GPs and pain specialists have raised concerns about new guidance which calls for non-pharmacological treatments for chronic pain.

GP leaders warned that practices and patients might struggle to get access to the kinds of interventions, such as acupuncture and psychological therapies, advocated in the National Institute for Health and Care Excellence guidance.

The Faculty of Pain Management, meanwhile, questioned the definition of chronic pain, warning that improved understanding is needed of its underlying mechanisms. It warned that the guidance could lead to specialist pain management services being decommissioned.

Royal College of GPs chair Professor Martin Marshall said: “GPs will always take a holistic approach to delivering care, considering physical, psychological and social factors when making a diagnosis and developing a treatment plan in partnership with our patients, so the patient-centred approach to this guideline is welcome. We also understand the move away from a pharmacological option to treating chronic primary pain to a focus on physical and psychological therapies that we know can benefit people in pain. However, access to these therapies can be patchy at a community level across the country, so this needs to be addressed urgently, if these new guidelines are to make a genuine difference to the lives of our patients with primary chronic pain.”

A statement from the Faculty said: “It should be noted that these guidelines refer to the assessment of all chronic pain, but management is limited to chronic primary pain only. There are also a significant number of patients that will have coexisting chronic primary and secondary pain the management of which is outside the scope of this document alone. If the full benefit of this document is to be achieved, and the considerable risks to patient care are to be avoided, there needs to be review of pain services, their delivery and how they interact from point of first contact to specialist level intervention. Currently the availability and delivery of services is variable across the country.”