Chronic pain is exhausting in a way that’s hard to explain to anyone who hasn’t lived with it. You take what’s prescribed, wait, and sometimes find that the relief either doesn’t come or doesn’t last. If you’ve been through that cycle, you’re not alone, and you’re right to ask whether other options exist.
Key Takeaways
- Conventional painkillers don’t work well for everyone, and long-term use carries real risks
- Several evidence-based alternatives are available in the UK, from physical therapies to psychological approaches
- Medical cannabis is a legal, clinically supervised option for patients whose pain hasn’t responded to at least two other treatments
- Access to alternative pain management in the UK is available both through the NHS and private clinics
- No single approach works for everyone; most people benefit from a combination
Why People Look Beyond Standard Painkillers
NSAIDs like ibuprofen and naproxen, paracetamol, and opioids are the most commonly prescribed treatments for chronic pain in the UK. For acute pain, such as a broken bone, or post-surgical recovery, they do the job. For persistent, long-term conditions, the picture is more complicated.
Opioids, in particular, carry significant risks with extended use. Tolerance builds over time, meaning higher doses may be needed to achieve the same effect. Dependency, constipation, cognitive fog, and withdrawal are all well-documented concerns.¹ NICE guidance has increasingly moved away from recommending opioids for chronic primary pain precisely because the evidence for long-term benefit is weak.²
That doesn’t mean you’re out of options. It means the options worth trying look different.
Physical and Movement-Based Therapies
Physiotherapy is one of the most well-supported chronic pain treatment alternatives available in the UK, and it’s often underused. A good physiotherapist doesn’t just give you exercises; they work with you to understand the mechanics of your pain and gradually build your capacity to move with less discomfort. For musculoskeletal conditions, nerve pain, and post-surgical recovery, the evidence is solid.³
Acupuncture is available through some NHS pathways for specific conditions, including chronic lower back pain and osteoarthritis. The evidence isn’t uniform across all conditions, but for some patients it provides meaningful relief where medication hasn’t.⁴
Hydrotherapy, TENS (transcutaneous electrical nerve stimulation), and massage therapy are also used, typically alongside other approaches rather than as standalone solutions.
Psychological Approaches to Pain Management
Pain is processed in the brain, not just at the site of injury or inflammation. This is why psychological therapies can make a real difference to how pain is experienced and managed, not because the pain is “in your head,” but because the nervous system plays an active role in amplifying or dampening it.
Cognitive Behavioural Therapy (CBT) adapted for chronic pain has good evidence behind it.⁵ It helps people identify thought patterns and behaviours that worsen their experience of pain and develop practical strategies to manage flare-ups. Pain management programmes are often group-based and delivered through NHS pain clinics, combining CBT with physiotherapy, pacing techniques, and education.
Mindfulness-based stress reduction (MBSR) has also been studied for chronic pain, with results suggesting it can reduce pain intensity and improve quality of life in some patients.⁶
Medical Cannabis as an Alternative Pain Relief Option
Medical cannabis became a legal treatment option in the UK in November 2018. It can be prescribed by specialist doctors on the GMC specialist register for patients with qualifying conditions where conventional treatments haven’t provided adequate relief.
Research into cannabis and chronic pain has grown significantly over the past decade. A 2022 systematic review found that cannabinoids showed modest but meaningful reductions in pain scores compared to placebo across several chronic pain conditions.⁷ It’s not a solution for everyone, and it’s not without side effects, but for some patients, it has provided relief where nothing else has.
To be considered, you typically need a diagnosed condition and evidence that at least two other treatments have been tried without sufficient benefit. It’s assessed on a case-by-case basis by a specialist clinician.
If you’re living with pain that hasn’t responded well to standard treatments, it may be worth finding out whether you could be eligible. You can take LeafEase’s free eligibility check to get a clearer picture.
Combining Approaches
Most people managing chronic pain effectively aren’t relying on a single treatment. Pain specialists increasingly advocate for a multimodal approach; combining physical therapy, psychological support, lifestyle modifications, and, where appropriate, medication or medical cannabis.
The goal isn’t to eliminate pain entirely. For many people with complex or long-standing conditions, a more realistic aim is reducing pain to a level that allows them to sleep, work, and engage with their lives again. That target is worth working toward, and the routes available to get there are wider than they might seem.
This article is for informational purposes only and does not constitute medical advice. Medical cannabis treatment requires a consultation with a qualified specialist clinician. To find out whether you may be eligible, visit leafease.co.uk.
Frequently Asked Questions
What are the main alternatives to painkillers for chronic pain?
Physical therapies such as physiotherapy and acupuncture, psychological approaches like CBT and mindfulness, pain management programmes, and clinically supervised options like medical cannabis are all used in the UK for chronic pain. The most effective approach for any individual depends on the nature of their condition, previous treatments, and overall health.
Can I get alternative pain treatments on the NHS?
Some alternatives are available on the NHS, including physiotherapy, certain acupuncture pathways, and pain management programmes. Access varies by region and condition. Medical cannabis is rarely prescribed by the NHS at present; most patients access it through licensed private clinics.
What is the difference between chronic pain and acute pain?
Acute pain is short-term pain that typically arises from an injury or illness and resolves as the body heals. Chronic pain persists beyond the expected recovery period, usually defined as pain lasting more than three months, and may continue even without obvious ongoing tissue damage.
Are there risks to long-term painkiller use?
Yes. Long-term use of opioids carries risks including tolerance, dependency, constipation, and cognitive effects. NSAIDs taken over long periods can affect kidney function and increase the risk of gastrointestinal problems. Your GP or pain specialist can advise on managing these risks.
How do I access medical cannabis for pain in the UK?
You can access medical cannabis through a licensed private clinic. You’ll need a qualifying diagnosis and evidence that at least two other treatments haven’t provided adequate relief. A specialist doctor will review your case before any prescription is issued.
Is medical cannabis the same as CBD?
No. CBD products sold in shops and online are not prescription medicines and are not the same as cannabis-based products for medicinal use (CBPMs). Medical cannabis is a prescription-only treatment involving regulated formulations that may contain THC, CBD, or both, prescribed by a GMC-registered specialist.
Can medical cannabis be used alongside other pain treatments?
In many cases, yes. A specialist clinician will review your full treatment history and current medications before prescribing, and will factor in any potential interactions. Medical cannabis is often used as part of a broader pain management plan rather than as a replacement for everything else.
References:
- [1] Vowles, K.E., McEntee, M.L., Julnes, P.S., Frohe, T., Ney, J.P. & van der Goes, D.N. (2015) Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis. Pain, 156(4), pp. 569–576. https://doi.org/10.1097/01.j.pain.0000460357.01998.f1
- [2] National Institute for Health and Care Excellence (2021) Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain. NICE Guideline NG193. Available at: https://www.nice.org.uk/guidance/ng193
- [3] Geneen, L.J., Moore, R.A., Clarke, C., Martin, D., Colvin, L.A. & Smith, B.H. (2017) Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database of Systematic Reviews, 4, CD011279. https://doi.org/10.1002/14651858.CD011279.pub3
- [4] Vickers, A.J., Vertosick, E.A., Lewith, G., MacPherson, H., Foster, N.E., Sherman, K.J., Irnich, D., Witt, C.M. & Linde, K. (2018) Acupuncture for chronic pain: update of an individual patient data meta-analysis. Journal of Pain, 19(5), pp. 455–474. https://doi.org/10.1016/j.jpain.2017.11.005
- [5] Williams, A.C.C., Fisher, E., Hearn, L. & Eccleston, C. (2020) Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database of Systematic Reviews, 8, CD007407. https://doi.org/10.1002/14651858.CD007407.pub4
- [6] Hilton, L., Hempel, S., Ewing, B.A., Apaydin, E., Xenakis, L., Newberry, S., Colaiaco, B., Maher, A.R., Shanman, R.M., Sorbero, M.E., & Maglione, M.A. (2017). Mindfulness meditation for chronic pain: systematic review and meta-analysis. Annals of Behavioural Medicine, 51(2), pp. 199–213. https://doi.org/10.1007/s12160-016-9844-2
- [7] Aviram, J. & Samuelly-Leichtag, G. (2022) Efficacy of cannabis-based medicines for pain management: a systematic review and meta-analysis of randomised controlled trials. Pain Physician, 20(6), pp. E755–E796.
