Chronic pain – discomfort that lasts over three months – needs GP assessment

Not-for-profit, evidence-based NPS MedicineWise is encouraging Australians who suffer pain for longer than three months to visit their general practitioner (GP) to have their condition checked. The advice follows the launch of an NPS MedicineWise visiting program on neuropathic pain, a kind of chronic pain experienced by one in 20 Australians.

Dr Andrew Boyden, medical advisor with NPS MedicineWise, says, “If pain continues for more than three months it becomes a form of chronic pain. Working out if neuropathic pain is behind the patient’s discomfort will help them to receive the best treatment. This educational visiting program aims to help GPs with the often difficult task of distinguishing neuropathic pain from other pain conditions.”

People with neuropathic pain, sometimes known as ‘nerve pain’, can experience shooting, stabbing or burning sensations. This is caused by damage or injury to nerves from conditions such as shingles, diabetes and nerve root compression around the spine.

The visiting program reminds GPs, and in turn, their patients, that finding medicines to provide pain relief for chronic conditions can be difficult. All medicines indicated for treating neuropathic pain are limited in their efficacy and there is significant variation between individuals and the level of pain relief they receive from their use.

Dr Boyden says, “The program reminds health professionals that in suitable patients, amitriptyline remains a first-line option according to Australian and international guidelines. This can provide a point for discussion between the patient and their doctor around optimal treatment for the pain.

“Apart from medication use, we emphasise the need to take a broad approach to pain management, suggesting physical activity and psychological techniques, such as cognitive behavioural therapy and meditation. This can help patients to understand and deal more easily with their condition.”

The program also reminds GPs that pregabalin isn’t useful in a diagnostic capacity for neuropathic pain because of the variable response that people with neuropathic pain have to it. Additionally, pregabalin for non-neuropathic pain conditions such as back pain without a neuropathic component, are not recommended where current evidence does not support its use. The Faculty of Pain Medicine (ANZCA), through the Choosing Wisely Australia initiative, has released a recommendation to avoid prescribing pregabalin or gabapentin for pain which does not fulfil the criteria of neuropathic pain.

Media enquiries

Eve Hanks: 0419 618 365, ehanks@nps.org.au