In its approach to chronic pain, the new NICE guideline recommends that patient assessment should include recognising that chronic pain can cause distress. The consultation should include asking the patient to describe how the pain is affecting their life, and what activities they do that might affect the pain. This could include:2

·       lifestyle and everyday activities, including work and sleep disturbance

·       physical and psychological wellbeing

·       social interaction and relationships.

Questions can also find out about how the patient perceives their pain, such as possible causes, concerns about the future (including the possibility of it worsening), and any expectations such as outcomes of potential treatments and quality of life. This can all contribute to a care plan.

Pain management (including pharmacological approaches) should be based on existing NICE guidelines where available, for example:12-19

·       headaches – Clinical Guidance CG150

·       low back pain and sciatica – NICE Guideline NG59

·       rheumatoid arthritis – NG100

·       osteoarthritis – CG177

·       spondyloarthritis – NG65

·       neuropathic pain – CG173

·       endometriosis – NG73

·       irritable bowel syndrome – CG61

As NICE found inconsistent evidence to support the use of pain management programmes, and no evidence currently to support social interventions, it has recommended there should be more research on these.2