Doctors have been told not to prescribe painkillers to chronic pain patients but rather antidepressants, exercise, and acupuncture.

Paracetamol Reportedly Not Effective Drug For Back Pain
(Photo: Scott Barbour/Getty Images)
MELBOURNE, AUSTRALIA - JULY 24: Paracetamol tablets sit on a table on July 24, 2014, in Melbourne, Australia. In a new study published in the prestigious medical journal, 'The Lancet,' the most common pain reliever for back pain, paracetamol, does not work any better than a placebo.

Patients who have unexplained and ongoing pain should not use painkillers like paracetamol and ibuprofen per new guidelines published today.

National Institute for Clinical Excellence (NICE) said in a victory for a Daily Mail campaign there is "little or no evidence" that painkillers "make any difference to people's quality of life, pain, or psychological distress."

Nice, which advises the NHS on treatments, said drugs - including benzodiazepines, nonsteroidal anti-inflammatory drugs, or opioids - could cause harm and addiction.

The Guardian said chronic secondary pain is pain caused by an underlying health condition. On the other hand, chronic primary pain is pain that has no specific cause and has lasted for at least three months. Chronic pain affects more than 20 million people in the United Kingdom.

Chronic Pain 101: What Should People Do To Cure Pain?

Nice suggests that doctors work with patients to develop a treatment and support plan about how to handle their pain based on how much it is impacting their day-to-day life, what things they believe they should do, and transparency "about the prognosis' confusion."

According to Evening Standard, the health department said people who are experiencing physical pain could also take antidepressants.

"Acupuncture is also recommended as an option, provided it is delivered within certain clearly defined parameters," Nice said.

Dr. Paul Chrisp, director of the Centre for Guidelines at Nice, said: "This guideline is very clear in highlighting that, based on the evidence, for most people, it's unlikely that any drug treatments for chronic primary pain, other than antidepressants, provide an adequate balance between any benefits they might provide and the risks associated with them."

"But people shouldn't be worried that we're asking them to simply stop taking their medicines without providing them with alternative, safer, and more effective options."

ALSO READ: CDC Adds Three New Common Side Effects of COVID-19 Vaccine; Are These Harmful?


Dr. Chrisp said people who are taking drugs for chronic primary pain that aren't recommended in the guideline should first ask their doctor to revisit their prescribing as part of mutual decision making.

This may include deciding to a plan to continue taking their medications if they provide benefit at a low dosage with minimal side effects or offering help to minimize and avoid taking the drug if necessary.

Nice said it's important to explore and properly resolve any withdrawal concerns while making joint decisions on whether or not to quit.

Chronic Pain 101: Here's What Royal College of GPs Said

The Royal College of GPs backed the change away from painkillers but warned that patients' access to the latest therapies was inconsistent.

Prof Martin Marshall, the college's chair, said the pain could cause untold suffering for patients and their families. He said chronic primary pain could be challenging to handle in general practice. Prof Marshall added the college has long called for recommendations to remedy this.

"We understand the move away from a pharmacological option to treating chronic primary pain to a focus on physical and psychological therapies that we know can benefit people in pain."

"However, access to these therapies can be patchy at a community level across the country, so this needs to be addressed urgently if these new guidelines are to make a genuine difference to the lives of our patients with primary chronic pain."

Lucy Ryan, a patient advocate who supported Nice in creating the new recommendations, praised it for recognizing the risks that a tablet regimen for chronic primary pain can entail, saying that patients aren't always consulted about them.

Ryan underscored that the more services available to help people manage their pain effectively, the better.

RELATED ARTICLE: How Binge Drinking Affects Your Brain Activity


Check out more news and information on Medicine and Health on Science Times.