The British Pain Society has stressed the importance of recognising that NICE’s draft recommendations focus on ‘chronic primary pain’ and “are not immediately applicable to the wider population of ‘chronic pain’ patients”.3

Many people with chronic pain will have clear mechanisms for their pain, but it is also likely that, for others, chronic primary pain co-exists alongside recognised chronic pain conditions which respond well to standard analgesics.

More important for the BPS is that efforts to identify all the potential conditions causing pain, whether primary or secondary, should be made with the patient, with appropriate referral to pain medicine teams if in doubt. This will mean treatment can be tailored to benefit the patient, improving the quality of life.

“The Society finds blanket diagnostic labelling of patients or indiscriminate withdrawal of pain treatment therapy to be unhelpful and potentially harmful. These could lead to unnecessary distress and suffering in the large number of chronic pain patients,” it said.