Long-term ("chronic") pain is pain lasting more than three months. NICE guideline NG193 recommends that, alongside any medicines, people with chronic pain are offered non-medicine approaches — these often help more, with fewer risks, than relying on painkillers alone.
The five things that help most
1. Stay active — gradually
Movement is one of the strongest treatments for long-term pain. Start small and build up: short walks, gentle stretching, swimming or cycling. NICE recommends considering a supervised exercise programme.
2. Pace yourself
Avoid the boom-and-bust pattern (overdoing it, then crashing). Plan activity in manageable chunks with breaks. The British Pain Society's "pacing" approach helps you do more, more reliably.
3. Look after your sleep and mood
Pain, poor sleep and low mood feed each other. NICE recommends acceptance and commitment therapy (ACT) or CBT for chronic pain. Our sleep hygiene and stress self-help pages can help.
4. Use heat, cold and TENS
For some people, heat packs, ice packs or transcutaneous electrical nerve stimulation (TENS) can take the edge off without medicines.
5. Stay connected
Isolation worsens pain. Peer support groups (online or in person) help many people feel more in control. Live Well with Pain and Versus Arthritis are good starting points.
What NICE says about medicines for chronic primary pain
NICE NG193 specifically does not recommend starting opioids, gabapentinoids, benzodiazepines or paracetamol/NSAIDs for chronic primary pain (pain without a clear underlying cause). For other types of long-term pain, medicines may have a role, but at the lowest effective dose for the shortest time, with regular review. See our safer use of pain relief guidance.
When to seek further help
- New, worsening or unexplained pain.
- Pain with weakness, numbness, fever or unexplained weight loss.
- Pain that is significantly affecting your sleep, mood or daily life.
- Concerns about your current pain medication — speak to your GP or our team.