Management of pain in the terminally ill

Pain is common in terminal illness. It is a multidimensional experience and requires an integrated approach for its management to be successful.Pharmacological treatment follows the World Health Organization pain ladder, with early use of strong opioid analgesia in moderate-to-severe cancer pain. A variety of opioids are now available and choice will be tailored to the individual needs of the patient. Complex pain states, such as neuropathic and cancer-induced bone pain, often require multi-modal treatment with adjuvant analgesia and interventional techniques. In the final days of life, drugs will be administered by continuous parenteral infusion, and titrated until symptom control is achieved.