensive state-wide “Pain Plan” and model of care. The ACI worked collaboratively with Chronic Pain Australia to develop consumer resources and I think this is becoming more common in Australia in health and especially in the pain networks. National Pain Week is a good example of clinicians and consumers collaborating on pain related events to benefit both parties.

CPA: What can the Government of Australia do to further assist those with chronic pain?

CW: A key aspect of the National Pain Strategy was to fund a national campaign of information about chronic pain to help the community better understand and manage chronic pain. To date this has not occurred.

CPA: How will the way society handles chronic pain evolve over the next several years?

CW: More focus on lifestyle medicine — non-medical approaches to helping people with chronic pain.