Managing Chronic Pain in Primary Care

Chronic pain is an important primary care condition and only a minority of sufferers receive treatment in specialist pain clinics. It is important that primary healthcare professionals have an understanding of the multidimensional nature of chronic pain and its management, and that the process and outcomes of specialist referral are optimized. Although there is a general lack of evidence for managing pain in primary care, a reasonable approach may be adopted, supported by consensus and guidelines. Chronic pain should be assessed for potentially treatable causes, and associated biopsychosocial mediating factors using standard primary care approaches. Pharmacological treatments are useful, if used appropriately and in association with other approaches, and with regular follow-up and review. Referral within and beyond the primary care team is frequently advantageous, and there are many innovative strategies in practice or under development to maximise benefits. The primary care physician is therefore well placed to perform, facilitate and develop excellent chronic pain management.