The Monday Memo
January 27, 2020 PITT DPT STUDENTS
Do We All Take Women’s Pain Seriously?
On the first day of neuromuscular PT 3, we watched a video where Selma Blair told her story of being diagnosed with multiple sclerosis. She mentioned how she was having symptoms of MS for months – weakness, falls, pain. She brought this up to her physicians, even asking for MRIs to be taken, but time after time they dismissed her claims. At one of her appointments, Selma unfortunately fell in front of her physician, and this is what it took for them to take her complaints seriously
Sadly, this is a story that many women know all too well, even me. Physicians often struggle to judge the seriousness of a woman’s pain, which can lead to fatal consequences. A study in The New England Journal of Medicine found that women are seven times more likely than men to be misdiagnosed and discharged from the emergency room while having a heart attack. Everyone is taught that left-sided chest and arm pain could mean a heart attack, however, women’s symptoms can differ vastly. Some women can experience an increase in fatigue, neck and jaw pain, and shortness of breath when having a heart attack. Many people do not immediately pick up on these female heart attack symptoms because our studies of medicine have predominately been based around male physiology. Research has recently become more diverse, including subjects of all races and genders, but for the majority of the past century that has not been the case.
Chronic pain is another area where the current U.S. medical system is failing women. 70% of people with chronic pain are women. Musculoskeletal pathologies such as fibromyalgia and complex regional pain syndromes are often seen as “made up” diagnoses, likely because the people suffering from them are mostly women. Stereotypes surrounding chronic pain diagnoses often lead to women experiencing pain more often and longer than men. Physical therapists can directly intervene here by listening to and advocating for our patients with chronic pain.
Women are not the only group who experiences disparities in pain management. According to the National Institute of Health, PCP’s are more likely to underestimate pain intensity in African American patients. African Americans are also less likely to receive pain medication than white people. The NIH reports that opioids are more often prescribed to those in a higher socioeconomic status, although low income patients are more likely to report having pain. Reasoning behind these statistics can be due to access to care (geographically and financially) as well as implicit biases.
To progress ourselves as a profession, physical therapists must be aware of our own implicit biases and educate ourselves on how to eliminate them. We need to listen to our patients and take their complaints seriously. One of the books on my reading wish list is Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick by Maya Dusenbery. In this novel, Dusenbery talks to physicians, researchers, and women to provide an account of what it’s like to seek medical help as a woman. From the brief excerpt I read, I believe that this book would be a valuable read to every student and practitioner in the health professions. Women deserve to have their pain seen as a priority. I hope someday we will get to the point where we don’t have another Selma Blair story.
-Kara Kaniecki, SPT