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Health July 2012

Aid for Age

Pain: Gender Differences and Complementary Approaches to Relief

By Tait Trussell

There is actually more scientific evidence that mind-body approaches can be useful for pain than there is for most of the drugs we prescribe.

An old guy goes to his doctor. “Doc,” he says, “I’ve got pain everywhere. I touch my head and it hurts. I touch my knee and it hurts. I touch my back and it hurts. The doctor examines Gus – that’s his patient’s name – and says, “Gus, your problem is that when you feel pain when you press on various parts of your body, the reason is that you have a broken finger.”

A corny joke. But pain is a serious subject.

Pain experienced when we were young and active was unlikely to be accepted as something “normal.” Yet, pain in older people is prevalent and widely accepted as something to be expected and regarded as “normal” in later life. So, suffering associated with persistent pain in older people often occurs without the appropriate assessment and treatment to alleviate the pain.

A recent study published in Scientific American said that women feel pain more intensely than men do. For a number of diseases, including arthritis, diabetes, and respiratory infections, women reported feeling more pain than men. The study reportedly was one of the largest to examine gender differences in pain perception. Men, of course, are at an advantage in not having to endure the pain of childbirth.

Yet men tend to be macho about pain. Some just grit their teeth and don’t complain. Women, generally being more verbal, express themselves when they hurt.

The analysis — looking at the medical records of 11,000 patients at Stanford University’s hospital and clinics — reported women suffered more severe pain than men did for the same disorders. At Stanford, as is the case in many places, patients rated their pain on a scale of 0 to 10, with 10 being excruciating. The researcher looked at ratings before any pain killers or other treatments were given.

According to reports in the study there was a pain difference of 20 percent or more for women. The results suggested that when doctors are prescribing pain medication, they may want to call for a stronger dose for women.

To be sure, there are exceptions. Take my wife. She has a very high tolerance for pain. In fact, she has burned her hand or arm when taking something out of the oven and wasn’t aware of the burn until she noticed a scar afterward. When she slipped on the ice this past winter and fell, she wasn’t planning to get checked out until I insisted she go to the emergency room. X-rays showed two bones in her wrist were broken.

By contrast, I’m a sniveling, whiner about my pains. Fortunately, bouts of sciatica have been cured by exercise or physical therapy. I rarely take any analgesic. I restrict pill popping to what my doctor recommends for specific ailments.

The reason for this difference in pain between most men and women is not known, doctors say. Past research suggests a number of factors contribute to perceptions of pain level, including hormones, genetics and psychological factors, which may vary between men and women. It's also possible the pain systems work differently in men and women, or women experience more severe forms of disease than men.

Two occupational therapists in New York, Jane Gatanis and Alyssa Frey, say they can cure pain naturally with a plan that combines mind-body techniques and traditional physical rehabilitation. They began developing the program in 1996 while working in the rehabilitation department of Beth Israel Medical Center in New York City. There they studied complementary approaches to treating chronic pain.

They say their approach works because they address a factor that many doctors ignore when treating pain -- namely, emotions. Gatanis says, “I have come to believe that about 95 percent of chronic pain has an emotional component. “Emotions and stress can either initiate the pain or exacerbate it.”

Beth Israel Medical Center’s Russell Portenoy, M.D., chairman of the department of pain medicine and palliative care, support their program. He says, “There is actually more scientific evidence that mind-body approaches can be useful for pain than there is for most of the drugs we prescribe.”

Gatanis and Frey have a program they give patients to follow at home. Exercises are said to take 30 to 60 minutes a day. Depending on how complex the pain is and its cause, relief, they say, can come in a matter of weeks.

Poor posture can be a large factor in chronic pain, they say, causing tension along the spine. It can also restrict breathing, reducing oxygen and blood needed to resolve inflammation and tension.

Gatanis and Frey have their patients use meditation and visualization to think less negatively about their pain. They maintain that those suffering with pain tend to condemn the painful part of their body. This, they say, increases their mental distress and muscular tension.

They recommend sitting in a quiet place and thinking about that part of your body that hurts. Slowly inhale and imagine space and light around your pain. Let the pain float in this space. As you slowly exhale, gently move the painful part of your body in small increments. As you breathe, move the painful area in different directions. Imagine the space around the pain growing larger. Visualize the pain floating in space. Talk to your pain, they advise.

Sounds slightly wacky. But it may be worth a try. Anything to stop severe pain.


Tait Trussell is an old guy and fourth-generation professional journalist who writes extensively about aging issues among a myriad of diverse topics.

Meet Tait