The aim of this study was to explore and describe experiences of physiotherapy treatment of people with persistent musculoskeletal pain. Eleven participants with persistent musculoskeletal pain from the back, neck, or shoulders were included in the study. Data were collected by interviews using a semi-structured interview guide and were analysed with qualitative content analysis. The analysis resulted in one main category “Towards acceptance and management of pain” which was formulated and built up by the four categories “Establishing and maintaining alliance”, “Being active, taking initiative and facing challenge”, “Appreciating guidance, incentive and a sounding board” and “Acquired knowledge and developed awareness”. The main category and the categories describe how the participants used knowledge, awareness, movements and exercises learned from the physiotherapy treatment to develop strategies to manage pain and the process of acceptance. A trustful alliance with the physiotherapist and a continuous dialogue was important. The participants were actively involved in the process when exercises, activities and other treatment modalities were individualized. This was rewarding but also an effort and a challenge. The physiotherapist’s initiatives and actions were considered important as incentive and support.