Russell Fleming, Content Manager, ME Association
Some people with ME/CFS have expressed concern about the new chronic pain guideline from NICE. But the recommendations contained in this guideline e.g., use of exercise and therapy instead of analgesic medications, are not aimed at people with ME/CFS.
The new draft of the NICE guideline for ME/CFS (due for final publication 18 August 2021) refers to pain and pain management as follows:
Managing pain
1.11.27 Refer to the following for advice on treating pain:
• NICE guideline on neuropathic pain in adults
• NICE guideline on headaches in over 12s
Pain as a symptom of ME/CFS and its importance is also recognised throughout the ME/CFS draft guideline.
The chronic pain guideline will be reviewed by the ME/CFS guideline committee and while we can't know what the final version of the ME/CFS guideline will contain, given the existing recommendations not to exercise or employ GET, it would be worrying if these weren't taken into account in any decisions relating to pain management in the final version.
In September last year, Forward-ME obtained clarification from NICE about the new Chronic Pain Guideline:
“With respect to the guideline in development for chronic pain, the main focus of the guideline is chronic primary pain.
“This is pain that persists or recurs for longer than 3 months and can’t be accounted for by another diagnosis, or where it is not the symptom of an underlying condition.
“The recommendations in the chronic pain assessment and management guideline do not apply to people with ME/CFS.
“We continue to work to support the ME/CFS guideline committee to proceed as promptly as possible with the development and publication of the new guideline on ME/CFS.”
Paul Chrisp
Director of the Centre for Guidelines
National Institute for Health and Care Excellence