SIGN 136: Chronic Pain Mgmt.pdf

SIGN 136, "Management of Chronic Pain," is a national clinical guideline published in December 2013. It provides evidence-based recommendations for managing chronic pain, focusing on assessment, self-management, pharmacological and psychological interventions, and physical therapies.

Evidence Levels and Grades:
- Levels of evidence range from 1++ (high-quality meta-analyses or RCTs with very low risk of bias) to 4 (expert opinion).
- Grades of recommendation range from A (highest strength, based on 1++ evidence) to D (lowest strength, based on level 3 or 4 evidence).

Key Recommendations:
1. Assessment and Planning of Care: Use validated assessment tools, intervene early, manage care holistically, and foster patient-professional interaction.
2. Supported Self-Management: Encourage self-management strategies, provide education, and consider cognitive behavioral therapy (CBT) for chronic pain.
3. Pharmacological Management: Use analgesics, antidepressants, and antiepileptics as appropriate, with regular review and monitoring.
4. Psychologically Based Interventions: Offer CBT, acceptance and commitment therapy (ACT), and other psychological therapies.
5. Physical Therapies: Consider physiotherapy, acupuncture, and other physical therapies based on individual needs and preferences.

Methodology:
- The guideline was developed using SIGN's standard methodology, accredited by NHS Evidence.
- It has been equality impact assessed to ensure it addresses age, disability, gender, race, religion/belief, and sexual orientation.
- The document is produced from elemental chlorine-free material and sourced from sustainable forests.