On 4 August 2020, the National Institute for Health and Care Excellence (NICE) published draft guidance on the management of chronic primary pain that stated that in place of common pain medicines — such as paracetamol; non-steroidal anti-inflammatory drugs, including aspirin and ibuprofen; benzodiazepines; and opioids — non-pharmacological options, such as cognitive behavioural therapy or acupuncture, should be offered to patients with chronic primary pain.
In this video, Gino Martini, chief scientist at the Royal Pharmaceutical Society, outlines the evidence-based management options for acute, chronic and chronic primary pain to address misconceptions and promote best practice in pharmacy.
A full list of the references and guidelines referred to in this video can be found below.
Video produced by Geoff Marsh.
Safety, mechanism of action and efficacy of over-the-counter pain relief
These video summaries aim to help pharmacists and pharmacy teams make evidence-based product recommendations when consulting with patients about OTC pain relief:
- Safety of over-the-counter pain relief
- Mechanism of action of over-the-counter pain relief
- Efficacy of over-the-counter pain relief
Promotional content from Reckitt
British Pain Society
Contemporary guidance, supported by available evidence, on clinical and other pain matters can be found on the British Pain Society website.
Moore R, Wiffen P, Derry S et al. Non-prescription (OTC) oral analgesics for acute pain: an overview of Cochrane reviews. Cochrane Database Syst Rev 2015;4(11):CD010794. doi: 10.1002/14651858.CD010794.pub2
Faculty of Pain Medicine of the Royal College of Anaesthatists
Conducting quality consultations in pain medicine. 2018. Available at: https://fpm.ac.uk/sites/fpm/files/documents/2019-08/Conducting%20Quality%20Consultations%202018.pdf (accessed December 2020)
Opioids Aware. Available at: https://www.fpm.ac.uk/opioids-aware (accessed December 2020)
Health Education England e-Learning Pain Management programme. Available at: https://www.e-lfh.org.uk/programmes/pain-management/ (accessed December 2020)
National Institute for Health and Care Excellence
Clinical Knowledge Summaries
Analgesia — mild-to-moderate pain. 2020. Available at: https://cks.nice.org.uk/analgesia-mild-to-moderate-pain#!scenarioRecommendation:1 (accessed December 2020)
Back pain — low (without radiculopathy). 2020. Available at: https://cks.nice.org.uk/back-pain-low-without-radiculopathy#!scenario (accessed December 2020)
Dysmenorrhea — primary dysmenorrhea. 2018. Available at: https://cks.nice.org.uk/dysmenorrhoea#!scenario (accessed December 2020)
NSAIDs — prescribing issues. 2019. Available at: https://cks.nice.org.uk/nsaids-prescribing-issues#!scenarioRecommendation:5 (accessed December 2020)
Sprains and strains — management. 2020. Available at: https://cks.nice.org.uk/topics/sprains-strains/management/management/ (accessed December 2020)
Acute use of nonsteroidal anti-inflammatory drugs (NSAIDs) for people with or at risk of COVID-19. 2020. Available at: https://www.nice.org.uk/advice/es23/resources/covid19-rapid-evidence-summary-acute-use-of-nonsteroidal-antiinflammatory-drugs-nsaids-for-people-with-or-at-risk-of-covid19-pdf-1158174128581 (accessed December 2020)
Chronic pain in over 16s: assessment and management. 4 August 2020. Available at: https://www.nice.org.uk/guidance/GID-NG10069/documents/draft-guideline (accessed December 2020)
CG150: Headaches in over 12s: diagnosis and management. 2015. Available at: https://www.nice.org.uk/guidance/cg150/chapter/Recommendations#management-2 (accessed December 2020)
NG59: Lower back pain and sciatica in over 16s: assessment and management. 2020. Available at: https://www.nice.org.uk/guidance/ng59/chapter/Recommendations (accessed December 2020)