(BlackDoctor.org) — Pain affects more than 116 million Americans annually and is a major cause of work disability and one of the most common reasons for taking medication, according to a 2011 Institute of Medicine report.
Of those Americans, about 50 million are women, according Campaign to End Chronic Pain in Women.
Today, a new study in the Journal of Pain reports that women seeking medical care for a wide range of medical problems in the hospital or clinics at Stanford University School of Medicine reported higher pain intensity, on average, compared with men with these same diagnoses.
Women reported more intense pain than men in 14 of 47 disease categories. Men did not report more intense pain in any category. Women with musculoskeletal disorders such as back, neck and joint pain, sinusitis and even high blood pressure reported more intense pain then men with these conditions.
Authors cautioned that this study cannot determine whether pain is actually experienced more intensely by women or whether women simply communicate better with their health care providers about pain.
But many other medical experts are skeptical about the Stanford study. They say the authors didn’t account for the possibility that if many women had additional diseases that caused pain, it could actually be the other diseases, and not their gender, which is responsible for the women having more pain than men.
“It’s a flawed study,” said Dr. Lloyd Saberski, medical director of the Advanced Diagnostic Pain Treatment Centers at Yale University. “Just how accurate is the data collected? Probably not too accurate.”
He said the study was “dangerous” and potentially misleading and adds “nothing” to doctors’ understanding of pain. Researchers did not control for factors such as coexisting depression and disease severity, he said.
Dr. Timothy Collins, assistant clinical professor of neurology at Duke University Medical Center, said researchers should have added this caveat: “Men consistently report lower levels of pain compared to women.”
“At least in the US, there is a culture expecting men to complain less, not admit to as much pain, where women are generally allowed to express pain and emotions connected with pain,” he said.
Dr. Carol Warfield, chairman of the department of anesthesia, critical care and pain medicine at Boston’s Beth Israel Deaconess Medical Center agreed the study was interesting, but a “big point” was missed.
“There have been a number of reports indicating that in our society stoicism is often considered virtuous, especially in men,” she said. “Therefore, men may be less likely to report high levels of pain even if they perceive them. In other words, men and women may experience the same levels of pain but women are more likely to actually admit that they have pain.”
Does Communicating Emotion Help Or Hurt?
Studies have suggested that doctors do tend to treat women in pain differently than they do men.
Doctors will ask women more often questions such as, “Are you feeling emotional?” or “How are things at home?”
Mindy Meyer, a professional facilitator who has lived with complex regional pain syndrome and fibromyalgia for years, agrees.
“I don’t know if women actually feel pain more,” said the 45-year-old from Venice Beach, Calif. “If they test by putting you hand in an ice bucket and see how long you can keep it there, maybe women are smart enough to take it out sooner.”
“But how women and men communicate their pain is very different,” she said. “Women feel very connected to their pain and have and their emotions come out when describing it.”
Meyer saw 13 doctors before she got a proper diagnosis and the majority were men. “It’s very uncomfortable for them to see real emotion: ‘Tell me the facts, ma’am, just the facts.’ I see them tune out.”
Now, she consciously spares the doctor the emotional talk. “I can literally be in so much pain I am crying when the staff is in there, but I pull it together when the doctor is in the room and have no tears at all. And it’s not easy to have to do that.”
She said doctors need to listen more to their female patients — “feelings are a part of the equation. Patients shouldn’t have to shut things down.”
The perceived need for better treatment of women in pain has led to the creation of For Grace, an advocacy organization that educates, supports and empowers women in pain through annual conferences and legislative outreach.
For Grace’s “Fail First” bill recently got through the California State Assembly’s appropriations committee on a 12-5 vote. If signed by the governor, it will allow women in pain much better access to pain medications, bypassing insurance companies.