Do Women Feel More Pain than Men?

September 11, 2013September 27, 2016 / Thomas Cohn, MD

Over the past few years, some studies have contended that women report more pain intensity than men. But there is no definitive answer to the question of whether or not women feel more pain than men.

Women may report more pain than men, but women are also generally more likely to go to the doctor for medical problems. For many men there is a stigma attached to seeing a doctor for pain – many would prefer to “tough it out.” One of the most common reasons people go to the doctor is pain. Since women tend to report their problems more than men, it’s easy to assert that women feel more pain than men.

Everyone Feels Pain Differently

However, this connection may be correlation, not causation. In practice, pain is very subjective, and every person describes his or her pain differently. By definition, pain is an unpleasant sensory or emotional experience associated with actual or potential tissue damage. The regions of the brain responsible for perception of pain are right next to critical emotional areas of the brain. For any painful condition, every person will report a different experience. As a result, it is impossible to compare men to women in their perception of pain.

To make sense of this oft-debated topic, we can make a few general statements about men, women, and how they feel pain:

Women go to the doctor more often than men,
Women tend to report their emotions more readily than men.

Since pain is subjective, each situation is unique and different and cannot be compared. Some people tend to hide their pain and emotions, while others want everyone to know their problems.

Do Men Feel More Pain than Women?

While some believe women feel more pain than men, others assert that women are much tougher than men, since no man has ever given birth. Again, the truth is that some people are tough and just grin and bear it while others scream every time they stub a toe. Men may be slightly more stoic at times, but once they have pain, they are usually no different than women.

Fibromyalgia: Symptoms & Pain Management Options

August 26, 2013September 27, 2016 / Thomas Cohn, MD

Fibromyalgia is a disorder characterized by diffuse musculoskeletal pain throughout the whole body. It is often accompanied by sleep issues, jaw pain, headaches, stomach problems, and depression. There is no special test, blood work, nerve or muscle test, or X-ray that confirms the diagnosis. Rather, diagnosis of Fibromyalgia is based on a patient’s history, medical exam, and the exclusion of other diseases that may cause similar problems.

Symptoms of Fibromyalgia

There are 2 core symptoms of fibromyalgia:

Diffuse muscle pain
Fatigue

With diffuse muscle pain even a light touch of the skin produces pain. Typical locations of muscle pain include all four extremities, head and trunk. Muscle pain often interferes with sleep, and contributes to fatigue and depression. This constellation of problems is thought to be driven by an over-active nervous system, which is hypersensitive to sensory inputs.

Treatment Options

Treatment of fibromyalgia is aimed at minimizing symptoms and maximizing function. People with fibromyalgia often greatly diminish activity and withdraw from normal interactions. A comprehensive strategy that teaches a person to understand the physical and mental aspects of the disease is often helpful. A multidisciplinary team that includes medical management, lifestyle, psychology, and physical therapy is one of the most effective strategies. Physical Medicine based pain clinics often coordinate such programs.

Medication Management

Medication management of fibromyalgia is aimed at modifying symptoms. There are 3 drugs now approved specifically for fibromyalgia. All these medications are considered neuropathics. They reduce the sensitivity of the nervous system so that stimuli are not perceived as intensely. Analgesics can be helpful when used judiciously, especially acetaminophen, anti-inflammatories, and occasionally tramadol. Symptom treatment for depression, and sleep management is also extremely important.

Fibromyalgia is a disorder that affects the whole body and every aspect of daily function. At this time, there is not a known cause and no definitive cure. Management of symptoms is the key to treatment. An experienced pain physician with a multidisciplinary team will often lead to the most beneficial personalized treatment strategy.

Does Laughter Really Help Relieve Pain?

August 12, 2013September 27, 2016 / Thomas Cohn, MD

There’s an old saying that laughter is the best medicine. While most would admit that laughter is good for your emotional health, can it really reduce pain on a physical level?

In short, yes. Laughing can help fight both mental and physical pain.

Physical Benefits of Laughter

There are many ways that the physical act of laughing can decrease pain and improve your overall health. Here are a few examples:

Increased Endorphins. When you laugh, your oxygen intake increases. This invigorates your organs and releases endorphins in your brain.
Decrease Stress. Laughing helps circulation and results in more relaxed muscles. This can undercut tension caused by stress.
Natural Pain Killers. Laughing helps the body create its own natural painkillers.

Additionally, laughter has been found to increase blood flow, lower blood pressure, and boost the immune system.

Laughter & Brain Signals

Laughter is the opposite of being sad and depressed. Too much sadness stimulates areas of the brain that are next to the centers that translate pain signals in the brain. The centers that are involved in depression can “talk” to and stimulate the pain centers. Emotional pain can make physical pain even worse. Therefore, you need to laugh and spend time relaxing and enjoying life.

When you are in pain it’s often difficult to find the funny things in life and laugh. The old saying that laughter is the best medicine may just help. It increases the body’s own pain fighting hormones, and decreases the activity areas of emotional pain. Laughter distracts the brain from bad signals and focuses on the enjoyable ones.

Osteoarthritis of the Knee – Signs & Symptoms

July 15, 2013September 27, 2016 / Thomas Cohn, MD

As we age, many of us develop knee pain. One of the most common knee conditions is Osteoarthritis – slow degeneration of the cartilage of the knee.

Symptoms of Osteoarthritis

The symptoms of osteoarthritis are:

Gradual onset of stiffness in the joint, especially after sitting for a period of time or lying down
Difficulty bending and straightening the knee
Swelling and pain when first moving the knees, sitting, or kneeling
In more severe cases, the size of the knee may become larger

As we get older, joints in the body age and deteriorate. This starts as early as our twenties, and is more common when we are past forty. Historically, the body was designed to get us to between age forty and fifty. Prior to the onset of modern medicine roughly 150 years ago, disease, trauma, and natural conditions like heart problems killed us by age fifty. So as we age, there is increasing wear from normal use and trauma on our joints including our knees. Weight also often increases as we age and further stresses weight bearing joints.

Factors & Signs

Factors that contribute to osteoarthritis development are:

Age
Trauma
Weight
Genetic tendency (some families may be more prone to its occurrence)

In the doctor’s office, when we examine a knee with osteoarthritis, we usually see a large knee, maybe slightly swollen but not warm, and stiff to move. Plain X-rays will reveal a large joint, often with narrowing of the joint space especially on the inside aspect, and the joint surfaces may appear to be irregular from deterioration.

Read our follow up blog on the treatment options for Osteoarthritis.

Top 4 Causes of Back Pain

July 10, 2013October 30, 2015 / Thomas Cohn, MD

The human spine consists of roughly 30 bones, known as vertebrae that are stacked on top of each other. In between each of these vertebrae are discs – bits of cartilage that prevent the bones from rubbing against one another. When something disrupts the organization of the spine, it often results in back pain.

Many people suffer from back pain, but it’s often difficult to pinpoint what exactly is causing the pain. Here are four of the most common causes of back pain:

Injuries to the muscles, and ligaments. This can include injuries from sports, car accidents, or simple slip and fall accidents. Jarring your back in an unnatural way can result in move the vertebrae or discs out of their place, resulting in chronic back pain.
Herniated Disc. This is also known as a slipped disc. It happens when a spinal disc expands and presses against the nerves in the spinal column.
Degenerative Changes. Over time all areas of the body gradually break down. The spine is no exception. As a person ages their bones generally weaken, and the spinal discs can weaken or shrink (causing vertebrae to rub against each other).
Pinched Nerve. When discs bulge or shift, they can press against or pinch nerves, resulting in sometimes extreme pain.

You don’t have to live out your life just dealing with back pain. There are numerous treatment options available that can help you get back on the road to a pain free life.