A draft National Institute of health and Care Excellence (Nice) guidance published earlier this week (August 3), said patients with chronic primary pain should be offered “supervised group exercise programmes, some types of psychological therapy or acupuncture”.

These therapies should replace the prescribing of pain medicines such as paracetamol, non-steroidal anti-inflammatory drugs including ibuprofen and aspirin, benzodiazepines and opioids, Nice said.

This is because there is “little or no evidence that they make any difference to people’s quality of life, pain or psychological distress”, but there is evidence to suggest they cause harm, including possible addiction, Nice explained

Other drugs that should not be offered to patients with chronic primary pain – defined as pain that cannot “be accounted for by another diagnosis, or where it is not the symptom of an underlying condition” – include gabapentinoids, ketamine, corticosteroids, antipsychotics and local anaesthetics.

However, antidepressants may be considered for these patients, according to the draft guidance, which concerns the assessment and management of chronic pain in patients over the age of 16.

The draft guidance is now open to the public for consultation until September 14.