For people living with chronic hip, knee or back pain, finding care that genuinely helps can be hard. For people in rural and regional areas, it can be even harder.
At UCRH, we’re leading a multi‑year research trial exploring whether integrated pain and lifestyle care can be delivered in new ways, including virtually, without compromising outcomes for patients.
The Healthy Lifestyle for Pain in Rural areas (HeLP‑R) Trial is testing whether virtual, multidisciplinary pain care can be just as effective as in‑person care for people living with chronic musculoskeletal pain. It’s also examining how these models can work in real hospital settings, with real clinicians and patients.
Why this research matters
Musculoskeletal conditions affect around one in three Australians, with people in rural areas experiencing a higher burden of chronic pain and related health issues. Alongside pain, many people also live with lifestyle factors that can make pain harder to manage, such as poor sleep, low physical activity, smoking or poor diet.
While physiotherapy remains central to care for conditions like osteoarthritis and chronic low back pain, evidence increasingly shows that pain is influenced by more than injury or movement alone.
“We know that chronic pain is complex,” says Professor Chris Williams, who leads UCRH’s research cluster focused on musculoskeletal pain and chronic disease risk factors.
“If we want to improve quality of life for people with persistent pain, we need approaches that help people understand their pain and support meaningful behaviour change, not just short‑term symptom relief.”
How the HeLP‑R Trial works
The HeLP‑R Trial is delivered in partnership with the Mid North Coast and Northern NSW Local Health Districts. It’s currently running through physiotherapy departments at Port Macquarie, Coffs Harbour, Lismore and Grafton hospitals.
Eligible people with longer term pain who have struggled to maintain a healthy lifestyle are provided one of two integrated physiotherapy‑led pain and lifestyle treatments, both delivered over six months – one in-person at a physiotherapist department, and one via telehealth consultations. Participants will be followed for 12 months to understand if or how well the program supported them.
Progress so far
Since recruitment began, the trial has moved steadily into active delivery.
From September 2025 to now, 93 participants have been enrolled, representing just over one fifth of the target sample. The first group of participants is now completing the six‑month intervention, with primary outcome follow‑up underway from March.
“These early milestones are really encouraging,” says Dr Emma Mudd, senior researcher and dietitian on the project.
“They show that patients are willing to engage with integrated models of care, including virtual delivery, and that the trial processes are working well across multiple hospital sites.”
Building clinician capability
A key feature of the HeLP‑R Trial is its focus on clinician capacity‑building.
Before the trial began, local physiotherapists undertook enhanced training to support integrated pain and lifestyle care delivery, including communication skills for building rapport and empathy in both in‑person and virtual settings.
“We’re not just testing an intervention in isolation,” Professor Williams explains.
“We’re working alongside clinicians in busy hospital settings, building skills and confidence, and learning what’s needed to make integrated care practical and sustainable in rural health services.”
How people can be involved
As recruitment continues, interested people can now self-refer to the program, however clinicians play a critical role in identifying patients who may benefit from the program.
The trial is seeking referrals for adults aged 18 years and over who have had hip, knee or lower back pain for more than three months and have at least one lifestyle risk factor, such as being overweight, smoking, poor sleep, low physical activity or poor diet.
Clinicians working in physiotherapy, general practice, emergency departments and other relevant allied health settings are well placed to support referrals. Clinicians interested in learning more about how to refer patients can contact the research team at [email protected].
Community members interested in participating in the trial can register their interest via our online form.
Looking ahead
Findings from the trial will contribute to growing evidence around how integrated, multidisciplinary pain care can be delivered effectively in rural settings.
For UCRH, the work is a reflection of our commitment to research that is grounded in real‑world practice and focused on improving health equity for rural communities.
