Older man holding his back due to pain

NICE recommends range of chronic primary pain treatments

As part of its new guidelines on the assessment and management of chronic pain, NICE has recommended a range of effective treatment to help them manage their condition, calling on healthcare professionals to recognise and treat a person’s pain individually.

Chronic or persistent pain is defined as pain which lasts for more than three months and can be often debilitating for those suffering from it, though hard to quantify. The prevalence of those with chronic pain in the UK is uncertain, but it believed to be common - potentially affecting as many as one third to half of the population.

Chronic primary pain prevalence is also unknown, but estimated to affect around 1-6% of the population in England.

Director of the Centre for Guidelines at NICE, Dr Paul Chrisp, said: “We want this guideline to make a positive difference to people with chronic pain, and their families and carers.

“It highlights that achieving an understanding of how pain is affecting a person’s life and those around them and knowing what is important to the person is the first step in developing an effective care and support plan that recognises and treats a person’s pain as valid and unique to them.”

Chronic pain that is caused by an underlying condition - such as, for example, osteoarthritis, ulcerative colitis or endometriosis - is considered chronic secondary pain.

Although the NICE guideline covers the assessment and development of a care and support plan for all types of chronic pain, it focuses on treatments for chronic primary pain. Pain management as part of palliative care is not covered in the guideline.

Within the new guidelines, NICE emphasises the need for shared decision making, putting patients at the centre of their care and fostering a collaborative, supportive relationship between patients and healthcare professionals.

It highlights the importance of healthcare professionals gaining an understanding of how a person’s life affects their pain and how pain affects their life, including their work and leisure time, relationships with family and friends, and sleep.

The guideline recommends that a care and support plan should be developed based on the effects of pain on day-to-day activities, as well as a person’s preferences, abilities and goals.

It also highlights the importance of being honest with the person about the uncertainty of the prognosis.

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NHE May/June 2024

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