Changing the conversation about health

Exercise, cognitive therapy and acupuncture could be better than paracetamol for chronic pain sufferers, NICE report finds

GPs treating people suffering with chronic primary pain shouldn’t prescribe painkillers including paracetamol and ibuprofen, new guidance from the National Institute for Health and Care Excellence (NICE) advises.

A draft report by a NICE committee suggests that exercise, cognitive therapy, and acupuncture could be better in managing the condition.

New draft guidelines from the National Institute for Health and Care Excellence (NICE) suggest long-term use of painkillers may not help sufferers of chronic primary pain (Image: Pixabay/Congerdesign)

Up to half of the UK population are thought to suffer from chronic pain, which is described as a condition that ‘can’t be accounted for by another diagnosis’.

The guidelines focus on treating patients over 16 in England, Wales and Northern Ireland who suffer from chronic pain, and conclude that long-term use of painkillers could be harmful to health.

The NICE committee behind the report said there was no evidence that painkillers are an effective long-term treatment for chronic primary pain, saying its continued use ‘made no difference to people’s quality of life, pain or psychological distress.’

The prescription of opioids was also strongly discouraged for managing the condition, with the committee citing a lack of evidence on effectiveness, alongside potential risks to health that include stomach and liver damage.

Cannabis-based remedies were also not recommended, on the grounds there is not yet enough evidence that they may provide an effective treatment.

Prof Martin Marshall, Royal College of GPs chair, said: “Most patients in pain do not want to take medication long-term, and GPs do not want this either, but sometimes medication has been the only thing that brings relief.

“As such these new guidelines, which focus on alternative therapies, have the potential to be beneficial for patients – but they will need to be guaranteed appropriate access to them.”

Nick Kosky, a consultant psychiatrist at Dorset HealthCare NHS University Foundation Trust and chair of the guideline committee said: “Understandably, people with chronic pain expect a clear diagnosis and effective treatment. But its complexity and the fact GPs and specialists alike find chronic pain very challenging to manage, means this is often not possible.

“This mismatch between patient expectations and treatment outcomes can affect the relationship between healthcare professionals and patients, a possible consequence of which is the prescribing of ineffective but harmful drugs.

“This guideline, by fostering a clearer understanding of the evidence for the effectiveness of chronic pain treatments, will help to improve the confidence of healthcare professionals in their conversations with patients. In doing so it will help them better manage both their own and their patient’s expectations.”