Why was the study done?
The rates of musculoskeletal (MSK) pain from diseases like arthritis or injuries are quite different for men and women. While this varies for different conditions, overall, women have much higher rates of chronic MSK pain. We wanted to understand whether differences were related to how pain was measured, different risks, or differences in treatment outcomes that affect recovery following an injury or joint replacement surgery. We focused on men and women who broke their wrist or had an arm joint replacement as these are common sources of acute pain that sometimes becomes chronic pain.
How was the study done?
We did a series of studies to look at different potential reasons for pain outcomes.
MEASUREMENT studies were performed on different tools used to assess pain in men and women to explore whether biases might explain the higher pain scores typically recorded for women.
COHORT studies were used to determine what factors might explain sex or gender differences in outcome following a wrist fracture or joint replacement surgery. We measured biological and social factors at baseline, recovery at multiple timepoints, and used statistical models to identify factors that affected recovery.
QUALITATIVE studies (interviews with surgeons, therapists, patients) were used to determine how experience, beliefs, and decision-making affected pain outcomes.
What were the study results?
MEASUREMENT study findings indicate that many of the tools used to assess MSK pain outcomes did not provide appropriate scaling of pain, and a minority measured differently for men and women.
Our ongoing COHORT study will identify factors that we can use to predict who is at risk of chronic pain following a wrist fracture or arm joint replacement. We will use these factors to triage patients into alternative treatment pathways.
QUALITATIVE study findings indicate that clinicians are reluctant to discuss sex and gender, but latent presumptions do exist. Some patients feel that their sex or gender does affect how their pain was managed or experienced. We will use this information to provide more sex and gender sensitive treatment programs.