Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain – guidance (NG193)

Guidance advises that chronic primary pain should be managed with exercise programmes, CBT, acceptance & commitment therapy, and acupuncture. For new patients the only medicines options are specified antidepressants. See guidance for existing patients taking other medicines.

SPS commentary:

The guidance advises that commonly used drugs including paracetamol, non-steroidal anti-inflammatory drugs, benzodiazepines or opioids should not be started as there is little or no evidence that they make any difference to people’s quality of life, pain or psychological distress, and with respect to benzodiazepines or opioids, can cause harm, including possible addiction.



National Institute for Health and Care Excellence