Chronic Pain Management in Primary Care: A Review of Practical, Individualized Approaches for Clinical Practice

Abstract

Background: Chronic pain is a complex condition affecting approximately 20–30% of adults worldwide. Increasing evidence demonstrates that chronic pain is a heterogeneous condition influenced by biological mechanisms, psychological factors, social circumstances and individual patient characteristics. These differences contribute to variable treatment responses and highlight the need for individualized clinical care. Objective: This narrative review provides a practical, clinical framework for individualized chronic pain management in primary care, emphasizing mechanism-informed clinical phenotyping, non-pharmacological and pharmacological interventions, shared decision-making, continuous reassessment and practical implementation within time-constrained practice settings. Methods: A non-systematic literature search of MEDLINE/PubMed, the Cochrane Database of Systematic Reviews and current international clinical guidelines (e.g., IASP, ICD-11, NICE, and CDC) was conducted for contemporary literature published from 2015 to 2026. Evidence was qualitatively selected and synthesized regarding pain mechanisms, primary care assessment, non-pharmacological therapies, modern pharmacotherapy, and health implementation frameworks. Results: Individualized chronic pain care requires the identification of contributing clinical pain mechanisms—nociceptive, neuropathic, nociplastic or mixed—while recognizing that these exist on a continuum rather than as mutually exclusive entities. Effective primary care management prioritizes active non-pharmacological interventions (exercise, pain neuroscience education as part of multidisciplinary rehabilitation, psychological therapies and sleep optimization) followed by selective, mechanism-informed pharmacotherapy. Regular reassessment using multidimensional functional criteria is essential for the optimization of benefit while minimizing treatment-related harms. Conclusion: Primary care clinicians are well positioned to deliver individualized chronic pain management through longitudinal relationships, clinical phenotyping, physical examination and coordinated multimodal care. An individualized approach focused on patient-defined functional goals provides a practical model for improving outcomes in primary care.