“People suffering from chronic pain that has no known cause should not be prescribed painkillers, the medicines watchdog [NICE] has announced, recommending such patients be offered exercise, talking therapies and acupuncture instead.” Extract from The Guardian, 7 April 2021.
NICE – the UK’s National Institute for Health & Care Excellence – published its Guideline NG193 on 7 April 2021 titled:
Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain.
Section 1.2.5 of the Guidance note begins:
Acupuncture for chronic primary pain
1.2.5 Consider a single course of acupuncture or dry needling, within a traditional Chinese or Western acupuncture system, for people aged 16 years and over to manage chronic primary pain…
The Guidance note goes on to define Chronic Pain and Chronic Primary Pain as follows:
Pain that persists or recurs for more than 3 months. This includes both chronic primary pain and chronic secondary pain, which can coexist. Other terms used include persistent pain and long-term pain.
Chronic primary pain
Chronic primary pain has no clear underlying condition or the pain or its impact is out of proportion to any observable injury or disease. The mechanisms underlying chronic primary pain are only partially understood and the definitions are fairly new. All forms of pain can cause distress and disability, but these features are particularly prominent in presentations of chronic primary pain. This guideline is consistent with the ICD-11 definition of chronic primary pain.
Fibromyalgia (chronic widespread pain) is a type of chronic primary pain. ICD-11 also categorises complex regional pain syndrome, chronic primary headache and orofacial pain, chronic primary visceral pain and chronic primary musculoskeletal pain as types of chronic primary pain.