Using a script during their doctor visits, the patients described the same symptoms, including morning knee stiffness and pain when they walked up stairs. But when they asked the physicians, “Do you think I need a new knee?” they got different responses. Some 42 percent of the doctors recommended a total knee replacement to the male patient, but only 8 percent suggested it to the female, according to study coauthor James G. Wright, MD, a professor of surgery at the University of Toronto.
Women also appear to bear the brunt of a general reluctance among physicians to prescribe potentially addictive opioid drugs such as morphine and codeine—a reluctance that is not supported by the research. “Most patients who are prescribed opioids for pain, even those undergoing long-term therapy, do not become addicted to the drugs,” says a report from the National Institute on Drug Abuse.
Nonetheless, women pay the price for physician prejudice. For example, research published in the Journal of Pain and Symptom Management shows that among cancer patients who were experiencing pain, women were significantly less likely than men to be prescribed high-potency opioids. Women in the study were also much more likely than men to report that their pain was not adequately controlled.
A case can be made that African-American women are even more likely to miss out on proper treatment. Deborah Chenault-Green, an author and actress who lives in Detroit, began having severe headaches and pain and numbness in her shoulder, hand, neck and arm in 1996. The cause was two herniated disks in her neck, but it took seven years for doctors to make the diagnosis, and in that time she was prescribed few effective pain-relief medications in doctors’ offices and emergency rooms. Instead, she received what she calls “fluff drugs,” mild pain relievers like Motrin that did not affect her discomfort. Chenault-Green attributes her undertreatment to race. “In the inner city, hospitals are overly concerned about drug abuse. They tend to think that if you come in complaining of pain, you’re just looking for drugs,” she says.
In fact, a 2008 study found that African-American women are less likely than comparable white women to receive adequate opioid treatment for chronic lower-back pain.
Overcoming Treatment Obstacles
Experts say certain smart strategies can boost your odds of getting the best pain treatment.