Women rule

A recent discernable shift in the search for better outcomes with patients who have been troubled with pain for some time is to view the clinician as a possible variable in the outcome (Houben, Ostelo et al. 2005). Traditionally it has been features of the patient such as chronicity and catastrophisation which have been the key focus. On this issue, it is quite interesting to consider that in education the teacher is known to be a critical variable in outcome, as well as the student, but this notion hasn’t really entered the world of health.

Women win!
I have been studying clinician based variables which may lead to knowledge of best evidence based practice for chronic pain in my home state. With modern neuroscience backed biopsychosocial management taken as best evidence, I have sampled about 20% of the workers in the state. One clear finding is that females are significantly more evidence based in their knowledge of chronic pain management strategies than males. Their quality of knowledge is better. The women clearly win! Congratulations and well done. What could we boys be doing wrong I ask myself.

A closer look at the gender win

I admit to checking this finding a few times and to trying novel statistical approaches but the women still won. I also measured the quality of knowledge about the processes which may relate to how a person travels from an acute injury to a chronic pain state (for example, knowledge of yellow flags) but here there was no gender difference. This superior quality of knowledge in females about chronic pain management may be even more pronounced because women are more likely to work in rural areas which is known to have a negative effect on knowledge of evidence based chronic pain management.

Why is this?
I need some help in writing up this finding. My female friends say “but of course, how long has it taken you to realise that” but that is of no help in a scientific paper. Sure, females experience more non pathological pain than men with menstrual associated pain and childbirth but is this enough to educate oneself about evidence and scientifically based strategies such as self management, education, appropriate medication, pacing and exposure to painful activities at a deeper level than the boys? Girls are known to have a greater prevalence of musculoskeletal pain as well and perhaps these experiences have been educational.

Why do you think this could be (or could not be)? We would love to hear your most interesting, valuable and expert opinions.

References
Houben, R. M. A., R. W. J. G. Ostelo, et al. (2005). “Health care providers’ orientations towards common low back pain predict perceived harmfulness of physcial activities and recommendation regarding return to normal activity.” European Journal of Pain 9: 173-183.

Another legendary NOI instructor
Here is a classic ‘women rule’ story. Martina Egan-Moog is practically an acrobat. She has a family of four young children and a loving husband. She teaches undergraduate and postgraduate courses about Physiology of Pain and Pain Management, is involved with clinical supervision, and publishes in various German and English speaking journals and books.

One of Martina’s amazing achievements was cycling in 2003 alongside her husband 4500km on an unassisted tour across the entire length of Australia, from Sydney to Perth. That’s  Malaga to Moscow, or New York to San Francisco with a gruelling, long and hot desert in the middle!

The wonder woman completed her Postgraduate Diploma in Manipulative Therapy (1996) and a Masters by Science degree (1999) at Curtin University in Perth, Western Australia. From 1999 to 2003, she worked with an interdisciplinary team in a Cognitive-Behavioural-Therapy (CBT) program for chronic pain patients at the Pain Management and Research Centre (PMRC), University of Sydney.

Martina has since returned to Europe, where she currently lives at the Swiss/German border, near Basel. Her main interest is to bridge research findings from pain sciences and behavioural medicine with clinical practice. For this she is an active member of SIG Pain and Movement (IASP) and SIG Physiotherapy and Pain (DGSS).

She is teaching Schmerzen Verstehen (Explain Pain) in Saarbrucken this month.

View more details on Martina’s courses.

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