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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Pharmacodynamics in Geriatric Patients: Effects of Age01:27

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Related Experiment Video

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Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
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Adopting Principles to Guide Pathways: The Best Model for Geriatric Pain Management.

Corey B Simon1, Stephanie A Eucker2, Kenneth E Schmader3

  • 1Department of Orthopaedic Surgery, Duke University School of Medicine, Duke Clinical Research Institute, Durham, NC, USA.

Clinics in Geriatric Medicine
|November 21, 2025
PubMed
Summary

Older adults face significant chronic pain and disability. New principles, including the biopsychosocial framework and function-focused care, are proposed to improve geriatric pain management pathways.

Keywords:
Biopsychosocial modelCommunicationFunctional outcomesGeriatric painPatient expectationsTherapeutic alliance

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Area of Science:

  • Geriatric Medicine
  • Pain Management
  • Public Health

Background:

  • Older adults bear the highest burden of chronic pain and related disability.
  • Current pain management pathways (multimodal, stepped, stratified) are insufficient for complex geriatric care.
  • The need for improved, patient-centered approaches in geriatric pain management is critical.

Purpose of the Study:

  • To propose guiding principles for developing effective geriatric pain management pathways.
  • To advocate for a nuanced application of the biopsychosocial framework in older adults.
  • To emphasize individualized, function-focused care for chronic pain in the elderly.

Main Methods:

  • Literature review and synthesis of existing pain management strategies.
  • Conceptual framework development based on the biopsychosocial model.
  • Analysis of challenges and opportunities in geriatric pain care delivery.

Main Results:

  • Key principles include adopting the biopsychosocial framework with nuance.
  • Effective communication, coaching, and managing expectations are vital.
  • Focusing on movement, function, and safe pain-modulatory interventions is essential.

Conclusions:

  • These principles support individualized, patient-centered, and function-focused pain care for older adults.
  • A comprehensive approach is needed to address the complexity of geriatric pain.
  • Optimized pain management pathways can reduce disability and improve quality of life in older populations.