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.
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