Pain Factory

Chronic pain is one of Australia's most significant and least understood health crises. More than three million Australians live with persistent pain, and for many, the search for relief has led them into the hands of practitioners who exploit their desperation.

Adele Ferguson's Pain Factory investigation, broadcast on ABC Four Corners in April 2024, documented a pattern of unnecessary and harmful procedures being performed on chronic pain patients — procedures that left many in worse condition than before, and some with permanent disability.

The investigation drew on patient testimonies, medical records, and interviews with pain specialists, surgeons, and health regulators. It found that a small number of practitioners were performing high volumes of invasive procedures — spinal injections, nerve ablations, implanted devices — on patients who had not been adequately assessed for suitability, and who had not been properly informed of the risks.

The financial incentives were clear. Procedures that could be billed to Medicare or private health insurance generated significant income, with little accountability for outcomes. Some practitioners were performing dozens of procedures per day — a volume that pain specialists said was clinically impossible to justify.

Ferguson also examined the role of the medical device industry in driving demand for implanted pain management devices, finding evidence of inappropriate relationships between device manufacturers and the practitioners who implanted their products. Patients were being steered toward expensive implanted devices without being told about the financial relationships involved.

The investigation prompted the Medical Board of Australia to announce a review of pain management practices, and several health funds announced they would tighten criteria for funding certain procedures. Multiple practitioners named in the investigation faced regulatory scrutiny in the months that followed.