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8 Articles in this Series
Introduction
Bench to Bedside: Clinical Tips From APS Poster Presentations
New Pain Research Underscores the Importance of Sufficient Rest
The Benefits of Exercise for Pain Management
Exercise as Postoperative Analgesic?
How Race Affects Pain
Increased Centralized Pain in African American Patients
Managing Post-Tonsillectomy Pain in Obese Children
Research Offers Insight Into Fibromyalgia and Pain

How Race Affects Pain

Over the last few years, a growing body of evidence has explored the phenomenon of racial disparity in how patients perceive pain. Compared to non-Hispanic white (NHW) patients, African-American (AA) patients appear to suffer from more severe pain, inflicting a heavy burden on their quality of life (QOL).1,2

Depression,3,4 disability,5,6 loss of control over their pain3—even the development of post-traumatic stress disorder5—are all prevalent issues for AA patients with pain, something that has been found with many types of pain and pain syndromes.5-7

Acute trauma appears to be no exception. A study presented at this year’s annual meeting of the American Pain Society (APS) compared the burden of acute pain suffered by AA patients (n = 801) and European Americans (EA) (n = 948) admitted to an emergency department (ED) setting following a motor vehicle accident.8 The patients were evaluated for pain severity (0-10 NRS, moderate to severe pain defined as ≥4 NRS), body regions of pain (Regional Pain Scale), and neuropathic pain (DN4).

Researchers from the University of North Carolina, Chapel Hill, found noticeable differences between the 2 groups, as AA patients appeared to suffer a greater overall pain severity compared to EA patients—6.92  versus 5.61 (P < .001), respectively. AA patients also showed a greater number of body regions with moderate to severe pain compared to EA patients—4.50 versus 3.35 (P < .001), respectively.

These statistical differences remained significant even after additional adjustment of the study site, the authors noted. No noticeable differences in neuropathic pain were found between AA and EA patients, however.

According to the authors, these results, while gleaned from 2 different prospective studies, suggest AA patients are likely to suffer greater overall acute pain severity following a car accident compared to their EA counterparts. It’s a conclusion that further agrees with the line of discovery showing AA patients to be more vulnerable to pain and more susceptible to pain syndromes compared to Caucasians. However, as to the explanation behind this emerging idea, there are a number of theories to explore.

References

1.     Edwards RR, Doleys DM, Fillingim RB, et al. Ethnic differences in pain tolerance: Clinical implications in a chronic pain population. Psychosom Med. 2001;63:316-323.

2.     Ruehlman LS, Karoly P, Newton C. Comparing the experiential and psychosocial dimensions of chronic pain in African Americans and Caucasians: Findings from a national community sample. Pain Med. 2005;6:49-60.

3.     Green CR, Baker TA, Smith EM, Sato Y. The effect of race in older adults presenting for chronic pain management: A comparative study of black and white Americans. J Pain Off J Am Pain Soc. 2003;4:82-90.

4.     Tan G, Jensen MP, Thornby J, et al. Ethnicity, control appraisal, coping, and adjustment to chronic pain among black and white Americans. Pain Med. 2005;6:18-28.

5.     Green CR, Ndao-Brumblay SK, Nagrant AM, et al. Race, age, and gender influences among clusters of African American and white patients with chronic pain. J Pain Off J Am Pain Soc. 2004;5:171-182.

6.     Edwards RR, Moric M, Husfeldt B, et al. Ethnic similarities and differences in the chronic pain experience: A comparison of African American, Hispanic, and white patients. Pain Med. 2005;6:88-98.

7.     Green CR, Anderson KO, Baker TA, et al. The unequal burden of pain: Confronting racial and ethnic disparities in pain. Pain Med. 2003;4:277-294.

8.     Jones L, Borstov A, Fillingin R, et al. (2016, April). African Americans experience a greater burden of acute pain after motor vehicle collision than European Americans. Poster presented at: Annual Meeting of the American Pain Society; May 11-14, 2016; Austin, Tx. Poster #100.

Next summary: Increased Centralized Pain in African American Patients
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