Pain is one of the most common — and most complex — presentations in general practice. While the temptation to “fix” pain quickly is strong, persistent or chronic pain often requires a team approach that moves beyond prescriptions and scans.
This is where coordinated pain care shines. Working closely with allied health professionals is not just a “nice to have”, it’s a crucial strategy for improving function, reducing disability, and restoring quality of life. As the central coordinator, the GP plays a pivotal role in making this work.
Why Coordination Matters
Persistent pain is rarely just about damaged tissues. It involves nervous system sensitisation, psychological distress, social factors, and often, a cycle of inactivity and fear.
Multidisciplinary pain care models — integrating GPs, physiotherapists, psychologists, occupational therapists, pharmacists, and others — have been shown to:
- Improve functional outcomes
- Reduce reliance on opioids and other medications
- Lower healthcare costs long-term
- Enhance patient satisfaction and self-efficacy
The GP: The Anchor in the Pain Care Team
As the first point of contact and ongoing care provider, GPs are uniquely positioned to:
- Identify the need for a team-based approach early
- Facilitate referrals and maintain communication among providers
- Provide consistent messaging and “hold the clinical narrative”
- Address coexisting medical conditions and medication management
- Act as a trusted point of continuity for the patient
Patients often see multiple specialists and therapists, which can be confusing and overwhelming. A proactive GP can keep the plan coherent and patient-centred.
Knowing Your Allies: The Key Roles
Physiotherapists
Focus on restoring movement and function through graded activity, pacing strategies, manual therapy, and exercise prescription.
GP support tip: Reinforce the importance of movement, discourage rest as a long-term strategy, and help set realistic expectations.
Psychologists
Pain is always both physical and emotional. Psychologists address pain-related distress, fear-avoidance, catastrophising, and mood disorders using techniques like CBT and ACT.
GP support tip: Normalise psychological referrals — position it as part of whole-person care, not a sign that “the pain is all in their head.”
Occupational Therapists
Help patients re-engage in daily activities, modify work environments, and develop pacing strategies.
GP support tip: Encourage patients to see OT support as a pathway back to meaningful participation in life, not just work restrictions.
Pharmacists
Provide medication reviews, support tapering plans, and assist in safe opioid stewardship.
GP support tip: Involve pharmacists early in patients on complex pain medication regimens to avoid polypharmacy pitfalls.
Exercise Physiologists
Deliver tailored exercise programs, particularly useful for patients with deconditioning or those who have lost confidence in movement.
GP support tip: Highlight the value of supervised, progressive exercise as a pain modulation tool.
Communication: The Glue of Collaborative Care
Even the best teams fail without clear communication. As a GP, consider:
- Shared care plans: Document agreed goals, roles, and review timelines.
- Regular updates: Brief emails or phone calls can avoid mixed messages.
- Patient summaries: Provide patients with written summaries to reinforce consistency across appointments.
Addressing Barriers
Patients might resist allied health referrals due to:
- Cost concerns
- Fear of movement or re-injury
- Stigma about psychological support
- Misconceptions that only medications “work”
GPs are trusted messengers to address these fears. Framing allied health as essential, evidence-based care — not an optional add-on — helps patients engage meaningfully.
The GP’s Superpower: Holding the Narrative
In complex pain cases, patients often hear conflicting advice. The GP’s role is to unify the narrative, gently correct myths, and maintain a steady focus on function and quality of life rather than pain elimination alone.
Coordinated pain care is a team sport — and GPs are the team captains. By working closely with allied health colleagues, GPs can help patients move from pain-centred lives to function-centred, purpose-driven futures.
Patients don’t need a hero who “fixes” them; they need a coach, a guide, and a trusted partner. In modern pain care, that’s exactly what a great GP provides.
