New draft NICE guidelines for chronic pain emphasises exercise, CBT and acupuncture over medication

[Jonathan Edwards]

Wasn't that.

"We really need to do a whole lot more to make readily available behavioural treatments for #chronic pain more evidence based"

 

[Andy]

Concerns have been raised over the possible application of certain provisions within the draft NICE guideline for ‘Chronic Pain Assessment and Management’ to people whose diagnosis of ME/CFS has yet to been confirmed. The guideline is aimed primarily at those experiencing chronic primary pain – i.e. pain that is not linked to an underlying medical condition and so, in theory, ought not apply to pain in ME/CFS – which can be severe, difficult to treat, and involve nerves (neuropathic pain), muscles and joints.

https://www.meresearch.org.uk/nice-draft-guideline-on-pain-and-application-to-me-cfs/

 

[MEMarge]

Healthwatch have produced a survey to gather info on those with chronic pain to feed back to NICE.

WARNING: includes questions on suicidal thoughts and self harm.

https://docs.google.com/forms/d/e/1...JccgrcBtTwe0LuYd7Slq65mqbZ5pEVg_iX9CKt73GrhSg

 

[Arnie Pye]

Healthwatch have produced a survey to gather info on those with chronic pain to feed back to NICE.

WARNING: includes questions on suicidal thoughts and self harm.

https://docs.google.com/forms/d/e/1...JccgrcBtTwe0LuYd7Slq65mqbZ5pEVg_iX9CKt73GrhSg

There are so many ways that answers to that survey could be twisted to use against a patient. And I couldn't answer quite a few of them because the actual situation I'm in wasn't given as an option. I hope I'm never in a situation where I am forced to answer this questionnaire as a condition of continuing to be prescribed the pain relief I get for chronic pain.

 

[Andy]

I haven't taken the survey, so I don't know how good it is or not.

 

[Sly Saint]

program on C4 How to beat Pain
"What simple techniques help relieve chronic pain, from migraine to backache? Is it often in the mind? Do yoga, tai chi, or acupuncture work? And who tolerates pain best, men or women?"

https://www.channel4.com/programmes/how-to-beat/on-demand/70184-003

I thought it rather trivialised the issue (eg describing migraine as a bad headache).
The only interesting bit was
"The most fascinating case was 71-year-old Jo Cameron, who feels no pain. She broke her arm as a child, but didn’t mention it until her mother noticed the limb turning a funny colour.
Scientists have discovered she has a pain-suppressing genetic mutation, which could prompt the development of new pain-killing drugs."

review on the program in 'the I'
https://inews.co.uk/culture/televis...ingless-kate-quilton-javid-abdelmoneim-576971

eta: included patients with fibromyalgia and RA

 

[Trish]

I haven't taken the survey, so I don't know how good it is or not.

I have just filled it in. I think it's worth doing. Used the boxes to make comments about unproven therapies being offered, and unblinded trials with subjective outcomes, and to point out the harm caused by therapy leaving people feeling blamed for not being able to contol physical pain with their minds.

 

[rvallee]

Very poor questionnaire, frankly. I don't think the responses will be of much use.

Probably worth filling it but it's poorly worded and structured, very superficial. As is tradition with anything psychosocial. By physicians for physicians.

 

[Amw66]

Very poor questionnaire, frankly. I don't think the responses will be of much use.

Probably worth filling it but it's poorly worded and structured, very superficial. As is tradition with anything psychosocial. By physicians for physicians.

By physicians for physicians to garner a particular response ?
Or will the expanded answers such as @Trish ' s be significant enough to count for something

 

[MEMarge]

The survey is presumably a response to the d(r)aft Guidelines, designed to be drawn up, completed over two week period, ie 31st Aug, and then analysed for results to be submitted by the consultation deadline of 14 Sep.

I think it is well worth noting things you want to add as you go through, so that you can add them in the final comments box.

 

[MEMarge]

There is a petition asking for these draft Guidelines to be amended, which I think is hugely important.They are getting close to the 25k target of signatures:
https://www.change.org/p/national-institute-for-health-and-care-excellence-stop-the-proposed-cruel-changes-to-chronic-pain-nice-guidelines?recruiter=false&utm_source=share_petition&utm_medium=facebook&utm_campaign=psf_combo_share_initial&utm_term=psf_combo_share_initial&recruited_by_id=370d4220-ee33-11ea-9854-afc7f9173e87&utm_content=fht-23919198-en-gb:0

Please sign if you believe that people with unexplained pain need access to some meds other than antidepressants!

 

[Sly Saint]

Please sign if you believe that people with unexplained pain need access to some meds other than antidepressants!

and also top of NICEs list of treatments is CBT, and ACT. This has got to stop.

 

[MEMarge]

Petition now over 24,000.

 

[Dx Revision Watch]

Letter to the Editor in today's TIMES from six pain consultants:

(Registration required for access)

https://www.thetimes.co.uk/edition/...lding-the-united-kingdoms-integrity-g97cjlqtz

and a brief article on page 4 of the print edition:

Patients will suffer under pain advice by Katie Gibbons, 14 September 2020


(Note the NICE Consultation closes on Monday 14 September 2020 at 5pm.)

 

[Dx Revision Watch]

the link is wrong, thats a letter about brexit

All the day's Letters to the Editor are usually listed under the one link.

 

[Dx Revision Watch]

There might be an individual link available for that specific Letter tomorrow.

 

[MEMarge]

Letter to the Editor in today's TIMES from six pain consultants:

Letter says 150 more signatories online. From an article in Pulse and comments from doctorsnet, many GPs and other doctors are really anti this draft as well.

 

[adambeyoncelowe]

Full list of signatories.

 

[Trish]

That letter makes it sound like if they can diagnose the source of the pain, the patient can have drugs to treat it, but if they don't know the source, no drugs, just psychobabble. Which is exactly what the problematic guideline says.

 

[MEMarge]

Above petition reached 25k and has been sent to NICE. It is still ongoing if anyone still wants to sign.

Yes @Trish, had not realised how disappointing the Times letter was!