What is the WHO Pain Ladder? | Pain Stop Clinics

What is the WHO Pain Ladder?

August 16, 2017

The vast majority of doctors’ consultations focus on pain management, but before 1986, there was no universally understood way to communicate pain levels. Doctors had to intuit their way through pain care one adjective at a time. The World Health Organization developed the pain ladder as a three step grading system to solve this problem.

The WHO Pain Ladder has evolved from a cancer pain guide into a treatment framework for all chronic pain conditions. The ladder leaked into the medical industry, acting as a catalyst for global teaching campaigns that improved pain awareness. It also came at a cost, triggering a cataclysmic opioid crisis.

Treatment-Based Pain Relief

The ladder doesn’t only guide the kind of treatment you receive, but acts as a flag to alert doctors if your condition requires extra investigation. It’s divided into three levels:

  • Step Three: Severe pain levels: Morphine and other opioids are indicated.
  • Step Two: Moderate, constant pain: Codeine and milder opioids are suggested.
  • Step One: Mild pain rated at 1-3 out of 10: Nonsteroidal anti-inflammatories and acetaminophen are best.

The Problem with Pills

Pain management has come a long way since the Eighties. New, non-opioid medications have been developed that address the cause of pain instead of its symptoms without introducing risky, addictive substances. Symptoms should be taken seriously, not stifled thoughtlessly. All unrelieved pain deserves a second and even third assessment. Pain is, after all, a signal that something is wrong. There is a massive range of therapies, from spinal fusion surgery to neuropathic solutions, that treat the foundation of pain.

The pain ladder fails to address each unique case on its own merits. In medicine, it’s often said that you should treat the patient, not the numbers. Physicians must advance towards a more personalized approach to care. Pain Stop Clinics will support you and your condition compassionately.

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