Women in Pain

Feature on World Confederation of Physical Therapist website: WCPT news January 2008.

BY PHYLLIS BERGER

Every physical therapist needs to draw attention to the important issues surrounding chronic pain in women, says Phyllis Berger, physical therapist representative on the International Association for the Study of Pain’s task force for the Global Year against Pain in Women.

The International Association for the Study of Pain (IASP) has dedicated a Global Year to Pain in Women, which began in October 2007. The “Real Women, Real Pain” campaign has been launched to draw attention to the significant impact of chronic pain on women and the lack of attention to this global problem.

Research has shown that chronic pain affects more women than men around the world, but women are also less likely to receive treatment. This is due to various societal and cultural factors and economic and governmental barriers. Through the campaign, IASP hopes to provide a voice to these women.

Knowledge is power and by information and education women will become advocates for themselves and others. The campaign will educate the public, healthcare providers and government agencies about the lack of diagnosis and adequate treatment of chronic pain in women. One of the biggest barriers to pain management is lack of knowledge in health care providers.

Chronic pain conditions which affect women more than men include fibromyalgia, irritable bowel syndrome (IBS), rheumatoid arthritis, osteoarthritis, temporomandibular joint disorder and migraine headache. Included in chronic pain in women are pregnancy, childbirth, chronic pelvic pain (endometriosis, adhesions) and opportunistic infectious processes and cancers of the pelvis and genitourinary tract.

For every 10 adult men living with HIV, 14 women are infected – and pain in HIV/AIDS is highly prevalent and diverse.

Women appear to experience pain differently than men, and it is believed that this difference is due to numerous genetic, hormonal and pharmacological influences. Anatomical differences in the brain may also be involved. One key influence in women may be that sex hormones such as oestrogen suppress the body’s natural pain relief systems. According to some studies, gender differences in pain prevalence appear to attenuate after the reproductive years.

Access to healthcare services, particularly in poverty stricken areas of the developing world, can act as a barrier for women seeking help for pain conditions and as a result there is a prevalence of most types of pain in developing countries compared with developed countries. Cultural factors also influence a woman’s likelihood of seeking treatment for medical conditions. For example, in many cultures, women believe that their suffering is part of their role in society. Treatment by a male healthcare provider may bring shame to a woman’s family, forcing her to go without treatment.

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