[Pain in geriatrics]

Pain is a frequent problem in aged population and often undertreated despite undesirable effects such as depression, malnutrition, sleep disturbance, decreased socialization, impaired ambulation with increased risk of falls problems, adverse effects from multiple inadequate drugs prescriptions, cognitive and behaviour impairments. Detection, diagnosis of the causes, evaluation with specific scales and adapted therapy of pain are essential to preserve quality of life and autonomy. Pharmacological therapy using the three-step analgesic ladder of W.H.O. is appropriate owing to individual age-related sensitivity which requires to follow the rule of "start low and go slow" with regular pain and side effects assessments, particularly for opioids. For chronic pain, non pharmacological strategies optimise pain management in addition to medications. Comprehensive geriatric assessment is recommended to complete the global view of the frailed patient with the help of a multidisciplinary team.