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Mark Jensen, PhD, professor and vice chair for research at the Department of Rehabilitation Medicine in the University of Washington School of Medicine, discussed with O&P Business News a study he co-authored entitled, Sex Differences in Pain and Psychological Functioning in Persons with Limb-Loss.
Although there are numerous studies detailing the differences between men and women in their experience of pain, how the different genders cope with pain associated with limb-loss has been overlooked, according to Jensen. The authors of the study evaluated responses from 335 adult amputees. Pain intensity was measured on a zero to 10 numeric scale.
Based on the findings from previous studies in patients with other pain problems, the authors of the study hypothesized that females would report greater general and amputation-specific pain intensity than males and that there would be differences in the ways that men and women cope with pain. Limited support for the first study hypothesis was found. Although there were no differences in average pain intensity ratings for amputation-specific pain, such as phantom limb pain (PLP) and residual limb pain (RLP), between males and females, differences were recognized for overall average pain rating. Support for the second study hypothesis was also found. Significant differences were established, however, in the way in which males and females manage the broader experience of pain, such as pain interference with function, catastrophizing (the anxiety one has regarding his or her pain), pain-coping and beliefs.
“On the one hand we were not surprised we found differences that did emerge, but on the other hand, I think it is interesting we found differences,” Jensen said.
Consistent with previous research, females reported greater overall average of pain intensity outside the amputation-specific pain area and females also reported significantly greater catastrophizing, according to Jensen. Females also reported more pain interference with daily activities than male participants.
“The person who thinks of the worst that can happen, can be better prepared,” Jensen said. “So it seems women plan ahead more than men. But catastrophizing also has a cost. Psychologically, it can take a toll.”
The study did conclude that females rested more often than males and females sought social support more often than males.
Although there was no difference reported between males and females in pain intensity at the amputation-specific site, females may experience more severe negative pain outcomes than males who have undergone amputation, the authors concluded. Still, both males and females used both adaptive coping strategies that lead to better outcomes as well as maladaptive strategies that lead to poorer outcomes, Jensen said.
The study concluded that this topic is worthy of more clinical and empirical attention. This information could be useful for practitioners treating post-operative amputees. Practitioners could become more knowledgeable in coping mechanisms.
“Maybe when a practitioner is helping someone manage their pain, their approach may differ depending on whether the patient is a man or a woman,” Jensen said. — Anthony Calabro
