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New draft NICE guidelines for chronic pain emphasises exercise, CBT and acupuncture over medication

Discussion in 'Other guidelines with public consultation process' started by Esther12, Aug 3, 2020.

  1. TrixieStix

    TrixieStix Senior Member (Voting Rights)

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    It's my understanding that there are some studies showing that there may be some small short-term benefits, but that it doesn't matter where the needles are inserted whatsoever. This contradicts the entire theory of 'acupuncture' which states that the needles must be placed in specific spots, believes in meridians, energy and other woo woo.

    The people I know who are acupuncturists spent about $100K in schooling for it which is a complete scam. It's almost like a religion to them and the things they talk about learning contain very little science whatsoever. Unfortunately the cost ends up being passed along to the patient. I doubt the acupuncture schools want to let the $$$$$$ go.
     
  2. chrisb

    chrisb Senior Member (Voting Rights)

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    Has there ever been a study as to whether the benefit to the therapist from the patient is greater than the benefit to the patient from the therapist?
     
    Philipp, JemPD, alktipping and 14 others like this.
  3. TrixieStix

    TrixieStix Senior Member (Voting Rights)

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    Lol
     
    alktipping, chrisb, Simbindi and 4 others like this.
  4. Kalliope

    Kalliope Senior Member (Voting Rights)

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    Norway
     
    Hutan, Simbindi, ladycatlover and 4 others like this.
  5. Mithriel

    Mithriel Senior Member (Voting Rights)

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    I have a friend whose crumbling hip could not be replaced until her asthma was stabilised. She was taking paracetamol, tramadol and oxycodone. 6 weeks after her operation she had stopped them all. Opiods used as prescribed for adequate pain relief has a very low risk of addiction.

    I read a report by a US doctor who felt that patients were dying of heart attacks because of the strain that constant unbearable pain put on the heart. he said that some deaths were being put down to opiod overdose when actual the doses had been so reduced that patients were still in extreme pain which lead to their deaths. Suicide from uncontrolled pain should be taken into account.

    It is amazing how much pain is underestimated by people who have never endured it. It is partly training; when my daughter was an orthopaedic trauma nurse junior doctors were forever giving people with broken limbs two paracetamol.

    The whole idea of pain catastrophizing has lead us here.
     
    Hutan, Philipp, Michelle and 18 others like this.
  6. Andy

    Andy Committee Member (& Outreach when energy allows)

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  7. NelliePledge

    NelliePledge Moderator Staff Member

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    So you can sedate a patient up to the eyeballs with tricyclics - are these even proven for pain? but paracetamol and ibuprofen are bad.

    As ibuprofen and paracetamol, even the lower dose paracetamol & codeine are available over the counter and quite a lot is even available in supermarkets this guideline is pissing in the wind. People can sort themselves out with otc. Also CBD widely available - if expensive.

    I don’t think the “problems” with what people are prescribed originate with the patients. I’ve been only too keen to stop taking medication that I’ve been prescribed that turned out to be unnecessary ineffective or produced unacceptable side effects. Fluoxetine, Amitryptiline, pregabalin.

    I agree there’s a problem with polypharmacy eg how many Drs are prescribing tricyclics on top of SSRIs. That’s not down to patients.


    ETA have tricyclics ever been properly proven in trials to be effective long term for chronic pain?
     
  8. ladycatlover

    ladycatlover Moderator Staff Member

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    That doctor isn't very keen on the guidelines is he? :rofl: Can't wait to see his next episode! :) :party:
     
  9. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    alktipping, shak8, MEMarge and 7 others like this.
  10. wigglethemouse

    wigglethemouse Senior Member (Voting Rights)

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    I saw a description of the make-up of this NICE guideline committee and it was awful - many psychologists etc. Ugggghhhhh politics. Anyway I thought it was on s4me but I cannot find it in this thread. Anyone else see the same thing and have a reference?

    EDIT : Here is the list
    https://www.nice.org.uk/guidance/gid-ng10069/documents/committee-member-list

    Conflicts of Interest Document
    https://www.nice.org.uk/guidance/gid-ng10069/documents/register-of-interests-2

    All project documents can be found here
    https://www.nice.org.uk/guidance/indevelopment/gid-ng10069/documents
     
    Last edited: Aug 5, 2020
  11. alktipping

    alktipping Senior Member (Voting Rights)

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    if nice remove the doctors ability to give palliative care then they might as well make all doctors unemployed what a boon for street dealers . this gross stupidity will have tragic consequences not only for those suffering but on society as a whole .
     
  12. Simbindi

    Simbindi Senior Member (Voting Rights)

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    Another (economic) impact on society will be a likely increase in sick days.
     
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  13. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    And suicides.
     
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  14. Daisybell

    Daisybell Moderator Staff Member

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    NICE just seem to be making themselves a laughing stock....
     
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  15. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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  16. rvallee

    rvallee Senior Member (Voting Rights)

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    It's really past time to have that discussion over antidepressants. The logic of arguing that analgesics cause more harm than good while pretending the opposite of antidepressants is completely insane. There are zero safety safeguards to antidepressants and antipsychotics, they are handed out like they are Tic Tacs and their side effects and withdrawal are completely denied. Incredibly reckless and irresponsible.

    By far the biggest harm coming from this distorted mental health approach is that there are no safeguards in mental health, it's a complete free-for-all where applying rules is impossible because everything is subject to interpretation. Hence why this approach has been chosen, no accountability means anything goes and ideology can flourish unopposed.
     
    Hutan, Philipp, shak8 and 11 others like this.
  17. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    Rona Moss-Morris

    There is no evidence that any of your behavioural treatments do anything other than keep you and your pals in work.
     
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  18. rvallee

    rvallee Senior Member (Voting Rights)

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    The scientific literature on this topic is mostly centered on the themes of: how to actually make it seem to work, how to convince people that it works and why is it that the patients reject it? This BS has been available for years to widespread failure, at this point the only way to increase its use is to make it even more coercive, DESPITE THE FACT THAT IT DOES NOT WORK.

    This is completely insane. These people are obsessed with figuring out how to make their thing work while doing everything they can to push it into practice. They have both thoughts simultaneously in their heads with zero afterthought. And almost no one seems to find fault with that, other than the patients but since there is no accountability or reporting process the patients can be entirely dismissed from all concerns.

    Seriously if someone set out, for whatever reasons, to destroy the credibility of modern medicine, this is the most effective way to accomplish this goal. It's completely indistinguishable from deliberate sabotage, a poster child for the post-truth society. And the medical professionals seem to love it. The level of insanity is really hard to comprehend.
     
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  19. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    And while they're at it accuse everyone else of stigmatizing mental health patients. If subjecting those patients to treatments with such poor evidence of safety or efficacy isn't stigmatizing then what the hell is?

    Except that having gotten away with it for so long there's mission creep for what they see as low hanging fruit from other fields.

    If other specialities aren't careful then by the time they get to see patients they'll already be beyond help & at death's door.
     
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  20. JemPD

    JemPD Senior Member (Voting Rights)

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    "evidenced based behavioural treatments"... isnt that an oxymoron?
     
    shak8, MEMarge, ukxmrv and 6 others like this.

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