GeriPAIN: First comprehensive S3 guideline for pain management in older people published in Germany

22.10.2025 16:35

This week, the German Pain Society (Deutsche Schmerzgesellschaft eV) officially published the first national and international S3 guideline specifically for older people with acute and chronic pain: "Pain Management in Geriatric Patients (GeriPAIN)." The guideline is registered in the AWMF Guideline Register (registration number: 145-002) under the designation "S3 Guideline" and is now freely available to all medical professionals, nurses, therapists, and decision-makers in healthcare.

Among those involved in the creation of the new guideline was Prof. Dr. Erika Sirsch, Professor of Nursing Science at the Medical Faculty of the University of Duisburg-Essen and the University Hospital Essen.

Pain is not a „normal“ age-related issue – but a risk factor

In Germany, over 22 percent of the population is already 65 years of age or older – a number that continues to rise. Geriatric patients are particularly sensitive to pain and at risk due to multimorbidity, polypharmacy, and cognitive impairment. Pain is not just a symptom, but a key predictor of frailty, a tendency to fall, the need for care, and increased mortality. Despite these risks, pain in older people often remains undiagnosed or inadequately treated – often because it is dismissed as "normal" in old age. This misperception has serious consequences for quality of life and well-being.

Evidence-based recommendations for safe and individual therapy

„"GeriPAIN" provides, for the first time, structured, evidence-based guidance for the diagnosis and treatment of pain in older people. The guideline addresses specific challenges such as the recognition of pain in people with dementia or cognitive impairment. It provides clear recommendations for non-pharmacological therapies such as physical therapy, occupational therapy, psychosocial support, and exercise therapy. At the same time, safe and effective pharmacological strategies are presented, based on individual risks and interactions. Invasive procedures such as targeted injections or nerve blocks are recommended only when clearly indicated and taking the overall risk profile into account.

A key scientific benefit lies in the integration of interdisciplinary perspectives: physicians, nurses, therapists, social workers, and patients are equally involved in the care process. This promotes holistic, patient-centered care that goes beyond mere symptom management.

Participation of those affected

A special feature of the "GeriPAIN" development is the active involvement of a representative of those affected by pain right from the application stage. Heike Norda from UVSD SchmerzLOS eV was involved in the process not only as an expert but also as someone with life experience. This underscores the objective of the guideline: to provide pain management from the perspective of those affected.

For more safety, quality and participation in old age

„"GeriPAIN" aims to increase patient safety, prevent gaps in care, and strengthen interprofessional collaboration in pain management. Clear, evidence-based recommendations enable better quality care that is both more cost-effective and more sustainable. At the same time, the guideline promotes the participation of older people in their own healthcare—a central concern of modern medicine.

A new standard for care in old age

With the publication of "GeriPAIN," a comprehensive, interprofessional, and cross-sectoral approach to pain management in older people in Germany is established for the first time – in outpatient, acute inpatient, and long-term inpatient care. The guideline builds on the existing S3 guideline "Pain Assessment in Older People in Full-Time Geriatric Care" (AWMF registry number 145-001) and expands it to include key aspects of diagnosis as well as non-pharmacological, pharmacological, and invasive pain therapy. This creates a previously lacking systematic framework for holistic pain management in old age.

Access and distribution

The complete S3 guideline "GeriPAIN" is now freely accessible in the AWMF guideline register and on the website of the German Pain Society (https://www.deutsche-schmerzgesellschaft.de). It is thus available to all professionals and interested parties to sustainably improve the care of older people with pain in Germany.

The development of the guideline was funded by the Innovation Fund of the Federal Joint Committee (reference number: 01VSF22017). The project was coordinated by the German Pain Society (Deutsche Schmerzgesellschaft eV) under the project leadership of Prof. Dr. Erika Sirsch (Essen), Prof. Dr. Thomas Fischer (Dresden), Dr. Corinna Drebenstedt (Friesoythe), and Heike Norda (UVSD SchmerzLOS eV).