Until recently, treatment approaches to chronic pain were predominantly repurposed approaches that had been tested, with variable success, in other conditions. However, discoveries around ‘how pain works’, how complex bodily systems learn and adapt, and how sensorimotor processing is disrupted in chronic pain, led to new treatments built ‘from the ground up’ that directly targeted those disruptions. The Fit for Purpose model was developed to integrate the most effective of those treatments into complex care programs, grounded in rethinking pain and its causes, refining neuroimmune networks (or ’neurotags’) and gradually reinstating functional and structural resilience. The model is centred around the concept of ‘bioplasticity’ and clinical trials testing the model against a range of comparators are in process, planned or completed. In this talk I will cover the scientific underpinnings of the model, the current evidence around its effectiveness in a range of conditions, its failures and limitations, the powerful role that consumer feedback has played in adaptation, and the resources that have been developed to standardise and optimise implementation.