Doctors Should Prescribe Antidepressants and physical therapy For Primary Pain management Instead of Analgesics

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National Institute for Health and Care Excellence (NICE)  has indicated that patients with persistent pain without cause should not be provided opioids. Still, rather they should be treated with talking therapy, exercise, and acupuncture.

NICE discourages the use of analgesics in primary chronic pain management 

Insignificant policy change in pain treatment, NICE says that physicians should advise pain sufferers to consider psychological and physical therapies instead of analgesic in managing pain.  Equally, medical teams should consider antidepressant prescription according to the medicines watchdog. 

Between 1% and 6% of the UK population is believed to suffer chronic primary pain. Nice’s new guidance can alter the treatment of many hundreds of thousands of UK residents. According to the organization’s new guidelines on chronic pain evaluation and management, there is “little or no evidence” suggesting that opioids use improves a person’s quality of life, psychological distress, or the pain they experience.

Usually, chronic secondary pain results from an underlying health problem such as rheumatoid arthritis, osteoarthritis, endometriosis, or ulcerative colitis. On the other hand, chronic primary pain has no recognized etiology and can last for at least three months.

NICE suggests that physicians should work with patients to develop a support plan on managing the pain depending on how much it is affecting their daily operations life, honesty about the prognosis’ uncertainty, and what activities they think they can accomplish.

Primary pain management interventions should be antidepressants and exercise. 

The plan should entail interventions that have demonstrated effectiveness in chronic primary pain management. Some of the interventions include psychological treatments, acceptance and commitment therapy (ACT) and cognitive behavioral therapy, and exercise. Nice says that acupuncture is recommended as an alternative if given within stipulated parameters.  Antidepressants such as duloxetine, citalopram, fluoxetine, amitriptyline, and sertraline can equally be used. 

Dr. Paul Crisp, Nice’s center for guidelines director, said that according to evidence, any medication for chronic primary pain besides antidepressants is unlikely to offer a sufficient balance between potential benefits and risks related to them for people. 

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