What is the WHO pain relief ladder?

The WHO pain relief ladder is a systematic framework designed for the management of pain, particularly in patients with cancer but applicable to a wide range of pain management scenarios. It emphasizes a stepwise approach that begins with non-opioid analgesics, such as acetaminophen or NSAIDs, for managing mild pain. As pain severity increases or if the initial treatment proves insufficient, the ladder advocates for the introduction of weak opioids, such as codeine or tramadol. Finally, for moderate to severe pain, the use of strong opioids, like morphine or oxycodone, is recommended.

This stepwise progression allows for a tailored approach to pain management that takes into consideration both the intensity of the pain and the potential for side effects associated with more potent medications. The structure of the ladder helps clinicians make informed decisions about appropriate analgesic use, optimizing pain relief while minimizing risk to the patient.

In contrast, other options do not accurately represent the purpose or methodology of the WHO ladder. Simply listing medications by preference or prioritizing opioid use from the outset does not align with the progressive strategy that is central to the ladder's design. Also, limiting the definition of the ladder to a surgical protocol overlooks its broader application to various types of pain management