Painkillers such as paracetamol and ibuprofen can do ‘more harm than good’ and should not be prescribed to treat chronic pain, health officials have said. The National Institute for Health and Care Excellence claims that there is ‘little or no evidence’ the drugs, as well as aspirin and opioids, work.
But in draft guidance, published on Monday, Nice said there was evidence painkillers can cause harm, including addiction.
It says it would be ‘inappropriate’ for them to offered to patients anymore, despite the NHS saying paracetamol is safe when taken over many years.
Nice suggests people with chronic pain are instead offered exercise classes, therapy, acupuncture or even antidepressants. Chronic primary pain is a condition in itself which cannot be accounted for by another diagnosis or as a symptom of an underlying condition, Nice said.
The NHS recommends a combination of the following to manage chronic pain:
Exercise: Walking, swimming, using an exercise bike, dancing, yoga or pilates should become part of a patient’s everyday life – even on their bad days – to help them stay out of bed despite their pain.
‘But try to avoid overdoing it on good days and paying for this by having more bad days,’ the website says.
Going to work: Research shows that people become less active and more depressed when they don’t work.
Being at work can help distract from the pain, and in most cases, won’t make the pain worse.
A person with chronic pain can talk to their employer about how they can work in a way that suits them, for instance changing their shift patterns.
Physical therapy: Pain experts often recommend a short course of physical therapy to help a patient move better and make tasks and activities like walking, going up stairs or getting in and out of bed easier.
Physical therapy for persistent pain can involve manipulation, stretching exercises and pain-relief exercises.
Physical therapy is usually delivered by a physiotherapist, chiropractor or osteopath, or in some cases, an occupational therapist.
Painkillers for long-term pain: The NHS says ‘it’s safe to use over-the-counter painkillers to reduce your pain so you can be more active.