More exercise and psychological therapies and much less drug prescribing prominent in draft NICE chronic pain guidance

National Institute for Health and Care Excellence (NICE) has launched draft guidance for Chronic pain: assessment and management’ which is out for public consultation until 14 September 2020.

This is the first NICE guidance on chronic pain which will suggest that, other than anti-depressants, people with chronic pain should not be prescribed opioid painkillers, and other addictive medications, such as ketamine, to patients as they are harmful and there was limited evidence of their effectiveness in managing chronic pain.

Added to existing NICE guidance which exposed the lack of evidence for many injections and operations for chronic low back pain, these draft guidelines move management of chronic pain away from “passive” injections and drug taking to psychological-based therapies (CBT or ACT) and self-management. The draft NICE guidance is critical that “evidence showed that discussion on self-management happens late in the pathway or not at all”.

Persistent pain affects 30-50% of people, around 28m adults in the UK, and its impact is significant, negatively affecting people’s physical and mental health, their social and home lives, as well as their ability to stay in work. This NICE guidance aims to improve the lives of those people.

Over 1.5 million people with musculoskeletal problems receive opioids, and according to guidelines, 45% are over-prescribed, at a loss to the NHS of £100 million per year.

Connect Health’s NHS pain services already meet with the proposed NICE guidelines and focus on non-pharmacological management of chronic pain including supervised group exercise programmes and a strong psychological approach.

Graeme Wilkes, CMO for Connect Health says

We welcome these guidelines which fit exactly with our philosophy on Chronic Pain management practiced in our current community pain services for the NHS. The direction of how to cope with chronic pain in the past has had an undue focus on “passive” treatments including a variety of drugs now shown to be largely ineffective, to add to many injections and operations for chronic spinal pain already deemed “not recommended” by previous NICE guidance. When published, this new guideline on Chronic Pain management should establish putting the patient “in the driving seat” of their care. People should now expect to work with their GP and NHS Pain Services with a focus on understanding and taking control of their pain using physical exercise and psychologically based methods rather than accepting often ineffective and potentially harmful drugs and injections.

Flippin’ Pain™ was launched earlier this year – a public health campaign, delivered by Connect Health and supported by NHS Lincolnshire Clinical Commissioning Groups. Its goal is clear – to change the way people think about, talk about and treat persistent pain.

You can find out more here

Flippin’ Pain