7. Pain: Different In Men and Women?

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By Thomas J. Haverbush, M.D.

Transforming patient information into patient understanding.

Treating pain and improving function is the job of all Orthopaedic Surgeons. Pain can certainly affect how well patients are able to function.

I would like to make my patients pain free and enable them to do the activities they need to do.

Pain

Pain from the different conditions our patients have varies tremendously. How do you judge how much pain a person should be having from a migraine headache or sciatica from a ruptured disc? It’s highly individual and variable.

It is easier to access pain coming from the surgery we do. After doing dozens or hundreds of a particular operation you kind of get a good idea about how much pain results from the surgery in the average patient. It is a bell shaped curve.

Some research has speculated that based on lab studies women’s pain receptors are different from men’s. It has never been proven.

Genetics. There are subtle differences not only between men and women, but between individual patients related to genetic makeup and perception of pain.

Pain Expression

Stoic. Some patients are stoic creatures who grit their teeth and endure pain.

Drama Queen (or King). Some patients express pain in vivid detail using words such as gnawing or sharp stabbing.

Then you have socio-cultural factors and secondary gain which greatly affect the patient’s description of pain.

Some patients feel if they don’t present their pain vividly and loudly, they won’t be taken as seriously.

Also caregivers are influenced tremendously by the patient’s pain presentation. Louder complaints, sometimes greater attention.

Doctors

A male doctor may have less tolerance or understanding about a woman’s pain complaints than a female doctor would. A doctor may take a woman’s pain complaints less seriously than complaints from a male, simply because the doctor believes that a man will only talk about it if it “really” hurts. And the reverse is sometimes true too.

Same Surgery, Vastly Different Response

I have been mystified for years about how you can do the same surgery (let’s take total knee replacement), use the same postoperative medications and protocol and one patient does beautifully and another is wiped out for days.

We are not able as yet to identify which person will say after surgery that they felt like a truck ran over them. Someday I think we will be able to know in advance and will possess proper treatment so a very painful postoperative experience doesn’t happen.

Bottom Line

• All of us, probably based on genetics feel pain differently from each other.

• Women as a group may be more expressive about their pain than men.

• Pain medications we use affect patients in greatly different ways.

• Patients can really help doctors by describing pain accurately regarding location, intensity, what makes it worse/better. Don’t minimize or exaggerate as it confuses the doctor.

• It is a very complicated subject that lacks at lot of answers.

My patients put their trust in me and what I do improves the quality of their lives.

Lakeview Times Orthopaedic Zone
All Orthopaedic Surgery problems including this week’s subject can be evaluated by Dr. Haverbush at his office.

315 Warwick Drive

Alma, Michigan 48801

Phone 989-463-6092

Office is across the street from Gratiot Medical Center.

Please call to make an appointment usually the same week you call
Attention!! Besides what you read today there is a huge amount of musculoskeletal information on the office website www.orthopodsurgeon.com. Please check it out.

Be well.

Dr. Haverbush

 

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