Chronic pain: how to self-manage

Pain management and community pharmacy

The Pharmacy Guild of Australia and Painaustralia have partnered to produce a fact sheet that advises on self-management of chronic pain

A key message of the fact sheet is that medicines alone are not the most effective way to treat chronic pain and that people managing their pain on a daily basis get the best results.

Guild president George Tambassis says that while chronic pain may never be completely resolved it can be managed, and there are many self-management strategies that could help patients.

“Most of us experience pain from time to time, but for 20% of people that pain simply doesn’t go away,” says Tambassis.

“While medicines such as codeine or other opioids are sometimes prescribed for chronic pain, research has shown they are not effective in the longer term, contributing on average to only a 30% reduction in pain.

“Evidence shows that people with chronic pain who are actively involved in managing their pain on a daily basis have less disability than those who are engaged in passive therapies, such as taking medication or surgery,” he says.

Painaustralia CEO Lesley Brydon says it is important for people suffering from chronic pain to learn to ways of managing their pain effectively without medicines.

“Pain medicines come with unwanted side effects such as nausea, drowsiness, constipation, mood change and difficulty in concentrating,” Lesley says.

“In addition, patients can develop a tolerance to opioids and the dosage must be progressively increased to achieve the same pain-relieving effect.

“This joint fact sheet points out a range of non-medicine measures patients can adopt to help manage chronic pain.”

The fact sheet is available on the website of the Guild’s MedsASSIST program and includes information about referral pathways, to assist patients with managing their pain better.

It is also available on the Guild website and the Painaustralia website.

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  1. Lorraine Lencina

    It is incorrect to say that research has shown opioids are not effective to treat longer term pain. This kind of statement is the most serious misinformation that I see being stated over and over–and believe me, it is simply not a true statement. What is correct is to say that there is are not definitive studies proving one way or another whether opioids are an effective treatment for chronic noncancer pain. Not having proof does NOT mean opioids aren’t effective–it means exactly what it says–we don’t have proof one way or the other in the form of studies. Pain management specialists and chronic pain patients however, can attest to the fact that for many people with chronic pain, opioids work better than all the other types of pain managment available. Even a 30-50% reduction in pain is very significant to someone who has round the clock moderate to severe pain. And for some, only opioids provide that much pain relief. The other listed types of pain management interventions may for some provide much less than a 30% reduction in pain for those with constant moderate to severe pain.

    Even the CDC guidelines for the prescription of opioids ONLY say there is “insufficient evidence” that opioids DO work for chronic pain…which is NOT the same as saying there is evidence that opioids do NOT work! It is terribly important to be accurate about this in reporting.

    I have never known anyone to take opioids longterm unless they have first tried many other pain intervention methods, which didn’t work adequately for them. Because doctors don’t typically prescribe opioids unless other methods have failed, and because the average patient these days is way too informed to agree to longterm opioids unless they haven’t been able to find an alternate method which works for them. It is naive to think otherwise.

    We all need to stop and think about what we are hearing about the “opioid problem” and we need to apply common sense to what we are being told, and to ask for more “proof” that what we are being told is fact and not misinformation or distortion of the facts.

    There is not an “opioid” problem. There is an “addiction” problem which is separate from the treatment of intractable pain with opioids. This addiction problem is serious enough by itself, but we must avoid blaming pain patients who have nothing to do with this problem, and who do benefit from the presciption of longterm opioids to treat severe pain.

    • arthritic chick

      Pretty much exactly what I was going to say. When you are in severe, daily pain, 30% is a whole lot, and worth the side effects. And the other interventions of course need to be tried. But would likely give not even 30% for someone in severe pain. There’s a double standard here, and it’s not to the benefit of those in severe chronic pain.

    • pa07950

      Some of the exact points I was going to post. One additional item:

      There are NO long term studies (ie double blind studies) that show any of the alternative medications for chronic pain work nor are there any long term studies for the non-medication alternatives. It’s truly a shame that there are simply too few studies on such a widespread problem.

      If you read many of the statistical studies that have been released – these studies are looking back at available data that was not collected for these specific studies – correlation doesn’t imply causation! A good example: cell-phone usage has exploded since the late 1990’s along with the number of people with chronic pain. Should we eliminate cell phones?

  2. David Senator

    I printed out the fact sheet but was horrified to see “Tips on managing chronic pain WITHOUT PAINKILLERS (my emphasis). This is a put off from reading the rest for many people suffering chronic pain, which is a pity as the material is good and will be helpful. It would be better if it were “Tips on managing Chronic Pain in addition to taking your prescribed pain killers.” Pain management is necessarily a very individualized matter, and those with it are sensitive about people who do not have pain pontificating to them what they should do.

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