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Society guideline links: Chronic pain management

Society guideline links: Chronic pain management

Introduction — This topic includes links to society and government-sponsored guidelines from selected countries and regions around the world. We will update these links periodically; newer versions of some guidelines may be available on each society's website. Some societies may require users to log in to access their guidelines.

The recommendations in the following guidelines may vary from those that appear in UpToDate topic reviews. Readers who are looking for UpToDate topic reviews should use the UpToDate search box to find the relevant content.

Links to related guidelines are provided separately. (See "Society guideline links: Neuropathic pain" and "Society guideline links: Cancer pain".)

International

World Health Organization (WHO): Guidelines on the management of chronic pain in children (2020)

World Federation of Societies of Anesthesiologists (WFSA): Statement on opioids (2019)

Canada

Canadian Paediatric Society (CPS): Position statement on the use of oral opioids to control children's pain in the post-codeine era (2021)

Choosing Wisely Canada: Don't initiate or escalate opioid doses for chronic non-cancer pain before optimizing non-opioid pharmacotherapy and non-pharmacologic therapy (2021)

Choosing Wisely Canada: Don't initiate therapy with opioids for patients with chronic non-cancer pain unless non-opioid pharmacotherapy and other non-pharmacological options have been optimized (2021)

Choosing Wisely Canada: Don't use opioid analgesic medication in the ongoing treatment of chronic, non-malignant back pain (2021)

Choosing Wisely Canada: Don't initiate opioids long-term for chronic pain until there has been a trial of available non-pharmacological treatments and adequate trials of non-opioid medications (2020)

Choosing Wisely Canada: Don't recommend the use of over-the-counter medications containing codeine for the management of acute or chronic pain. Counsel patients against their use and recommend safe alternatives (2020)

Canadian guideline for opioids for chronic non-cancer pain (2017)

United States

American Academy of Pediatrics (AAP): Clinical report on pain assessment and treatment in children with significant impairment of the central nervous system (2017, reaffirmed 2022)

Centers for Disease Control and Prevention (CDC): Clinical practice guideline for prescribing opioids for pain, United States (2022)

American Physical Therapy Association (APTA): Clinical practice guidelines for interventions for the management of acute and chronic low back pain, revision (2021)

Choosing Wisely: Do not prescribe opioids for chronic pain management in patients with autoimmune disease (2020)

Choosing Wisely: Don't provide long-term opioid therapy for chronic non-cancer pain in the absence of clear and documented benefits to functional status and quality of life (2020)

Choosing Wisely: Don't prescribe opioids for acute or chronic low back pain before a thorough evaluation, consideration of a trial of alternative medications and treatments, and discussion of the risks of opioid therapy (2019)

American Academy of Pain Medicine (AAPM): Consensus recommendations on rational urine drug monitoring in patients receiving opioids for chronic pain (2018)

American Society of Anesthesiologists (ASA): Statement on privileging for chronic pain management (amended 2018)

American Society of Regional Anesthesia and Pain Medicine (ASRA), AAPM, American Society of Anesthesiologists (ASA): Consensus guidelines on the use of intravenous ketamine infusions for chronic pain (2018)

American Academy of Family Physicians (AAFP): A position paper for management of chronic pain and opioid misuse (2017)

American College of Physicians (ACP): A clinical practice guideline on noninvasive treatments for acute, subacute, and chronic low back pain (2017)

Choosing Wisely: Do not provide long-term pain management without a psychosocial screening or assessment (2017)

American College of Occupational and Environmental Medicine (ACOEM): Practice guidelines on opioids for treatment of acute, subacute, chronic, and postoperative pain (2014)

Choosing Wisely: Don't prescribe opioid analgesics as first-line therapy to treat chronic non-cancer pain (2014)

Choosing Wisely: Don't prescribe opioid analgesics as long-term therapy to treat chronic non-cancer pain until the risks are considered and discussed with the patient (2014)

Choosing Wisely: Don't prescribe opioids for treatment of chronic or acute pain for workers who perform safety-sensitive jobs such as operating motor vehicles, forklifts, cranes or other heavy equipment (2014)

Europe

European Academy of Neurology (EAN): Guidelines on central neurostimulation therapy in chronic pain conditions (2017)

United Kingdom

National Institute for Health and Care Excellence (NICE): Interventional procedures guidance on neurostimulation of lumbar muscles for refractory non-specific chronic low back pain (2022)

NICE: Guideline on chronic pain (primary and secondary) in over 16s – Assessment of all chronic pain and management of chronic primary pain (2021)

Faculty of Pain Medicine (FPM) of the Royal College of Anaesthetists (RCoA): Improving the lives of people with complex chronic pain: how to commission effective pain management services in England (2020)

Scottish Intercollegiate Guidelines Network (SIGN): A national clinical guideline for the management of chronic pain (2013, revised 2019)

Australia-New Zealand

Faculty of Pain Medicine (FPM) of the Australian and New Zealand College of Anaesthetists (ANZCA): Position statement on the use of ketamine in the management of chronic non-cancer pain (2021)

FPM of the ANZCA: Statement regarding the use of opioid analgesics in patients with chronic non-cancer pain (2021)

Choosing Wisely Australia: Do not deprescribe or stop opioid treatment in a patient with concurrent chronic pain and opioid dependence without considering the impact on morbidity and mortality from discontinuation of opioid medications (2020)

Choosing Wisely Australia: Avoid prescribing opioids (particularly long-acting opioids) as first-line or monotherapy for chronic non-cancer pain (CNCP) (2018)

Choosing Wisely Australia: Do not continue opioid prescription for chronic non-cancer pain (CNCP) without ongoing demonstration of functional benefit, periodic attempts at dose reduction and screening for long-term harms (2018)

Choosing Wisely Australia: Do not prescribe opioids for the treatment of acute or chronic pain without assessing the patient's clinical condition, potential side effects, alternative analgesic options, work status, and capacity to perform safety-critical activities such as driving a motor vehicle (2017)

Japan

[In Japanese] Japan Society of Pain Clinicians (JSPC): Chronic pain practice guidelines (2021)

[In Japanese] JSPC: Chronic pain treatment guidelines (2018)

[In Japanese] JSPC: Opioid analgesic prescribing guidelines for non-cancer chronic pain, 2nd edition (2017)

[In Japanese] Choosing Wisely Japan: Drugs to relieve chronic pain – When and when not opioid analgesics are needed (2016)

Topic 118305 Version 14.0