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In this review, we aimed to reflect on our own learning journey across multiple musculoskeletal projects and identify lessons learned from meaningful involvement. We then consider the changes needed at the researcher, funder and institutional levels to support involvement as a driver of relevance and impact. This is a narrative position paper drawing on experiential learning from three musculoskeletal pain studies and ongoing community engagement. We reflected on what we have learned from public contributors in our research, focusing on how involvement reshaped study priorities and tools. Lessons were synthesised to highlight recurring themes, supported by reference to reviews, guidance and empirical studies. Across all projects, several key themes emerged: (1) emphasis on purpose rather than process; (2) co-production and partnership rather than review; (3) flexibility and adaptation rather than predetermined steps; (4) relevant public contributors and partners; (5) focus on \u2018learning\u2019 rather than \u2018doing\u2019; and (6) approaches to diversity and inclusion. Public partnerships should be a collaborative, transformative, relational and learning-based process that reshapes all aspects of research. Realising this potential might require flexible funding for early engagement, training in facilitation and reflexivity, sustained support beyond the research project to promote impact, and taking steps beyond building more infrastructure towards strengthening the systems that enable involvement to work effectively.<\/jats:p>","DOI":"10.1177\/1759720x261436838","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T11:42:58Z","timestamp":1777030978000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Patient and public involvement in musculoskeletal pain research: using mutual learning to improve research quality"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7195-4018","authenticated-orcid":false,"given":"Vasileios","family":"Georgopoulos","sequence":"first","affiliation":[{"name":"NIHR Nottingham Biomedical Research Centre, University of Nottingham, A25 Academic Rheumatology, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK"},{"name":"Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK"},{"name":"Arthritis UK Pain Centre, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3365-0144","authenticated-orcid":false,"given":"Stephanie L.","family":"Smith","sequence":"additional","affiliation":[{"name":"NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK"},{"name":"Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK"},{"name":"Arthritis UK Pain Centre, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0581-1895","authenticated-orcid":false,"given":"Daniel F.","family":"McWilliams","sequence":"additional","affiliation":[{"name":"NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK"},{"name":"Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK"},{"name":"Arthritis UK Pain Centre, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Desforges","sequence":"additional","affiliation":[{"name":"Independent Consultant Arthritis UK Pain Centre, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stevie","family":"Vanhegan","sequence":"additional","affiliation":[{"name":"Independent Consultant Arthritis UK Pain Centre, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7747-1634","authenticated-orcid":false,"given":"Kristina","family":"Staley","sequence":"additional","affiliation":[{"name":"TwoCan Associates, Ross on Wye, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"NIHR. 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