The bigger picture

Chronic pain is common and can be defined as pain that lasts for more than three months. It is estimated to affect between one third to half of the UK population. The prevalence of chronic primary pain is unknown, but is estimated to affect between one per cent and six per cent of the population in England.

The NICE guideline emphasises the need for person-centred care and shared decision making between healthcare professionals and patients. It also highlights the importance of healthcare professionals understanding how a person’s pain affects their life, including their work and leisure time, their relationships with family and friends and also their sleep. A care and support plan should be agreed based on this and the patient’s preferences.

If a person with chronic primary pain is already taking any of the medicines not recommended in the guideline, the prescribing of these medicines should be reviewed, and a shared decision made with the patient regarding the benefits and possible harms of continuing these medicines, as well as any possible issues associated with their withdrawal.