Chronic Pain, Women, and Words
In 2009, researchers looked at pain language and gender differences. They identified dissimilarity in the words and patterns of language regarding pain descriptions and emotional response between the sexes. Since women are typically viewed as storytellers and nurturers, it’s no surprise investigators J. Strong, T. Mathews, R. Sussex, et al found women used more words, were more descriptive, and were more graphic than men, or that they typically focused on the sensory aspects of their pain event. In a 2013 study, researchers E. J. Bartley and R. B. Fillingim suggest the influence of sex hormones represents a significant source of pain-related variability, including sensitivity, and that pain likely impacts men and women differently. And, there are differences between a man and a woman’s brain that influence pain.
What’s in a word?
Women do experience pain differently than men, and we relate our symptoms differently than men do. For instance, Stephanie Watson, executive editor, Harvard Women's Health Watch, says, "There’s long been a perception that angina symptoms in women are different than they are in men. That comes in part from the words used to describe these symptoms. Men tend to describe angina as ‘chest pain’ while women use words like ‘heaviness’ to explain what they are feeling. Those descriptions sometimes translate into different diagnoses.” So, our words are powerful and how we relate them and how they are perceived can make a huge difference in our treatment plan.
Researchers found that language-associated cortical regions are proportionally larger in the female brain and anatomical differences may correlate with superior language skills. So, maybe our brain structure differences make us more likely to paint a picture with words. Knowing this, one would think what we have to say about our symptoms would provide us better care; however, we know this is not the case. Instead, women often feel judged by gender-biased misconceptions.
Will changing our language affect better treatment? It’s my opinion that it’s most important to develop trust with our provider and communicate effectively. This means we need to expand our language, not limit it. We need to be persistent and repetitive. This means we need to clarify that our words are heard and perceived as they are intended without room for misinterpretation.
Rethinking our pain speak
Our health care provider’s words matter too. We should feel safe when communicating our concerns and symptoms and never judged for having a medical condition that has no cure. Our provider should be part of our team, part of our plan, not part of the problem. When we feel heard, we do better. That is only human of us.
With changing medical paradigms, it’s important that we make use of every minute we have with our health care provider.
What is legitimate pain? Isn't all pain legitimate? Of course it is. We know men and women describe angina differently, but the damage from an untreated heart attack is the same. A heart attack does not discriminate based on gender. That’s why we should be persistent in pursuing having our voices heard.
Ask – listen – clarify
We can improve our communication by asking open-ended questions, questions that can’t be answered with a yes or no.
After we ask each question, we can listen carefully and clarify with our provider what they hear and what we hear.
This approach should help us be fully heard, and our health care improved as we ask, listen, and clarify our words.