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Cellen advisors contribute to NICE guidelines for chronic pain

Our latest blog is written by Chris Oldfield, who lives with persistent pain. He is a medical student and patient inclusion advisor at Leva Clinic. Chris reflects on the latest NICE chronic pain guidelines published today, as both a patient and healthcare professional.

NICE (National Institute for Health and Care Excellence) has just published updated guidelines on the assessment and management of chronic pain. These guidelines, to be used by both healthcare professionals and people with chronic pain, highlight the need for patient-centred, collaborative treatment of chronic pain. It is fantastic to see two of Leva Clinic’s advisory and clinical team members a part of the guidelines committee: Diarmuid Denneny (Advisor and Lead Physiotherapist at Leva Clinic) and latest addition to the team Dr Benjamin Ellis (Advisor at Leva Clinic). The two healthcare professionals joined our team following writing the guidelines draft.

Dr Benjamin Ellis (left) and Diarmuid Denneny (right)

The guidance suggests a wider view to treating chronic pain, moving away from only prescribing paracetamol, opioids and other common medications as there is limited evidence for their efficacy but a well-documented risk of harm and addiction. Antidepressants may be beneficial in some patients, according to the evidence, but the benefits of these medications must be weighed up against potential harms before they are prescribed. Other areas of management options suggested include:

· Exercise programmes and physical activity

· Psychological therapy

· Pharmacological management

As a young person with chronic pain, I have the prospect of living with this condition for the rest of my life. I have learnt that there is no ‘quick fix’, but instead the importance of a series of lifestyle changes and adaptions to manage the pain. From psychological support to exercise programmes, I have been able stay on top of the pain as opposed to let it overrun my life. As such, this updated guidance from NICE has given me much more confidence in the ability of clinicians to treat myself and others in the most effective way. For me, it is great to see that the evidence-based guidelines are in line with what I have personally found to be the most efficient treatments.

When new guidelines are published, a large challenge is the implementation of the suggested changes. Often, there may not be a framework that quickly and effectively puts into place new treatment plans for patients. However, the principles and practicalities of Leva Clinic’s management of chronic pain are already perfectly in line with the NICE guidelines.

The NICE guidelines state that clinicians should ‘Offer a person-centred assessment to those presenting with chronic pain … to identify factors contributing to the pain and how the pain affects the person's life’ as well as ‘Foster a collaborative and supportive relationship with the person with chronic pain.’ This patient-centred approach lies at the heart of Leva Clinic’s attitude to the management of chronic pain. Given the complexities of chronic pain management, giving the individual the opportunity to be a member of the decision-making team, as opposed to being passively told what to do, is key to successful treatment. The multi-disciplinary approach to Leva Clinic’s pain management is highlighted by the roles of doctors, physiotherapists, clinical psychologists and prescribing nurses all working together alongside a single patient.

Ultimately, these new guidelines are exactly what is needed for the field of chronic pain management. Leva Clinic continues to put guideline-based best practice care at the forefront of their approach and I look forward to supporting the team alongside these recently updated NICE guidelines to optimise patient care!

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