A Novel Investigation
Flippin’ Pain is pleased to announce the publication of new research in Musculoskeletal Science and Practice (August 2026)!
‘An investigation of a novel public health campaign to improve understanding of persistent pain’ explores the impact of Flippin’ Pain’s approach, and how it can help people understand and manage persistent pain.
The study focuses on the 2023 Flippin’ Pain Peloton Tour, a week-long initiative across the Tees Valley that combined awareness-raising with pain education events led by clinicians, researchers and people with lived experience.
To hear more, we asked Tom Middleton, lead researcher, to share his experience working on the paper.
“We know persistent pain is globally a big problem. In the UK alone, it effects around 28 million people.
“Misconceptions about persistent pain are common and may lead to less helpful ways of managing pain. At Flippin’ Pain we are on a mission to change the way people understand their pain: for many people, this can be a key factor for recovery. Without this understanding of persistent pain, many of the best treatments make so sense.
“As a physiotherapist, I often see how someone ‘flipping’ their understanding of pain can lead to a shift in optimism, confidence and openness to try different approaches that the science backs up as being helpful.
“But how can we do this on a bigger scale - the scale required to tackle such a global issue? Well, one way is through public health campaigns such as Flippin’ Pain. And I wanted to ask: does this campaign approach actually work?
“In 2023, Flippin' Pain embarked on their peloton tour around the Tees Valley region. For a week, a 25-strong group of pain experts (people with lived experience, health professionals and researchers) cycled around the region to raise awareness and deliver pain education events. This was in aid of the charity Pain Concern raising over £7,000!
“Around 500 people attended these 14 pain education events, and they were invited to complete surveys before and after. These surveys asked for information on their pain experience and their thoughts on ways to manage it. Some events were aimed at the public and others to healthcare workers.
“I had the opportunity to be involved in writing up the anonymous research data that people had consented to be used.
“We thought (and hoped) that:
Attending a pain education event would change people’s understanding - away from thinking pain is only related to our body’s tissues, to be more in line with the contemporary understanding that everything matters when it comes to pain.
The event would help people understand that movement is both safe and beneficial when you have persistent pain.
The event would change people’s thoughts on taking opioid medications, helping them to realise medications aren’t always the answer.
“We also asked whether people felt they could manage their pain.
“The results were exactly as we had hoped! The surveys showed a positive ‘flip’ in understanding. People’s views on ways to manage pain shifted to be more in line with pain management guidelines - and away from less helpful treatment approaches.
“We must be careful interpreting the results - as changes in intentions do not necessarily mean changes in behaviours. further work is needed to explore this. But overall, this research adds important insight into the power of public health campaigns like Flippin’ Pain in tackling the global health issue that is persistent pain.”
Many thanks to Tom and all the other researchers who made this happen!
You can read the paper on the Musculoskeletal Science and Practice website.