Difficult to recognize and treat, chronic pain is not perceived as a female problem. However, women are 2 to 9 times more likely than men to suffer from it. They often struggle to be heard, even though the consequences on their daily lives can be immense.
Rachel* has suffered from migraines for years. More than just a headache, these migraines can keep her bedridden for days. “The pain can be so bad that it makes me vomit. I’m paralyzed and I can’t even take my medication,” she says.
Now in her thirties, Rachel started taking painkillers for her migraines when she was 12, so most of them don’t work anymore.
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“It can be triggered by overpowering smells, too much noise or bright light, even strong emotions. Sometimes, everything is fine and I have a migraine without knowing why,” she says.
She is one of many Canadians living with chronic pain. Estimates vary depending on the criteria used to define it. Its prevalence would be between in Canada, depending on the study.
Catherine Côté, a master’s student in political science who works on chronic pain, defines it as “pain of at least 3 on a scale of 1 to 10, [et] which lasts for more than 3 months. The intensity may change over time as the pain comes and goes.
Pain can be caused by a large number of different factors, such as osteoarthritis, fibromyalgia, or connective tissue disease. It can also be the result of an injury or an accident.
“According to this definition, a quarter of the Canadian population is affected. This proportion will increase with the aging of the population and the consequences of the long COVID”, specifies Catherine Côté.
A female problem
Of this number, women represent a majority.
Thus, “we find [de] 2 to 9 times more women than men in most types of chronic pain. On average, these pains are more intense, more diffuse in the body and last longer in women”, notes the student who published on his own experience of chronic pain.
The scientific community does not yet agree on the causes of this concentration of chronic pain in women. Violence once morest women is nevertheless a factor to consider in order to understand their greater prevalence, according to Catherine Côté.
“Women who have experienced domestic violence suffer from chronic pain resulting from injuries inflicted on them, for example. There is also a link between the phenomenon and post-traumatic syndrome. It has been studied in veterans, but the same should be done with survivors of violence. [sic].»
These women also tend to be less believed when sharing their pain with loved ones or healthcare professionals.
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“We will often psychologize their pain, telling them that they are exaggerating or that it is in their head. However, people who have a uterus have on average a high pain tolerance threshold, if we think of childbirth or menstruation,” says the master’s student.
Studies done on trans women show that they would be by chronic pain.
invisible pain
The fact that there are very few visible signs of chronic pain would partly explain why it is so difficult to have it recognized.
“There is a barrier to communication, it’s very hard to put into words. Often the metaphors do not express the experience well”, explains Catherine Côté. She also remembers having herself noticed a change in the attitude of her attending physician, once she learned to express her symptoms in scientific language.
For Rachel, she had to be hospitalized for gastro so that we decided to treat her migraines.
“I was taking so many painkillers it ruined my stomach, I was throwing up blood. When we realized that at the hospital, I was finally referred to neurology. It saved my life,” she says.
“It’s depressing to spend the week in bed”
The consequences of chronic pain go far beyond its effects on the body.
Rachel, for example, is unable to keep a regular 9 to 5 job because of her migraines.
“It’s happened before that colleagues had to take me home because I mightn’t walk anymore. My employer is understanding, but I am absent so much that I don’t work enough hours to live well,” she laments.
It is up to 25% of her income that she loses in absences, while she quickly exhausts all her sick leave.
“All this time I’m not traveling or having a good time. It’s depressing to spend the week in bed, ”she says.
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Even when the migraines have passed, the lingering fatigue is hard on her mental health, she says.
“It’s hard to be in pain all the time. I feel like I got run over by a ten-wheeler, so sometimes I lack enthusiasm. I don’t want to be the one who complains all the time.”
The extent of the psychological distress caused by chronic pain often goes under the radar, but “14% of people who suffer from it have attempted suicide,” recalls Catherine Côté, who deplores the lack of accessibility to psychological services. .
The need for interdisciplinary care
To prevent people with chronic pain from “falling into the cracks of the system”, as is too often the case, we must encourage interdisciplinary care, insists Catherine Côté.
“Right now, it’s very complicated to navigate [dans] the system and waiting lists are long. We need accessible treatments that take into account the complexity of the problem,” she insists.
She suggests considering the person experiencing pain as an integral part of the care team.
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This is not an issue that governments can afford to ignore, as the population ages and the protracted COVID leaves lasting scars for many people.
This is the case of Rachel who, following contracting COVID, was left struggling with new significant muscle pain. “I do not qualify for any government assistance. Either you are disabled or you are in great shape, and there is nothing in between, ”she criticizes.
*We have changed the first name of the person so that their testimony has no consequences on future administrative procedures.
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