module menu iconA different approach to pain

NICE guidance

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NICE GUIDANCE

The National Institute for health and Care Excellence (NICE) has produced guidance for the management of different types of pain.

Click on each of the tabs below for a brief summary of what the NICE guidance recommends.

MILD-TO
MODERATE PAIN
LOW
BACK PAIN
TENSION
HEADACHE

Analgesia – mild-to-moderate pain4

For adults and children aged over 16 years, a stepwise strategy for managing mild-to-moderate pain is recommended:

Step 1 - paracetamol should be used

Step 2 - paracetamol should be substituted with ibuprofen or, if ibuprofen is unsuitable, a weak opioid (such as codeine)

Step 3 - paracetamol should be added to ibuprofen or the weak opioid

Step 4 - paracetamol should be continued and ibuprofen replaced with an alternative non-steroidal anti-inflammatory drug (NSAID)

Step 5 - a weak opioid should be started in addition to paracetamol and/or an NSAID

Low back pain (without sciatica)5

  • Offer an NSAID such as ibuprofen, if there are no contraindications
  • An NSAID should be used at the lowest effective dose for the shortest possible time
  • If an NSAID is contraindicated, not tolerated or ineffective, offer codeine with or without paracetamol, taking into account the risk of opioid dependence and adverse effects such as constipation
  • DO NOT offer paracetamol alone for managing low back pain
  • DO NOT routinely offer opioids for managing acute low back pain
  • DO NOT offer opioids for managing chronic low back pain

Headaches in over 12s6
Acute treatment of tension-type headache

  • Consider aspirin, paracetamol or an NSAID for the acute treatment of tension-type headache, taking into account the person’s preference, comorbidities and risk of adverse events
  • Because of the association with Reye’s syndrome, preparations containing aspirin should not be offered to under 16s
  • DO NOT offer opioids for the acute treatment of tension-type headache

P
Ibuprofen 400mg

For customers wanting fast and effective pain relief, you can recommend Nurofen Express Liquid Capsules.

Nurofen Express starts to get to work within 8 minutes* and lasts up to 8 hours**

*Refers to absorption
**Based on a 400mg dose

P
Ibuprofen 200mg + Paracetamol 500mg

For the temporary relief of mild-to-moderate pain you can recommend Nuromol Pain Relief. It is especially suitable for pain that has not been relieved by ibuprofen or paracetamol alone.

1 x Nuromol Pain Relief 200mg/500mg film coated tablet was significantly more effective than combinations of paracetamol and codeine† up to 12 hours and is not known to cause addiction7

†paracetamol 1000mg + codeine 30mg

A different approach to pain

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