Introduction
Introduction
Cultivating a collaborative and supportive relationship with a person living with chronic pain will enable them to be active participants in their care. This is associated with:
- Higher levels of satisfaction with their care and treatment
- Increased knowledge of and engagement with their health conditions, tests and treatments
- More realistic expectations of the benefits and harms of different treatments and interventions; improved adherence to screening, diagnostic or treatment plans
- Improved health outcomes.
In April 2021, the National Institute for Health and Care Excellence (NICE) published the study: Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain. Below are some of the management options it considers.
Management options
Self-management strategies that people living with pain can adopt include undertaking exercise; improving their sleep hygiene; eating a healthier diet, reducing alcohol intake and managing stress. The use of a pain diary can also help to monitor the progress or effects of treatment interventions, establishing which are best.
Supporting and encouraging people with chronic primary pain to stay physically active also benefits their general health. Exercise is an easily sustainable treatment option that has been shown to be more effective than usual care in reducing pain and improving quality of life, with minimal adverse effects.1
During ACT, clients are encouraged to stop avoiding, denying or struggling with their inner thoughts and emotions; instead, they are encouraged to accept them as appropriate responses to some situations, and to realise that these deeper feelings need not prevent them from moving forward in their lives. They can then begin to accept hardships and commit to making necessary behavioural changes, regardless of what is going on in their lives and how they feel about it.3
CBT aims to help an individual progressively take steps towards managing any problems that feel overwhelming, by breaking them down into smaller parts in a more positive way. CBT doesn’t aim to ‘cure’ an individual’s chronic pain but to help them cope with their symptoms, and by extension, to live well with pain.4
If acupuncture is considered as part of the management strategy for chronic pain, NICE recommends a single course of acupuncture or dry needling in the traditional Chinese or Western medical acupuncture system for people aged 16 years and over.2
NICE recommends the use of antidepressants such as amitriptyline, citalopram, duloxetine, fluoxetine, paroxetine or sertraline for the pharmacological management of chronic primary pain for adults.