A new way of treating chronic pain is attracting global attention, and for sufferers like Adelaide woman Freiya Reef Macnicol it's been a godsend.
The 32-year-old has been plagued by the problem since her teens, her lower back issues starting as a premenstrual ache that just never stopped.
"When it was at its worst, I couldn't focus on anything else and just sat in excruciating pain," Ms Reef Macnicol said.
"I saw lots of physios and doctors, I got scans and nothing ever showed anything so I had this fear it was all in my head."
She finally found some relief thanks to physiotherapist Dave Moen who has launched an online course, offering a clinically applicable and practical way to manage chronic pain using the most recent research.
Permission to Move teaches the science of pain to both patients and clinicians and paves a path for recovery.
The course has received global recognition from practitioners in public hospitals, pain clinics and private practices.
Mr Moen said learning pain's biology removed the threat from the experience.
That is followed by a gradual re-exposure to activities that may have caused issues for the individual.
As part of his research, Mr Moen conducted a six-week telehealth study implementing this approach.
More than 70 per cent of participants said they had a better outcome than expected.
"Because these ideas are new, there are not yet lots of clinicians practicing in this way, yet the research says this is how we should treat pain," Mr Moen said.
"There is currently a lack of education for clinicians and we're working hard to fill that gap."
Pain Australia chief Carol Bennett said more science-based and cost-effective resources, like Permission to Move, were needed.
"We've also seen a lot of surgery, tests, wasted resources and treatments that in some cases could make people's conditions worse," Ms Bennett said.
Unfortunately, only one in 100 patients receive multidisciplinary care while 70 per cent of sufferers leave GPs with just medication.
Ms Bennett said the use of opioids to manage chronic pain was escalating and showed an increasing rate of harm.
"It makes people experience hyperalgesia, where they become more sensitive to pain (and) need to use higher doses in order to get the same pain-reducing impact," she said.
But she said the level of harm related to chronic pain could be averted with the right education, treatment and care in its early stages.
Australian Physiotherapy Association chair Dianne Wilson said chronic pain involved biological, psychological and social components.
Because of its complexity, she said physiotherapists often worked in multidisciplinary clinics but a lack of funding restricted their success.
"Many health practitioners have been slow to integrate modern pain science into the management of chronic pain," Ms Wilson said.
She said evidence-based treatment could be difficult to implement, especially in private practices where the duration of appointments was limited.
After suffering from age 19, Ms Reef Macnicol said her life had turned around since working with Mr Moen.
Although she still has premenstrual flare-ups, she manages her pain better by exercising daily.
"I had accepted that I was a person who just had to live with pain and I've learned that I don't have to," she said.
Australian Associated Press