Sex, Poverty and Education Linked to Chronic Pain

By Pat Anson, Editor

If you are female, poor and never finished high school, you are much more likely to suffer from chronic pain than other Americans, according to a new study published in the journal Pain.

“Women, the less educated, and the less wealthy experience not only more pain, but also more severe pain, as well as greater disability, said Hanna Grol-Prokopczyk, an assistant professor of sociology at the University of Buffalo.

Grol-Prokopczyk studied over 12 years of data from nearly 20,000 Americans aged 51 and over, who participated in the national Health and Retirement Study from 1998 to 2010.

Her research uncovered some unexpected findings about chronic pain in the United States.

She found that the severity and frequency of pain is increasing in older adults. People who were in their 60’s in 2010 reported more pain than people who were in their 60’s in 1998.

“There are a lot of pressures right now to reduce opioid prescription,” says Grol-Prokopczyk. “In part, this study should be a reminder that many people are legitimately suffering from pain. Health care providers shouldn’t assume that someone who shows up in their office complaining of pain is just trying to get an opioid prescription.

“We have to remember that pain is a legitimate and widespread problem,” she added.

The study is among the first to measure chronic pain by degree. Participants were asked whether their pain was mild, moderate or severe, and if they were “often troubled with pain.” Participants were followed for over 12 years, as opposed to most studies that follow patients over a much shorter period.

“I found that people with lower levels of education and wealth don’t just have more pain, they also have more severe pain,” she says. “I also looked at pain-related disability, meaning that pain is interfering with the ability to do normal work or household activities.  And again, people with less wealth and education are more likely to experience this disability.”

About one out of every four people who didn’t finish high school said their pain was severe, while only 10 percent of those with college graduate degrees did so.

About 8 percent of African Americans and Hispanics said their pain was severe, compared to about 5 percent of whites.

“If you’re looking at all pain – mild, moderate and severe combined – you do see a difference across socioeconomic groups. And other studies have shown that.  But if you look at the most severe pain, which happens to be the pain most associated with disability and death, then the socioeconomically disadvantaged are much, much more likely to experience it,” said Grol-Prokopczyk.

More research needs to be done to understand why pain is so unequally distributed in the population, and Grol-Prokopczyk says it’s critical to keep the high burden of pain in mind as the nation grapples with an overdose epidemic.

“We don’t have particularly good treatments for chronic pain. If opioids are to some extent being taken off the table, it becomes even more important to find other ways of addressing this big public health problem,” she said. “If we as a society decide that opioid analgesics are often too high risk as a treatment for chronic pain, then we need to invest in other effective treatments for chronic pain, and/or figure out how to prevent it in the first place.”