期刊论文详细信息
BMC Musculoskeletal Disorders
Gender differences in pain levels before and after treatment: a prospective outcomes study on 3,900 Swiss patients with musculoskeletal complaints
Christian WA Pfirrmann2  Jürg Hodler3  B Kim Humphreys1  Cynthia K Peterson4 
[1] Department of Chiropractic, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008, Zürich, Switzerland;Department of Radiology, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008, Zürich, Switzerland;Department of Radiology, University Hospital, Rämistrasse 100, 8091, Zürich, Switzerland;Department of Radiology and Department of Chiropractic, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008, Zürich, Switzerland
关键词: Pain;    Outcomes;    Sex differences;    Pain intensity;    Gender differences;   
Others  :  1134373
DOI  :  10.1186/1471-2474-13-241
 received in 2012-03-27, accepted in 2012-11-30,  发布年份 2012
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【 摘 要 】

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.

【 授权许可】

   
2012 Peterson et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]LeResche L: Defining gender disparities in pain management. Clin Orthop Relat Res 2011, 469:1871-1877.
  • [2]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.
  • [3]Pizzo P, Clark N: Relieving pain in America: A blueprint for transforming prevention, care, education, and research. Washington: DC, National Academies Press; 2011.
  • [4]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.
  • [5]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.
  • [6]Fillingim R, King CD, Ribeiro-DaSilva MC, Rahim-Williams B, Riley JL 3rd: Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain 2009, 10:447-485.
  • [7]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.
  • [8]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.
  • [9]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]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.
  • [11]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.
  • [12]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.
  • [13]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.
  • [14]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.
  • [15]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.
  • [16]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.
  • [17]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.
  • [18]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.
  • [19]Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N: Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 2001, 26:1873-1878.
  • [20]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.
  • [21]Yezierski RP: The effects of age on pain sensitivity: preclinical studies. Pain Med 2012.
  • [22]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. BioMed Central Full Text
  • [23]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. BioMed Central Full Text
  • [24]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.
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