The National Institute for Health and Care Excellence has advised doctors in England and Wales not to prescribe common painkillers, including paracetamol and ibuprofen, to patients with chronic pain that is not caused by a specific illness or injury. The Institute operates under the Department of Health in England and is involved in the analysis and evaluation of healing practices.
Experts recommend using acupuncture and psychotherapy instead of antidepressants. According to them, there is not enough evidence that paracetamol and ibuprofen work well in such cases, but their long-term use may be harmful. The Institute also strongly recommended that these patients not be prescribed opioids. In the published guidance, chronic pain is defined as “unexplained by other diagnoses and persisting or recurring regularly for more than three months. The most common cases are headaches and back pain. The Institute estimates that between one-third and one-half of the population of the United Kingdom is affected.
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This is the Institute’s first recommendation specifically dedicated to chronic pain as a special condition of the body. There is not enough evidence to prove the effectiveness of paracetamol for treating people whose problem is pain itself, and drugs from the family that includes ibuprofen “do not have an impact on the quality of life of patients with pain and psychological disorders,” claims the committee of experts who prepared it. Both drugs cause damage to the stomach and liver when used for a long time. The committee also included cannabis-based drugs in the number of drugs with unproven effectiveness.
In addition to antidepressants and acupuncture, the Institute advises treating physicians to consider prescribing several sessions of cognitive therapy to help patients accept their condition as inevitable. According to the president of the Royal College of General Practitioners, Professor Martin Marshall, this “marks a radical shift from pharmacology to alternative therapy. “Most patients don’t want to be on medication for a long time, and neither do their doctors, but until recently, medication was often seen as the only relief,” he says. “Shifting attention to alternative methods has the potential to bring greater benefits to patients, provided these methods are accessible,” Professor Marshall said. The Institute’s instructions to treating physicians emphasize the importance of open but sensitive communication with patients. “In the absence of a diagnosis, normal test results are sometimes perceived by patients as an underestimation of their painful condition on the part of the physician.”
A New York photographer uses everyday objects to depict pain in his work.