Sex Differences in Pain and Pain‐Related Disability among Primary Care Patients with Chronic Musculoskeletal Pain
Abstract
BACKGROUND: Although previous research suggests women report more severe pain than men, evidence for sex-related differences in pain-related disability is conflicting. Also, the impact of psychological factors on sex differences in disability is uncertain. OBJECTIVE: The purpose of this study is to assess sex differences in pain-related disability and evaluate whether they are accounted for by psychological factors. METHODS: Analysis of baseline data from the Stepped Care for Affective disorders and Musculoskeletal Pain study. Participants included 241 male and 249 female primary care patients with moderately severe persistent pain of the back, hip, or knee. Multivariable log-linear models were used to determine the association between sex and pain-related disability and whether sex differences persisted after adjustment for psychiatric comorbidity and potential psychological mediators. RESULTS: Compared with men, women reported worse pain intensity, greater pain-related interference with function, and more disability days due to pain. They also had worse depression, anxiety, and self-efficacy. Sex differences in pain interference with function and pain disability days remained significant in multivariable models. Depression, poor self-efficacy, and fear of reinjury were independently associated with disability in both men and women. CONCLUSIONS: Women report greater pain-related disability than do men, even after controlling for depression, anxiety, and other psychological factors. Pain management strategies that target functional disability may be particularly important in the treatment of women with pain.
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The prevalence of chronic musculoskeletal pain is higher among women than men in community and treatment-seeking cohorts.
“It is well known that the prevalence of chronic musculoskeletal pain is higher among women, both in community and treatment seeking cohorts [1–5].”
From Chronic pain and sex-differences; women accept and move, while men feel blue (2017) · cites this paper as [5]
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Strategies for Coping with Chronic Lower Back Pain in Patients with Long Physiotherapy Wait Time
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Psychosoziale Faktoren in der Prävention von Schmerz
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The TMD-7 as a Brief Measure for Assessing Temporomandibular Disorder
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- Authors
- Stubbs, D., Krebs, E., Bair, M., Damush, T., Wu, J., Sutherland, J., & Kroenke, K.
- Affiliations
- Indiana University Indianapolis (US)
- Regenstrief Institute (US)
- Dartmouth College (US)
- Venue
- Pain Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-02
- Volume
- 11
- Issue
- 2
- Pages
- 232-239
- ISSN
- 1526-2375 (ISSN-L)
- 1526-4637
- OpenAlex
- W2068799913
- Cited by
- 170
- References
- 42
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 25 · 2023: 21 · 2022: 14 · 2021: 14 · 2020: 7 · 2019: 7 · 2018: 4 · 2017: 5 · 2016: 6 · 2015: 9 · 2014: 14 · 2013: 10 · 2012: 9
- FWCI
- 3.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01MH071268)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- sex differences, chronic musculoskeletal pain, pain-related disability, depression, anxiety, self-efficacy, fear of reinjury, psychological mediators, back pain, hip pain, knee pain, primary care patients
- MeSH terms
- Aged, Analysis of Variance, Arthritis, Attitude, Chronic Disease, Depression, Disability Evaluation, Fear, Female, Humans, Male, Middle Aged, Musculoskeletal Diseases, Pain, Pain Measurement, Primary Health Care, Prospective Studies, Sex Factors, Socioeconomic Factors, Comorbidity
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