GENDER DIFFERENCES IN THE PRESENTATION AND MANAGEMENT OF CHRONIC PAIN: EVIDENCE FROM AN OBSERVATIONAL STUDY

L. Farina¹, A.A. Carrideo¹, N. Di Francesco¹, T. Di Foggia¹, C. Gallo², G. Cinnella¹ | ¹Pain Therapy Clinic Ambulatory, Foggia University Hospital, Foggia, Italy; ²Department of Clinical and Experimental Medicine, University of Foggia, Italy

Abstract

Background and Aims. Gender-specific medicine in pain management requires considering biological sex and psychosocial factors, as they influence the prevalence, perception, and outcomes of pain treatment. The objective is to analyze the interaction between pain intensity, biopsychosocial impact, and disability.
Methods. The observational study was conducted at the Pain Medicine Outpatient Clinic of the Foggia Polyclinic on adult patients suffering from chronic persistent pain. The analysis involved 85 patients (32 males and 53 females). Internationally validated scales were used: NRS, Oswestry Disability Index, and Hamilton. Statistical correlations between these indices, clinical covariates, and administered therapies were assessed, monitoring recurrence rates at 1-, 3-, and 6-month follow-ups.
Results. Male patients presented at admission with higher pain intensity (NRS 7.1 vs. 6.5) and functional disability (ODI 63 vs. 40). Females show a higher Hamilton score (11 vs. 8). The temporal analysis clearly shows the different behaviors of the two genders. In males (NRS-ODI: r = 0.730), treatment approaches are delayed ("male stoicism") until the onset of actual disability. In females, functional resilience is greater but influenced by emotional state (Hamilton-ODI: r = 0.461). Males receive more interventional therapies (fix-it approach) than females (conservative medicalization).
Conclusions. In males, the interventional approach must be integrated with counseling and functional rehabilitation to prevent relapses. In females, early management of the anxiety-depressive component that underpins disability and reconsidering the use of interventional therapy are priorities.