pain Archives - PPM Healthcare

April 4, 2023

Statins Won’t Worsen Muscle Pain or Fatigue During Moderate Exercise

Statin remedy does not boost the chance of muscle injuries, soreness, or exhaustion when participating in average-intensity training.
The researchers examined men and women who took aspect in the 4Times Marches, an event in the Netherlands where by people today wander between 18 and 30 miles every single day for four times in the town of Nijmegen.
The study’s effects reveal that statins did not worsen muscle mass injury, discomfort, and exhaustion, as these signs or symptoms improved equally in all groups.

Statin treatment does not enhance the danger of muscle injuries, soreness, or exhaustion when participating in average-depth exercising, in accordance to a new examine posted in the Journal of the American University of Cardiology.

Researchers evaluated the influence of reasonable-intensity exercise routines, this sort of as strolling, on the muscle groups of people taking statins – symptomatic and asymptomatic – for coronary heart illness.

The participants of the examine integrated 100 persons. This involved 35 persons taking statins with statin-affiliated muscle signs and symptoms, 34 folks taking statins who did not show any muscle problems and 31 individuals not getting statins as a regulate team.

Individuals getting statins had been carrying out so for at minimum 3 months right before the examine. Men and women with selected overall health problems which include diabetes, hypo or hyperthyroidism, hereditary skeletal muscle condition were excluded from the study:

Persons utilizing CoQ10 nutritional supplements had been also excluded.

At the start of the examine, entire body mass index (BMI), midsection circumference, bodily exercise amounts, and vitamin D3 concentrations were being comparable. Muscle agony and exhaustion scores had been increased in symptomatic members at the beginning of the review.

The researchers examined folks who took section in the 4Times Marches, an event in the Netherlands where people today stroll involving 18 and 30 miles each day for 4 days in the city of Nijmegen.

“The individuals wander 30, 40, or 50 km [18mi, 24mi or 31mi] every day for four consecutive times. This implies that individuals walk amongst 120 (74 miles) and 200 (124 miles) km in four days’ time,” discussed Dr. Neeltje A.E. Allard, of the Radboud Institute for Wellness Sciences and the department of physiology at Radboud College Clinical Heart in the Netherlands and the guide writer of the research. “It is certainly a whole lot of walking, and men and women prepare in progress. In fact, it commenced as a military services event in 1909 and now has grown into the world’s biggest strolling party, in which both of those army and recreational walkers participate.”

The scientists compared the influence of strolling on muscle mass personal injury in symptomatic contributors to those who were being asymptomatic.

The study’s final results suggest that statins did not worsen muscle harm, soreness, and exhaustion, as these indications enhanced likewise in all teams.

In an accompanying editorial, Dr. Robert S. Rosenson,director of metabolic rate and lipids for the Mount Sinai Health Program and professor of medication in cardiology at the Icahn Faculty of Medication at Mount Sinai, stated, “exercise is an critical element of restoring health and fitness for retaining wellbeing and health and fitness in all patients at amplified risk for an atherosclerotic cardiovascular disease function, specifically those people with a disabling occasion, this sort of as myocardial infarction, and therapy of key cardiovascular possibility elements, this sort of as hypertension, prediabetes, or diabetic issues and dyslipidemia.”

“Many clients who develop muscle mass injuries and tiredness indicators may perhaps have interaction in a reasonably intensive strolling system without having problem for worsened muscle biomarkers or efficiency,” Rosenson reported in the piece.

“Although the exercising was accompanied by more fatigue in symptomatic vs. asymptomatic statin people in this short-phrase review, it stays uncertain from this analyze no matter if sustained training in SAMS [statin-associated muscle symptoms] patients” will aid strengthen essential biomarkers and physical exercise potential in the very long expression.

The examine does have some constraints.

“The sample measurement, for occasion, is large, but we should think about that not all contributors took the exact same statin,” mentioned Michael Masi, DPT, OCS, CSCS, CISSN, CMTPT, USAW-1, a energy and sports activities health practitioner at Masi Health and fitness. “The researchers also focus on how the inclusion standards for the analyze needed participants to be in a position to walk at minimum 30km/working day, which is tough on its own and might exclude a substantial portion of people taking into consideration statin use.

Masi position out that statin use boosts with age (from 17{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of adults aged 40–59 to 48{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of grown ups aged 75 and over) and with age men and women build several other well being challenges that can limit the means to physical exercise for long durations of time.

Statins are medications employed to reduced cholesterol and can lower the hazard of coronary heart attack, stroke, and the want for surgical procedure, angioplasty, or stenting in men and women with coronary heart illness, in accordance to the Health and fitness and Human Companies Division (HHS) of the United States. They not only support by cutting down cholesterol, but they might also assistance minimize inflammation in artery partitions.

The larger your threat of a heart assault, the more profit you receive from statins.

About 29{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of people having statins practical experience aspect consequences, such as muscle mass aches or weak point. Though altering the dose or picking out a various statin drug can lower side outcomes, lots of men and women quit using statins, increasing their chance of coronary heart assault or stroke.

HHS notes that “people who have experienced a coronary heart assault or stroke, who have diabetes or pretty high ‘bad’ cholesterol ranges, and who are at large possibility for heart disease or stroke owing to other aspects like large blood pressure will dwell much healthier and for a longer period life by taking a statin.”

Previous investigation has found that statins are typically very well tolerated.

Still, some folks can encounter muscle signs or symptoms, such as myalgia or muscle mass aches. These symptoms can worsen in the course of actual physical exercise.

“The recent suggestions for persons taking statins are that sufferers should proceed to acquire their statins at their maximally tolerated dose soon after discussion with their health care vendors,” suggests Dr. Michael Broukhim, an interventional cardiologist at Providence Saint John’s Health Heart in Santa Monica, California. “They need to put into action a frequent work out software, with preference to a average intensity workout system.”

“I experience relaxed recommending average-intensity exercising and inspire my clients to engage in at minimum 150 minutes for every week of this training,” Broukhim advised Healthline. “If people are not able to exercise 150 minutes a 7 days, I advocate performing exercises as considerably as the person client can.”

“People who just take statins and are setting up an work out application really should be additional cautious in superior-depth physical exercise, which can increase muscle enzyme amounts to a better extent and may consequence in muscle problems,” Broukhim continued. “If people have substantial ache although training, they ought to cease their workout routines and consult with their medical professionals.”

Examples of average-intensity exercises include:

Brisk strolling
Biking
H2o aerobics
Basic calisthenics
Doubles tennis
Ballroom dancing

Masi stated for people today who want to start working out, gurus advise a mixture of resistance coaching and cardiovascular training. Masi claimed every person should start off out at their very own tempo and capability and improve the two length and resistance slowly.

“If workout is new to another person, the greatest point they can do is try out a few different possibilities. It’s less about getting what is ideal and far more about getting what is ideal,” Masi claimed. “Find training that is pleasing so it can feasibly be carried out during the foreseeable long term.”

April 3, 2023

Musseling Up study finds post-menopausal knee pain solution

Andrew Stanley says he is excited by the findings of the study, and what it could mean for women’s health.

STEVE HUSSEY 850A/Nelson Mail

Andrew Stanley says he is excited by the conclusions of the analyze, and what it could mean for women’s well being.

Scientists have identified that Greenshell mussels’ anti-inflammatory features might reduce knee and joint pain in post-menopausal women.

A series of scientific trials termed ‘Musseling Up’ observed females who consistently took 3g of Sanford’s Greenshell mussel Perna Ultra powder experienced a decline in the biomarker that measures style 2 collagen breakdown for girls with knee and joint discomfort.

The exploration task was a partnership among Cawthron Institute, Sanford Ltd, Massey University and Plant and Food items Exploration, and got renewed funding from the High Price Nourishment Nationwide Science Problem.

Mussel powder has been found to reduce joint pain in post-menopausal women at Sanford’s new Bioactives centre. — Nelson Mail

Mussel powder has been discovered to lower joint ache in write-up-menopausal ladies at Sanford’s new Bioactives centre.

Andrew Stanley, common supervisor of innovation at Sanford, said the funding authorized the study to appear at what he known as MINK (mussels strengthening nimble knees).

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Stanley reported people today experienced prolonged acknowledged Greenshell mussels had wellbeing benefits, but they hadn’t been very well researched.

“We experienced plenty of proof that Greenshell mussel powders had been excellent for joints, and a good healthy as an anti-inflammatory,” Stanley said. But it was all anecdotal.

What they have been lacking was an actual study completed on individuals, who could report the impacts they felt right after having the supplement.

Lead scientist, Massey Professor Marlena Kruger said the trial results are pleasing and agreed Sanford’s mussel powder can effectively be used as a preventative treatment for people with knee pains. — David Wiltshire/Nelson Mail

Guide scientist, Massey Professor Marlena Kruger claimed the demo benefits are pleasing and agreed Sanford’s mussel powder can correctly be used as a preventative treatment method for people with knee pains.

Maryam Abshrini, Massey College doctoral college student, stated the demo had serious impacts on the gals who participated.

“Study individuals have been telling us the mussel supplements enabled them to carry out every day life pursuits with out soreness.”

Direct scientist Professor Marlena Kruger claimed she was “pleased and surprised” with the study final results. The mussel powder can be a preventative intervention therapy for persons with early signals of knee pain, she explained.

One particular of the participants, Kruger stated, preferred executing triathlons and observed that immediately after frequently taking the powder, recovery was a lot quicker.

The results of this clinical trial experienced been interesting, Stanley mentioned.

“It’s incredibly interesting to have great potent proof that supports what we have been stating for a very long time.”

Most of Sanford’s mussels come from the Marlborough region. — Nelson Mail

Most of Sanford’s mussels arrive from the Marlborough region.

Stanley said getting in a position to give prospects assurance in the product and how it could enable them was some thing the analyze opened up for Sanford.

The organization would now appear into new chances, and refine its analysis, for instance focusing on the knee joint, Stanley explained. In transform, Sanford could deliver more precise solutions for the industry.

Stanley explained the conclusions were a New Zealand accomplishment tale.

A lot of the science was accomplished at Sanford’s Bioactives centre in Marlborough, where the bulk of Sanford’s mussel provide arrived from.

February 2, 2023

New Research Reveals Dangerous Consequences of Stopping Opioid Treatment for Chronic Pain

Prescription Bottle Medicine Drugs Opioids

Opioid habit is a really serious public health issue that affects millions of men and women throughout the world. It is characterized by the compulsive use of opioids regardless of unfavorable implications, such as wellness problems, marriage problems, and money troubles. The dependancy can be brought about by a wide variety of factors, such as chronic ache, psychological health difficulties, and exposure to opioid medicine.

Discontinuation of opioid therapy for suffering may well increase the possibility of overdose in clients.

Opioid-connected overdose has turn out to be a key contributor to accidental deaths in the United States and Canada. A new analyze not too long ago printed in the journal PLOS Medicine, led by Mary Clare Kennedy of the University of British Columbia, Kelowna, Canada, indicates that halting recommended opioids may well boost the hazard of overdose.

In an effort and hard work to reduce opioid-relevant sickness and dying, Canada and the United States have recognized tips to limit opioid prescriptions for chronic pain. Even so, the influence of discontinuing opioid treatment plans on overdose chance continues to be largely unstudied. To investigate the relationship amongst discontinuing prescribed opioid remedy for agony and overdose risk, a group of researchers conducted a retrospective cohort research of men and women acquiring long-time period opioid treatment for ache in British Columbia in between Oct 2014 and June 2018. They analyzed the clinical information of 14,037 people registered with the provincial wellbeing insurance coverage shopper roster in British Columbia who had been on opioid therapy for at the very least 90 times.

The researchers found that discontinuing opioid remedy for discomfort was affiliated with improved overdose danger between people with no opioid use condition (OUD). However the affiliation was much better in these with OUD, including all those not acquiring opioid agonist treatment (AHR = 3.18 95{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} CI = 1.87 – 5.40, p<0.001) and receiving opioid agonist therapy (AHR = 2.52 95{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} CI = 1.68 – 3.78, p<0.001). Finally, tapering opioid therapy was associated with decreased risk of overdose in those with OUD who had not received opioid agonist therapy (AHR = 0.31, 95{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} CI = 0.14 – 0.67, p=0.003).

The study had several limitations as the outcome measure did not capture overdose events that did not involve a healthcare encounter or result in death. Additionally, the researchers were unable to determine the source of the drugs involved in overdoses and whether they were prescribed or obtained illicitly.

According to the authors, “These findings point to the need to avoid abrupt discontinuation of opioid treatment for pain and to enhance guidance for prescribers in modifying opioid treatment tapering strategies on the basis of opioid use disorder and opioid agonist therapy status.”

Kennedy adds, “Given the increased risk of overdose, sudden discontinuation of opioid treatment for chronic pain should be avoided in almost all instances. Enhanced guidance is needed to support prescribers in implementing safe and effective opioid for pain tapering strategies, with particular consideration of opioid use disorder and prescribed opioid agonist therapy status.”

Reference: “Discontinuation and tapering of prescribed opioids and risk of overdose among people on long-term opioid therapy for pain with and without opioid use disorder in British Columbia, Canada: A retrospective cohort study” by Mary Clare Kennedy, Alexis Crabtree, Seonaid Nolan, Wing Yin Mok, Zishan Cui, Mei Chong, Amanda Slaunwhite and Lianping Ti, 1 December 2022, PLOS Medicine.
DOI: 10.1371/journal.pmed.1004123

This study was funded by a Canadian Institutes of Health Research Project Grant. SN is supported by the Michael Smith Foundation for Health Research and the University of British Columbia’s Steven Diamond Professorship in Addiction Care Innovation. LT is supported by a Michael Smith Foundation for Health Research Scholar Award. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.

January 17, 2023

Women’s pain often is dismissed by doctors

One woman was told she was being “dramatic” when she pleaded for a brain scan after suffering months of headaches and pounding in her ears. It turned out she had a brain tumor.

Another was ignored as she cried out in pain during a 33-hour labor. She was supposed to be getting pain medication through her epidural, but it had fallen out.

Dozens of women complained of torturous pain as their vaginal walls were punctured during an egg retrieval process. They were told their pain was normal, but, in actuality, they were getting saline instead of anesthesia.

These are just some of the stories of women who say their pain and suffering has been dismissed or misdiagnosed by doctors. Although these are anecdotal reports, a number of studies support the claim that women in pain often are not taken as seriously as men.

This year, the Journal of the American Heart Association reported that women who visited emergency departments with chest pain waited 29 percent longer than men to be evaluated for possible heart attacks.

An analysis of 981 emergency room visits showed that women with acute abdominal pain were up to 25 percent less likely than their male counterparts to be treated with powerful opioid painkillers.

Another study showed that middle-aged women with chest pain and other symptoms of heart disease were twice as likely to be diagnosed with a mental illness compared with men who had the same symptoms.

“I was told I knew too much, that I was working too hard, that I was stressed out, that I was anxious,” said Ilene Ruhoy, a 53-year-old neurologist from Seattle, who had head pain and pounding in her ears.

Despite having a medical degree, Ruhoy said she struggled to get doctors to order a brain scan. By the time she got it in 2015, a tennis ball-sized tumor was pushing her brain to one side. She needed surgery, but first, she rushed home, hugged her 11-year-old daughter and wrote her a letter to tell her goodbye.

Ruhoy did not die on the operating table, but her tumor had grown so large it could not be entirely removed. Now, she has several smaller tumors that require radiation treatment.

She said many of her female patients have had experiences similar to hers. “They’re not validated with regards to their concerns; they’re gaslit; they’re not understood,” she said. “They feel like no one is listening to them.”

Doubts about women’s pain can affect treatment for a wide range of health issues, including heart problems, stroke, reproductive health, chronic illnesses, adolescent pain and physical pain, among other things, studies show.

Research also suggests that women are more sensitive to pain than men and are more likely to express it, so their pain is often seen as an overreaction rather than a reality, said Roger Fillingim, director of the Pain Research and Intervention Center of Excellence at the University of Florida.

Fillingim, who co-wrote a review article on sex differences in pain, said there are many possible explanations, including hormones, genetics and even social factors such as gender roles.

Regardless, he said, “you treat the pain that the patient has, not the pain that you think the patient should have.”

Women say reproductive health complaints are commonly ignored

Women often cite pain bias around areas of reproductive health, including endometriosis, labor pain and insertion of an intrauterine device, or IUD.

When Molly Hill made an appointment at a Connecticut clinic in 2017 to get an IUD, she said she was warned it would be uncomfortable, but she was not prepared for “horrific” pain. Hill, now 27 and living in San Francisco, recalled that during the procedure, she began crying in pain and shouted at the doctor to stop.

“We’re almost done,” she said the doctor told her and continued the procedure.

“It was full-body, electrifying, knife-stabbing pain,” she said. After it was done, she said she lay sobbing on the table in physical and emotional pain. “It felt violating, too, to have that pain that deep in your core where you feel the most vulnerable.”

Would you like to share your own experiences of coping with pain and navigating the medical system? Fill out this form, and we may include you in a collection of reader stories.

My wife of 35 years complained of intense abdominal pain for over 5 years. She was dismissed. My wife returned home from work and begged me to take her to the ER because her pain was unberaable. In the hospital a female physician’s assistant did what multiple doctors had not done: She believed my wife. After a series of tests, she diagnosed Stage 3 ovarian cancer, and 18 months later, my wife died.

Mick, South Carolina, 69

I was told for 15 years that what turned out to be super-ventricular tachycardia was “anxiety attacks.” It finally took a female nurse at the school I worked for to put a blood pressure cuff and blood oxygen reader on me to realize I had a bigger issue.

Angelina, New Jersey, 27

I had a uterine biopsy to rule out cancer. Women are typically not given any kind of anesthesia or pain relief for this procedure. The pain was so intense that I couldn’t keep myself from screaming. I asked my doctor afterward why they don’t administer any sort of anesthesia for that procedure, and the answer was, “We just don’t.”

Jeanna, Georgia, 46

I started to experience strange sensations along my face, extending along the right side of my body. My GP laughed and said, “What do you want me to do, order a total body neurological work up?” At the same time, I complained to my eye doctor I was experiencing double vision and blurriness. I joked it was a brain tumor; they reassured me it was not. Six months later I lost consciousness and had an MRI. It was a brain tumor.

Anne, Maryland, 60

I, too, had extreme pain from an IUD insertion. I passed out on the table and was awakened by a nurse telling me to hurry and get dressed because they needed the room.

Margaret , CA, 70

I was 45 when I consulted a GYN about cramping pain and excessive bleeding. He told me I was being mildly inconvenienced by perimenopause. A year later, when I changed medical insurance, I learned I had endometrial cancer.

Diane, NY, 68

It saddens me that this is still an issue so many years after I experienced it myself. In the early 1960’s, at the age of 29, I developed a gastric ulcer. My doctor refused to believe it was anything more than ”heartburn.“ I lost weight and suffered for an entire year before my doctor reluctantly ordered tests. I am now 89 years old and remember this as one of the worst periods of my life.

Jean, Maryland, 89

I was having an emergency C-section and could feel every cut my doctor made. It was excruciating. I was screaming and my female doctor stopped and instructed the male anesthesiologist to up my pain meds. Instead of addressing me, he turned to my husband and said “All she’s feeling is pressure. And pressure feels like pain to some people.” Luckily my doctor insisted he up the dosage. Her subsequent cuts started feeling less painful.

Lauren, PA, 35

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Studies consistently show that women who have not experienced vaginal birth have much higher pain during IUD insertion compared with women who have given birth. A Swedish study found that among 224 women who had not given birth, 89 percent reported moderate or severe pain. One in six of the women said the pain was severe.

Although numbing agents and local anesthetics are available, they are rarely used.

In some cases, women have sued physicians for ignoring their pain. Dozens of women sued Yale University claiming that during an egg harvesting procedure at its infertility clinic, they were supposed to be receiving the powerful painkiller fentanyl. But some women were getting only diluted pain medication or none at all, according to lawsuits filed in the state Superior Court in Connecticut.

Later, the clinic discovered a nurse had been stealing vials of fentanyl and replacing the painkiller with saline solution. The nurse pleaded guilty last year and was sentenced for tampering with the drugs.

One of the plaintiffs, Laura Czar, wrote about her experience for Elle magazine, describing it as “a horrible, gut-wrenching pain,” and told a doctor at the time, “I can feel everything you’re doing.” Despite her protests, the doctor continued.

Yale said in a statement that it “deeply regrets” the women’s distress and has “reviewed its procedures and made changes to further oversight of pain control and controlled substances.”

Racial disparities in pain management

For Sharee Turpin, the pain of sickle-cell disease sometimes feels like tiny knives slicing her open. Sickle cell disease is an inherited blood disorder that can cause suffering so severe, its attacks are called “pain crises.”

But when Turpin, who is Black, experiences a pain crisis, the 34-year-old does not rush to the ER in Rochester, N.Y. Instead, she combs her hair, mists some perfume and slips on her “Sunday best” in hopes that the doctors and nurses won’t peg her as a drug seeker, she said.

Sometimes, Turpin gets a care team that understands her pain. Other times, she is treated as a bother. “I’ve even been told ‘shut up’ by a nurse because I was screaming too loud while I was in pain,” she said.

Abundant research shows racial bias in pain treatment. A 2016 study found half of white medical students and residents held at least one false belief about biological differences between Blacks and Whites, and were more likely to underestimate Black patients’ pain.

“The management of pain is one of the largest disparities that we see between Black people and White people in the American health-care system,” said Tina Sacks, an associate professor at the University of California at Berkeley and author of “Invisible Visits: Black Middle-Class Women in the American Healthcare System.”

Labeling women “hysterical” or blaming psychological causes

Research shows men in chronic pain tend to be regarded as “stoic” while women are more likely to be considered “emotional” and “hysterical” and accused of “fabricating the pain.”

Carol Klay, a 68-year-old from Tampa, had endured years of chronic pain from arthritis, degenerative disk disease and spinal stenosis. During a hospital stay last year, her doctor noted in her medical record that she was crying “hysterically.”

Klay said she was crying because she was unable to sit, stand or walk without agony, and the doctor had removed morphine from her cocktail of pain medications. She wonders whether the doctor “would have called me hysterical if I was a man,” she said.

Tampa General Hospital said it could not discuss specific patients, but stated: “Patient treatment plans, including medication orders to reduce pain, are prescribed by multi-disciplinary clinical teams.”

Research shows women’s physical pain is also often attributed to psychological causes.

Jan Maderios, a 72-year-old Air Force veteran from Chipley, Fla., said the trauma of having pain dismissed by doctors has stayed with her for years. She saw about a dozen doctors in the early 1970s for pelvic pain. When clinicians could not identify the cause of her pain, she was referred to a psychiatrist.

“You start to doubt yourself after so many medical experts tell you there’s nothing wrong with you,” she said.

After a hysterectomy in 1976, Maderios learned that fibroid tumors in her uterus had been the source of her pain. She said learning her pain was real — and physical — “made all the difference in the world.”

Why women’s pain complaints often aren’t taken seriously

During a 33-hour labor with her first child in 2011, Anushay Hossain, 42, of D.C., opted for epidural pain relief but said she still felt it all — every contraction, every cramp and every dismissal of her pain by her medical team. The doctor reassured her that she was getting the maximum dosage of pain medication.

In fact, she wasn’t getting any at all. She said her epidural had slipped out. By the time the error was caught, she was shaking uncontrollably and in need of an emergency Caesarean section, she said.

“There’s a pain gap, but there’s also a credibility gap,” said Hossain, author of “The Pain Gap: How Sexism and Racism in Healthcare Kill Women.” “Women are not believed about their bodies — period.”

This pain gap may stem, in part, from the fact that women have historically been excluded from medical research. It wasn’t until 2016 that the National Institutes of Health (NIH) required sex to be considered as a biological variable in most studies it funded.

“We’re making progress,” said David Thomas, special adviser to the director of NIH’s Office of Research on Women’s Health. “But we do have a long way to go because there’s this whole institutional approach to doing research — pain and beyond — where it tends to be male-focused.”

Nearly 95 percent of U.S. medical school students said instruction on sex and gender differences in medicine should be included in curriculums, according to a 2015 survey. But only 43 percent said their curriculum had helped them understand those differences and only 34.5 percent said they felt prepared to manage them in a health-care setting.

“It is changing, but it’s changing very slowly,” said Janice Werbinski, immediate past president of the American Medical Women’s Association and chair of the mentorship committee of the association’s Sex and Gender Health Collaborative.

How women can advocate for better pain care

It took decades to solve the mystery of Maureen Woods’s chronic pain. Woods, 64, of Myersville, Md., started having joint pain in her teens and, over the years, told dozens of doctors her pain was “debilitating,” she said. Some told her it was all in her head. In 2017, she was diagnosed with hypermobile Ehlers-Danlos syndrome, a connective tissue disorder often causing loose joints, dislocations and chronic pain.

She said women who are not being heard should keep advocating for themselves. “You have to go with your gut — something is wrong and I need to find a doctor who can figure it out,” she said.

Marjorie Jenkins, dean of the University of South Carolina School of Medicine Greenville, urged women against feeling pressured to accept an “everything is normal” non-diagnosis.

“If your provider does not appear to be listening to you or believing what you’re saying, then you need a new provider,” Jenkins said. “You are the client, you are the customer and you are the owner of your health.”

Women can also take a family member, friend or other support person who can corroborate their stories, said Alyson McGregor, an emergency medicine professor at the University of South Carolina School of Medicine Greenville and author of the book “Sex Matters: How Male-Centric Medicine Endangers Women’s Health and What We Can Do About It.”

Particularly in emergency departments, she said, there can be an inherent bias. “There’s this assumption that women are emotional and they’re anxious and that that’s the main issue,” she said.

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December 5, 2022

A digital application and augmented physician rounds reduce postoperative pain and opioid consumption after primary total knee replacement (TKR): a randomized clinical trial | BMC Medicine

Vowles KE, McEntee ML, Julnes PS, Frohe T, Ney JP, van der Goes DN. Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis. Pain. 2015;156(4):569–76.