Rethinking pain: a paradigm shift in primary care for chronic pain via community-based, culturally-responsive GP support.

Abstract

Chronic pain presents a complex challenge in general practice, often leading to cycles of over investigation, overprescribing, and underutilization of holistic support. This article explores how GPs can be better supported to identify chronic pain early, make clinically appropriate decisions without overmedicalizing, and confidently signpost patients to non-medical pain support at the right time. Drawing on the example of Rethinking Pain in Bradford, England - a cross-sector initiative that invests in GP education and provides demedicalised, culturally informed, person-centered pain support - we argue for a shift in the primary care paradigm. Importantly, this approach recognizes the valuable and needed role of GPs in chronic pain care - one that does not necessarily require more time, but rather a shift in mindset and confidence. By enabling GPs to intervene more effectively and holistically, this model has the potential to reduce repeated consultations and break the cycle of high-frequency GP use among people living with chronic pain. Empowering GPs with the tools, training, and networks to navigate chronic pain holistically can reduce harm, improve outcomes, and align care with national strategies for sustainable pain management.