In August, The New York Times published a guest article by David Roberts, who suffered from chronic pain for years and finally found relief. The article immediately went viral, with prominent journalist and personality Dan Rather posting it on his Facebook page, adding that it could “give hope” to some suffering patients. However, many of us in the chronic pain community, especially women, found this article annoying and upsetting.
The first and most surprising source of shock for me in this work was the part where the author finally revealed his pain to his employer, and it was taken very seriously. Even if there is no specific diagnosis, it is recommended to take a medical leave immediately. This is in stark contrast to the experience of many (if not most) women who view our pain as purely psychological—a physical manifestation of stress, anxiety, or depression.
Women with chronic pain suffer longer and longer than men
Think about it: women in pain are far more likely than men to receive prescriptions for sedatives rather than painkillers. One study found that women who underwent coronary artery bypass graft surgery were half as likely to be prescribed painkillers as men who underwent the same procedure. In the United States, we wait an average of 65 minutes before taking a pain reliever for acute abdominal pain, compared to just 49 minutes for men.
These gender biases in our medical system can have serious and sometimes fatal consequences. For example, a 2000 study published in the New England Journal of Medicine found that women are 7 times more likely than men to be misdiagnosed and discharged from the hospital after a heart attack. Why? This is because the medical concept of most diseases is based on the understanding of male physiology, and the symptoms of a heart attack in women are very different from those in men.
Going back to the issue of chronic pain, let’s say 70% of people who suffer from it are women. However, 80% of pain studies are conducted in males or male mice. One of the few studies examining gender differences in pain perception found that women experience more frequent and more intense pain than men. Although the exact cause of this discrepancy has yet to be determined, biology and hormones are thought to play a role.
For Roberts, his lab tests couldn’t explain his back pain. Eventually, he enrolled in a program at the Mayo Clinic that treats chronic pain as a “sensory dysfunction,” an addiction to self-reinforcing and acting out pain.
The solution, as Robert explains: “…don’t dwell on the pain, try to fix it – no props, no drugs. Eventually the mind has to go.”
Treatment should be individualized
This tactic may have helped the author, but I doubt it would work for many women with gender-specific conditions such as rheumatoid arthritis, multiple sclerosis, chronic migraines, or endometriosis. For me, the monthly (several times a month) bleeding, cramping, daily gastrointestinal issues I ignored, and repeated dismissal of doctors never made my pain go away. Trying to ignore the pain didn’t stop the endometriosis from strangulating the colon and attaching the ovaries and fallopian tubes to the colon. This pain required surgery, and possibly more surgery. Similarly, ignoring the back pain doesn’t stop the nerve compression that pulls, involuntarily, and gives me intermittent convulsions in my right leg. What I need most are doctors who are willing to listen, empathize, and work with me to determine the optimal treatment plan that will minimize my pain and best treat my underlying condition.
While I applaud Roberts for getting rid of his ankle implant “crutches,” people with true degenerative conditions like arthritis and connective tissue disease need these drugs to stabilize their joints and prevent further damage and pain. The Times article asks the medical community to understand that generic solutions to chronic pain may not work for many patients because most of us are women. In fact, since most studies