Can primary can provide effective management of chronic pain?

Major players in our health care system are our GP’s and other primary care providers such as pharmacies, physiotherapists, osteopaths, chiropracters and nurses. The following slide show confirms the importance of primary care for managing both acute and chronic pain.
This lecture was given by Professor Gary Macfarlane, Professor of Epidemiology at the University of Aberdeen, to the North British Pain Association Spring Scientific Meeting in Edinburgh on Friday 18th May, 2007. Professor Macfarlane is introduced by Dr Colin Rae. The lecture forms part of a conference “Blurring the Boundaries – Managing Pain in Primary Care and Secondary Care”.



  1. In my experience, good pain management is hard enough for pain specialists, let alone GP’s. Of course, it’s possible for a GP do learn enough about pain treatment. Overall though, I think earlier referrals end up with the patient getting much better treatment.

  2. I agree that management of chronic pain is difficult for all of us! I think what this slide presentation shows is that if we are to manage chronic pain more effectively, we do need to target our interventions at primary and secondary prevention level rather than tertiary. What i mean is: all people with chronic pain started with acute pain, and present with elevated risk factors that need to be identified early and managed – but most people do get better by themselves. It’s about triage in terms of secondary prevention, while primary prevention seems to be less about biomechanical factors (where most of our efforts have gone) and much more about attitudes and beliefs about pain.
    If we could encourage the general population to learn that having pain (esp. common back pain) is quite a normal experience, and that moving and returning to normal activity is the best treatment, perhaps we’ll reduce the need for emphasis on referral for tertiary treatment.

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