Management of chronic pain (part 1)
Current Status
This interim guideline was published in December 2025 and replaces SIGN 136: Management of chronic pain. It contains the first part of the content of this guideline. The second part will be added in summer 2026. It will be considered for review in three years.
Summary
This guideline focuses on managing chronic non-malignant pain (pain lasting longer than 12 weeks) in adults. It applies to non-specialist healthcare settings that are not specifically designed for treating chronic pain. This part of the guideline includes recommendations and information on:
- opioids
- naloxone
- medicinal cannabis
- antidepressants
- pain management programmes
- psychological interventions
- self-help interventions, and
- occupation-based interventions.
The second part of the guideline will be published in 2026 and contains information on:
- muscle relaxants
- simple analgesics
- topical analgesics
- antiepileptics
- combination pharmacological therapies
- hands-on physical therapies
- hands-off physical therapies
- electrotherapies
- alternative interventions
- dietary interventions.
The guideline does not cover:
- pain caused by cancer
- pain caused by migraine (see SIGN 155: Pharmacological management of migraine pain in children and young people).
Who it’s for
The clinical guideline will be of interest to healthcare professionals in primary and secondary care involved in managing people with chronic pain, including:
- general practitioners
- pharmacists
- anaesthetists
- psychologists
- psychiatrists
- physiotherapists
- rheumatologists
- occupational therapists
- nurses
- patients, carers and voluntary organisations with an interest in chronic pain.
We will also be producing a booklet for patients, families and carers that will cover:
- understanding your pain better
- what help is available
- ways of helping you to manage your pain
- information about the care you are likely to receive.
How this guideline was developed
This guideline was developed using a standard methodology based on a systematic review of the evidence. Further details can be found in SIGN 50: A Guideline Developer’s Handbook.
Current < 3 years
