Who Handles Pain Better: Men or Women?

Well, we don’t know the answer to that, but it hasn’t stopped several  news outlets, including the Daily Mail and MSNBC, from implying that we do. Articles have popped up this week exclaiming that women experience more pain than men. However, an exploration of the original article shows that these news stories may not be completely on the mark (and, they’re not completely off the mark, either).

Sensationalist headlines and ledes aside, both the Daily Mail and MSNBC get into some good science writing, complete with caveats and expert quotes. But let’s get to the source and see what the original journal article really says. For those of you with access to The Journal of Pain (real name ““ isn’t that fantastic and mildly hilarious), here’s the link. For those of you without access, the article was published on January 12, and it was written by David Ruau, Linda Y. Liu, J. David Clark, Martin S. Angst (geez with a name like that, he had to get into pain research), and Atul J. Butte. Its title? “Sex Differences in Reported Pain Across 11,000 Patients Captured in Electronic Medical Records.” That’s a little less flashy.

And with good reason–the article had a whole lot of substance, but it understood its own limitations. The original article had 3 main points: first, medical records could be an extremely useful tool in medical and psychological research, especially research focused on pain; second, men and women self-report statistically significantly different levels of pain for the same ailments; and third, these self-reported pain differences may be due to any number of factors, and there need to be more studies, animal and human, that include both males and females and look explicitly at sex differences.

I know I am a little nutty about science, but I was sad to see only the second point really make it to press (MSNBC did mention the lack of pain research that included female animals). The lack of research in this field, especially the lack of research on female animals and women, coupled with a new resource made available through technology (electronic records) means that our understanding of pain could improve rapidly. This is exciting stuff. It’s also exciting to see scientists find a gap in their field and work to close it, both through their own research and by calling attention to that gap.

It was heartening, though, to see in each article about the study and in the study itself the acknowledgment that the differences in the self-reports of pain could come from a variety of sources. See, self-reported pain in this case was where people ranked themselves on an 11-point scale, with 0 being no pain at all and 10 being the worst pain anyone could ever imagine ever. Patients came in and when they spoke with nurses and physicians, told them where on that scale they fell. So the pain scores could be totally reflective of real pain differences between men and women, perhaps caused by genes or hormones, or they could be caused, at least in part, but gender differences in pain reporting (men may feel pressure to seem strong and stoic).

What’s great about this uncertainty is that when it is stated explicitly, it opens the doors to new, more targeted research that may be able to untangle some of these findings. This is the kind of uncertainty scientists thrive on, opening the door to new questions. It’s not a problem that the researchers don’t know why there are differences in the self-reported pain–it’d only be a problem if it was not reported correctly or at all.