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Doctors raise concerns about NICE guidelines on chronic primary pain

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n942 (Published 09 April 2021) Cite this as: BMJ 2021;373:n942
  1. Zosia Kmietowicz
  1. The BMJ

Doctors in pain management have raised concerns about the National Institute of Health and Care Excellence’s guidance on treating chronic primary pain,1 which they said do not reflect clinical practice or current evidence.

Patients could be left in “despair,” said the British Pain Society, because of the recommendation that the only drugs that doctors should prescribe are certain antidepressants. Commonly prescribed drugs, including paracetamol, non-steroidal anti-inflammatory drugs, benzodiazepines, and opioids, should not be used to treat chronic primary pain, said NICE. Instead patients should be offered exercise programmes, therapy, and acupuncture.

The British Pain Society, an alliance of over 1200 clinicians in pain management, emphasised that the “blanket and inexpert withdrawal of medication in such a vulnerable group of patients could …

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