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Chronic Pain: A Different Approach Needed

Chronic pain in the UK affects between one-third and one-half of the population. However, it isn’t known what proportion of people with debilitating symptoms from chronic pain seek support from healthcare services.

Almost half of people with chronic pain have a diagnosis of depression and two-thirds of people are unable to work outside the home. Studies of disability in relation to a number of long-term health conditions show that pain contributes the most to disability measures. Painful conditions such as arthritis and back pain account for one-third of all claims for disability benefits in the UK.

There is no medical intervention, pharmacological or non-pharmacological, that is helpful for more than a minority of people with chronic pain, and benefits of treatments are modest in terms of effect size and duration. However, attempts to treat chronic pain are costly to the healthcare system. In 2016, £537 million was spent on prescribing analgesics, with at least an additional 50% cost incurred from the prescription of other drug classes such as antidepressants and antiepileptic drugs. Further healthcare costs include visits to primary care, referrals to secondary care for opinions from pain and other specialists, and costs of investigations and interventions, including surgery.

The economic impact of pain is high due to absenteeism, poor productivity and people with pain leaving the work force. The annual indirect cost of back pain in the UK was estimated to be between £5 billion and £10.7 billion.

NICE is in the process of developing a guideline for chronic pain entitled “Chronic pain:  Assessment & Management”.  It is due for publication in August 2020, with draft guidelines being released in February 2020 for a consultation period (21st February 2020 – 3rd April 2020). 

Many complementary, traditional and natural therapists already work with patients with chronic pain so have a lot to offer in this area. We would encourage any professional association, patient, therapists or other CAM stakeholder to think about contributing to the consultation next year. Patient care could be improved with a more holistic, non drugs based approach.

See https://www.nice.org.uk/guidance/indevelopment/gid-ng10069 for further details. Well keep you up-to-date with developments too.