Offer exercise, therapy, acupuncture, or antidepressants for chronic primary pain, says NICE

Chronic primary pain should be managed with exercise programmes, cognitive behavioural therapy, acceptance and commitment therapy, and acupuncture, NICE has said in guidance on the assessment and management of chronic pain.1

The antidepressants amitriptyline, citalopram, duloxetine, fluoxetine, paroxetine, or sertraline are the only drug treatments that should be offered to patients with chronic primary pain because evidence shows these may improve quality of life, pain, sleep, and psychological distress, even in the absence of depression, says NICE.

For many commonly prescribed drugs, including paracetamol, non-steroidal anti-inflammatory drugs, benzodiazepines, or opioids there is little or no evidence that they make any …