Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2012

Open Access 01-12-2012 | Research article

Gender differences in pain levels before and after treatment: a prospective outcomes study on 3,900 Swiss patients with musculoskeletal complaints

Authors: Cynthia K Peterson, B Kim Humphreys, Jürg Hodler, Christian WA Pfirrmann

Published in: BMC Musculoskeletal Disorders | Issue 1/2012

Login to get access

Abstract

Background

Current studies comparing musculoskeletal pain levels between the genders focus on a single point in time rather than measuring change over time. The purpose of this study is to compare pain levels between males and females before and after treatment.

Methods

Eleven different patient cohorts (3,900 patients) included in two prospective outcome databases collected pain data at baseline and 1 month after treatment. Treatments were either imaging-guided therapeutic injections or chiropractic therapy. The Mann–Whitney U test was used to calculate differences in numerical rating scale (NRS) median scores between the genders for both time points in all 11 cohorts.

Results

Females reported significantly higher baseline pain scores at 4 of the 11 sites evaluated (glenohumeral (p = 0.015), subacromial (p = 0.002), knee (p = 0.023) injections sites and chiropractic low back pain (LBP) patients (p = 0.041)). However, at 1 month after treatment there were no significant gender differences in pain scores at any of the extremity sites. Only the chiropractic LBP patients continued to show higher pain levels in females at 1 month.

Conclusions

In these 11 musculoskeletal sites evaluated before and after treatment, only 3 extremity sites and the chiropractic LBP patients showed significantly higher baseline pain levels in females. At 1 month after treatment only the LBP patients had significant gender differences in pain levels. Gender evaluation of change in pain over time is likely to be more clinically important than an isolated pain measurement for certain anatomical sites.
Appendix
Available only for authorised users
Literature
2.
go back to reference Ruau D, Liu LY, Clark D, Angst MS, Butte AJ: Sex differences in reported pain across 11,000 patients captured in electronic medical records. The Journal of Pain. 2011, 10.1016/j.jpain.2011.11.002. Ruau D, Liu LY, Clark D, Angst MS, Butte AJ: Sex differences in reported pain across 11,000 patients captured in electronic medical records. The Journal of Pain. 2011, 10.1016/j.jpain.2011.11.002.
3.
go back to reference Pizzo P, Clark N: Relieving pain in America: A blueprint for transforming prevention, care, education, and research. 2011, Washington: DC, National Academies Press Pizzo P, Clark N: Relieving pain in America: A blueprint for transforming prevention, care, education, and research. 2011, Washington: DC, National Academies Press
4.
go back to reference Bingefors K, Isacson D: Epidemiology, co-morbidity, and impact on health-related quality of life of self-reported headache and musculoskeletal pain – a gender perspective. Eur J Pain. 2004, 8: 435-450. 10.1016/j.ejpain.2004.01.005.CrossRefPubMed Bingefors K, Isacson D: Epidemiology, co-morbidity, and impact on health-related quality of life of self-reported headache and musculoskeletal pain – a gender perspective. Eur J Pain. 2004, 8: 435-450. 10.1016/j.ejpain.2004.01.005.CrossRefPubMed
5.
go back to reference Rustoen T, Wahl AK, Hanestad BR, Lerdal A, Paul S, Miaskowski C: Gender differences in chronic pain – Findings from a population-based study of Norwegian adults. Pain Manag Nurs. 2004, 5: 105-117. 10.1016/j.pmn.2004.01.004.CrossRefPubMed Rustoen T, Wahl AK, Hanestad BR, Lerdal A, Paul S, Miaskowski C: Gender differences in chronic pain – Findings from a population-based study of Norwegian adults. Pain Manag Nurs. 2004, 5: 105-117. 10.1016/j.pmn.2004.01.004.CrossRefPubMed
6.
go back to reference Fillingim R, King CD, Ribeiro-DaSilva MC, Rahim-Williams B, Riley JL: Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009, 10: 447-485.CrossRefPubMedPubMedCentral Fillingim R, King CD, Ribeiro-DaSilva MC, Rahim-Williams B, Riley JL: Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009, 10: 447-485.CrossRefPubMedPubMedCentral
7.
go back to reference Popescu A, LeResche L, Truelove EL, Drangsholt MT: Gender differences in pain modulation by diffuse noxious inhibitory controls: a systematic review. Pain. 2012, 150: 309-318.CrossRef Popescu A, LeResche L, Truelove EL, Drangsholt MT: Gender differences in pain modulation by diffuse noxious inhibitory controls: a systematic review. Pain. 2012, 150: 309-318.CrossRef
8.
go back to reference Racine M, Tousignant-Laflamme Y, Kloda LA, Dion D, Dupuis G, Choinière M: A systematic literature review of 10 years of research on sex/gender and experimental pain perception – Part 1: are there really differences between women and men?. Pain. 2011, 10.1016/j.pain.2011.11.025. Racine M, Tousignant-Laflamme Y, Kloda LA, Dion D, Dupuis G, Choinière M: A systematic literature review of 10 years of research on sex/gender and experimental pain perception – Part 1: are there really differences between women and men?. Pain. 2011, 10.1016/j.pain.2011.11.025.
9.
go back to reference Humphreys BK, Peterson CK, Muehlemann D, Haueter P: Are Swiss Chiropractors so Different? Results from the Swiss Job Analysis Survey 2009. J Manipulative Physiol Ther. 2010, 33: 519-535. 10.1016/j.jmpt.2010.08.003.CrossRefPubMed Humphreys BK, Peterson CK, Muehlemann D, Haueter P: Are Swiss Chiropractors so Different? Results from the Swiss Job Analysis Survey 2009. J Manipulative Physiol Ther. 2010, 33: 519-535. 10.1016/j.jmpt.2010.08.003.CrossRefPubMed
10.
go back to reference Schnabel A, Poepping DM, Gerss J, Zahn PK, Pogatzki-Zahn EM: Sex-related differences of patients-controlled epidural analgesia for postoperative pain. Pain. 2012, 153: 238-244. 10.1016/j.pain.2011.10.022.CrossRefPubMed Schnabel A, Poepping DM, Gerss J, Zahn PK, Pogatzki-Zahn EM: Sex-related differences of patients-controlled epidural analgesia for postoperative pain. Pain. 2012, 153: 238-244. 10.1016/j.pain.2011.10.022.CrossRefPubMed
11.
go back to reference Cepeda MS, Africano JM, Polo R, Alcala R, Carr DB: What decline in pain intensity is meaningful to patients with acute pain?. Pain. 2003, 105: 151-157. 10.1016/S0304-3959(03)00176-3.CrossRefPubMed Cepeda MS, Africano JM, Polo R, Alcala R, Carr DB: What decline in pain intensity is meaningful to patients with acute pain?. Pain. 2003, 105: 151-157. 10.1016/S0304-3959(03)00176-3.CrossRefPubMed
12.
go back to reference Cepeda MS, Africano JM, Polo R, Alcala R, Carr DB: Agreement between percentage pain reductions calculated from numeric rating scores of pain intensity and those reported by patients with acute or chronic pain. Pain. 2003, 106: 439-442. 10.1016/j.pain.2003.09.006.CrossRefPubMed Cepeda MS, Africano JM, Polo R, Alcala R, Carr DB: Agreement between percentage pain reductions calculated from numeric rating scores of pain intensity and those reported by patients with acute or chronic pain. Pain. 2003, 106: 439-442. 10.1016/j.pain.2003.09.006.CrossRefPubMed
13.
go back to reference Carmona L, Ballina J, Gabriel R, Laffon A: The burden of musculoskeletal diseases in the general population of Spain: results from a national survey. Ann Rheum Dis. 2001, 60: 1040-1045. 10.1136/ard.60.11.1040.CrossRefPubMedPubMedCentral Carmona L, Ballina J, Gabriel R, Laffon A: The burden of musculoskeletal diseases in the general population of Spain: results from a national survey. Ann Rheum Dis. 2001, 60: 1040-1045. 10.1136/ard.60.11.1040.CrossRefPubMedPubMedCentral
14.
go back to reference Ihlebaek C, Hansson TH, Laerum E, Brage S, Eriksen HR, Holm SH, Svendsrod R, Indahl A: Prevalence of low back pain and sickness absence: a “borderline” study in Norway and Sweden. Scand J Public Health. 2006, 34: 555-558. 10.1080/14034940600552051.CrossRefPubMed Ihlebaek C, Hansson TH, Laerum E, Brage S, Eriksen HR, Holm SH, Svendsrod R, Indahl A: Prevalence of low back pain and sickness absence: a “borderline” study in Norway and Sweden. Scand J Public Health. 2006, 34: 555-558. 10.1080/14034940600552051.CrossRefPubMed
15.
go back to reference Schmidt CO, Raspe H, Pfingsten M, Hasenbring M, Basler HD, Eich W, Kohlmann T: Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey. Spine. 2007, 32: 2005-2011. 10.1097/BRS.0b013e318133fad8.CrossRefPubMed Schmidt CO, Raspe H, Pfingsten M, Hasenbring M, Basler HD, Eich W, Kohlmann T: Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey. Spine. 2007, 32: 2005-2011. 10.1097/BRS.0b013e318133fad8.CrossRefPubMed
16.
go back to reference Schneider S, Randoll D, Buchner M: Why do women have back pain more than men? A representative prevalence study in the federal republic of Germany. Clin J Pain. 2006, 22: 738-747. 10.1097/01.ajp.0000210920.03289.93.CrossRefPubMed Schneider S, Randoll D, Buchner M: Why do women have back pain more than men? A representative prevalence study in the federal republic of Germany. Clin J Pain. 2006, 22: 738-747. 10.1097/01.ajp.0000210920.03289.93.CrossRefPubMed
17.
go back to reference Webb R, Brammah T, Lunt M, Urwin M, Allison T, Symmons D: Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general populations. Spine. 2003, 28: 1195-1202.PubMed Webb R, Brammah T, Lunt M, Urwin M, Allison T, Symmons D: Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general populations. Spine. 2003, 28: 1195-1202.PubMed
18.
go back to reference Takatalo J, Karppinen J, Niinimäki J, Taimela S, Näyhä S, Marjo-Riitta J, Kyllönen E, Tervonen O: Prevalence of degenerative imaging findings in lumbar magnetic resonance imaging among young adults. Spine. 2009, 34: 1716-1721. 10.1097/BRS.0b013e3181ac5fec.CrossRefPubMed Takatalo J, Karppinen J, Niinimäki J, Taimela S, Näyhä S, Marjo-Riitta J, Kyllönen E, Tervonen O: Prevalence of degenerative imaging findings in lumbar magnetic resonance imaging among young adults. Spine. 2009, 34: 1716-1721. 10.1097/BRS.0b013e3181ac5fec.CrossRefPubMed
19.
go back to reference Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N: Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine. 2001, 26: 1873-1878. 10.1097/00007632-200109010-00011.CrossRefPubMed Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N: Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine. 2001, 26: 1873-1878. 10.1097/00007632-200109010-00011.CrossRefPubMed
20.
go back to reference Matsumoto M, Fujimura Y, Suzuki N, Nishi Y, Nakamura M, Yabe Y, Shiga H: MRI of cervical intervertebral discs in asymptomatic subjects. J Bone Joint Surg (Br). 1998, 80-B: 19-24.CrossRef Matsumoto M, Fujimura Y, Suzuki N, Nishi Y, Nakamura M, Yabe Y, Shiga H: MRI of cervical intervertebral discs in asymptomatic subjects. J Bone Joint Surg (Br). 1998, 80-B: 19-24.CrossRef
21.
go back to reference Yezierski RP: The effects of age on pain sensitivity: preclinical studies. Pain Med. 2012, 10.1111/j.1526-4637.2011.01311.x. Yezierski RP: The effects of age on pain sensitivity: preclinical studies. Pain Med. 2012, 10.1111/j.1526-4637.2011.01311.x.
22.
go back to reference Kongsted A, Leboeuf-Yde C: The Nordic back pain subpopulation program – individual patterns of low back pain established by means of text messaging: a longitudinal pilot study. Chiropr Osteopat. 2009, 17: 11-10.1186/1746-1340-17-11.CrossRefPubMedPubMedCentral Kongsted A, Leboeuf-Yde C: The Nordic back pain subpopulation program – individual patterns of low back pain established by means of text messaging: a longitudinal pilot study. Chiropr Osteopat. 2009, 17: 11-10.1186/1746-1340-17-11.CrossRefPubMedPubMedCentral
23.
go back to reference Kongsted A, Leboeuf-Yde C: The Nordic back pain subpopulation program: course patterns established through weekly follow-ups in patients treated for low back pain. Chiropr Osteopat. 2010, 18: 2-10.1186/1746-1340-18-2.CrossRefPubMedPubMedCentral Kongsted A, Leboeuf-Yde C: The Nordic back pain subpopulation program: course patterns established through weekly follow-ups in patients treated for low back pain. Chiropr Osteopat. 2010, 18: 2-10.1186/1746-1340-18-2.CrossRefPubMedPubMedCentral
24.
go back to reference Axén I, Rosenbaum A, Röbech R, Wren T, Leboeuf-Yde C: Can patient reactions to the first chiropractic treatment predict early favorable treatment outcome in persistent low back pain?. J Manipulative Physiol Ther. 2002, 25: 450-4. 10.1067/mmt.2002.126473.CrossRefPubMed Axén I, Rosenbaum A, Röbech R, Wren T, Leboeuf-Yde C: Can patient reactions to the first chiropractic treatment predict early favorable treatment outcome in persistent low back pain?. J Manipulative Physiol Ther. 2002, 25: 450-4. 10.1067/mmt.2002.126473.CrossRefPubMed
Metadata
Title
Gender differences in pain levels before and after treatment: a prospective outcomes study on 3,900 Swiss patients with musculoskeletal complaints
Authors
Cynthia K Peterson
B Kim Humphreys
Jürg Hodler
Christian WA Pfirrmann
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2012
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-13-241

Other articles of this Issue 1/2012

BMC Musculoskeletal Disorders 1/2012 Go to the issue