Professor Roger Knaggs BSc BMedSci PhD EDPM FHEA FFRPS FRPharmS FFPMRCA
President of the British Pain Society, Professor of Pain Management at the University of Nottingham and Specialist Pharmacist, Primary Integrated Community Services
Chronic pain impacts 20% of the population. We need to shift from medical treatments to holistic, supported self-management approaches.
Pain becomes chronic after three months when tissue healing has usually been completed. Moderate to severe disabling chronic pain affects around 8 million adults in the UK, disrupting lives of individuals, families and communities. Back pain is the leading cause of disability, costing UK taxpayers an estimated £10 billion annually. Our approach to managing chronic pain must change.
Medicines have limited effect on chronic pain
Pain is processed in the nervous system through many mechanisms, but most medicines target only one. Medicines may relieve many types of pain but work best when combined with regular activity, exercise or enjoyable activities. Some types of pain may not respond to medicines or only for short periods.
Opioids like codeine, morphine and tramadol cause long-term issues such as constipation, itching, weight gain, low sex drive and breathing difficulties. For any concerns, your care team or pharmacist can advise on maximising benefits and managing side effects.
Medicines may relieve many types of pain but
work best when combined with regular activity.
National survey on chronic pain
The 2024 British Pain Society (BPS) national survey on chronic pain found that 87% of patients were prescribed pain medicines, primarily opioids. Approximately 86% had taken these medicines for over two years, and 77% reported benefits. However, 67% experienced side effects, and worryingly, 69% had not been informed about long-term risks.
Former vice-chair of BPS patient committee Louise Trewern recalls: “I lived with unexplained pain for years, leading to high-dose opioid prescriptions. I transformed my life by tapering off opioids and managing my pain through activity, diet and sleep.”
Psychological approaches
NICE recommends psychological therapies, such as acceptance and commitment therapy (ACT) or cognitive behavioural therapy (CBT) in managing chronic pain for people aged 16 years and over. ACT improves quality of life by enhancing sleep and reducing pain and psychological distress. These therapies can be provided by trained professionals through the NHS or privately.
BPS honorary member Pete Moore moved from relying on medicines to self-management after attending a Pain Management Programme in 1996. Since then, he has not needed to take medicines. “Empower patients to understand their pain and then take up self-management strategies,” Moore advocates.
Learn more at www.britishpainsociety.org
