By Ruth Graham | The Boston Globe | June 15, 2014
If you stopped the average person in an emergency room and asked why she’s there—not just her guess at the problem, but what really motivated her to show up—the number one answer would be “pain.”
Women are twice as likely as men to suffer from migraines; African-Americans were 1.4 times as likely as whites to report recent pain that interfered with their lives; both white and black test subjects rate blacks’ pain as less intense than whites; women are up to 25 percent less likely than men to receive opiod painkillers when they come to the ER with acute abdominal pain.
For all that modern medicine has learned about disease and treatment, it’s alleviating pain that still lies at the heart of the profession. And in recent years, the notion of treating “pain” as its own entity has been rising to the forefront in medicine. Pain management now has its own journals, conferences, clinics, and specialists, and pain relief is sometimes referred to as a human right. The Institute of Medicine reports there are more than 100 million chronic pain sufferers in the United States, and others have estimated the problem costs $60 billion a year in lost productivity. In September, a coalition that includes the FDA, the CDC, and the NIH is expected to release a long-awaited “National Pain Strategy.”
But as pain rises on the agenda for clinicians and patients, research is uncovering some unsettling facts about how it really affects people. First, not everyone experiences pain similarly. In experiments, women and black people have frequently shown lower pain tolerance when asked to do things like hold their hands in ice water. Gender differences in pain prevalence and intensity emerge in adolescence, and for reasons not fully understood, women are particularly vulnerable to conditions including migraines, back pain, and fibromyalgia. Low-income Americans, too, are more likely to suffer pain than their high-income peers: They are likelier to be engaged in manual labor, to eat poorly, and to go to the doctor less often, to name just a few causes. Among pain patients, blacks and Hispanics are likelier to report their pain is severe. Continue reading »