NICE chronic primary pain guidelines: what the busy GP needs to know

Assessment of chronic pain should be holistic including consideration of wider factors that could contribute to and/or be impacted by the chronic pain. It should aim to differentiate between chronic primary and secondary pain, recognising that they can coexist.

Exercise, psychological therapy, and a single course of acupuncture are recommended.

No analgesic medication is recommended.

Patients already on these medications should be involved in a shared decision-making process including discussion about potential staged reduction and deprescribing.

Antidepressants should be considered, even for those without concomitant depression.