Managing chronic pain
Chronic pain has traditionally been managed using a range of approaches, including medicines such as gabapentinoids and opioids, which can play an important role in short-term pain relief. As the evidence base has grown, NICE guidance began to place greater emphasis on reviewing long-term use and supporting people with a broader, more holistic approach to pain management.
Frome Medical Practice is explores sustainable ways of helping pain management
At Frome Medical Practice – a leading practice in sustainability and green impact – there is a strong commitment to improving care for patients and communities, from day-to-day clinical practice to developing innovative projects and wider system change. Recognising that some patients were established on long-term pain medications before this shift in guidance, Dr Georgina Kirby and her team set out to improve care further by exploring a supportive and sustainable approach, helping people regain control over their pain and improve their quality of life.
Launched Chronic Pain Management initiative – Live Well With Pain
With funding from Green & Healthy Frome, the Chronic Pain Initiative invited patients to take part in structured medication reviews, exploring alternative approaches to pain management, and to engage in the Ten Footsteps course – a supportive face-to-face programme designed to empower self-management to live well with persistent pain. Pain Cafés provided welcoming spaces for people to connect, share experiences, and encourage one another on their journey. The approach was not simply about reducing medication, but about offering choice, support, and the resources needed to live well with pain.
Encouraging results
Most importantly, patients reported increased life satisfaction and happiness, a stronger sense that life felt worthwhile, and a significant reduction in anxiety. Many also described an improved ability to take part in everyday activities and live a more normal, active life. Encouragingly, 37% of patients invited to engage with the programme responded. Of those who took part, 54% reduced or stopped their pain medication, and over half were referred to a pain self-management programme: Ten Footsteps programme.
The benefits beyond human health
The benefits extend beyond individual human health. Globally, the pharmaceutical industry has a carbon footprint larger than that of the automotive industry, and within the NHS in England, medicines account for around 25% of total carbon emissions each year. Every reduction in unnecessary medication represents a small but meaningful environmental gain. High-dose opioids and gabapentinoids carry a carbon cost through their manufacture, transport, and disposal; over time, reducing reliance on these medicines contributes to lower emissions and a lighter ecological footprint. Fewer unused or excess medicines also mean fewer pharmaceutical residues entering waterways, helping to protect freshwater ecosystems and the species that depend on them.
Healthier people means for a healthier planet
This is the power of aligning positive health with planetary health: patients regain vitality, communities grow stronger, and our environment is shielded from unnecessary harm. Green and Healthy Frome highlights how individual health choices are deeply interconnected with wider systems, showing that it is possible to create a future in which both people and the planet can thrive.