Sunday, February 20, 2005

Brandy Baker / The Detroit News Simone Orton of Ann Arbor searched for years for relief from chronic pain due to a rare form of arthritis. "I have to tell you, I really think that you can die from severe pain," she says.

Living in Agony

Women fight to have pain taken seriously

Female patients are less likely to receive adequate treatment and medication.

By Sheri Hall / The Detroit News

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For the first half of Simone Orton's life, doctors didn't believe her complaints of severe lower back pain.

At age 23, Orton finally met a rheumatologist who diagnosed her with a rare form of arthritis. But even then doctors still couldn't control her pain, which got so bad it would make her vomit.

"My experience with doctors is they don't believe you, and when they prescribe a narcotic, they don't prescribe nearly enough," said Orton, now 42, of Ann Arbor. "Doctors in my case were too afraid to try anything stronger, fearing I would be addicted or there would be an overdose situation."

Researchers have found that, like minorities, women are more likely to suffer because of inadequate pain treatment.

A 2001 study reviewing cancer care at seven outpatient clinics in California found that female cancer patients were prescribed half the pain medication as male patients with the same pain intensity scores. And a 1994 study from the New England Journal of Medicine found that female cancer patients were significantly more likely to receive inadequate pain medications than males.

While the problems are similar, the disparity among genders is less pronounced than differences among racial groups, said Dr. Roger Fillingim, a disparities expert at the University of Florida's College of Dentistry. And the reasons are different.

"My biggest concern is that because women seek more health care and report more painful symptoms, the risk that their symptoms will be taken less seriously is higher," he said.

In addition, a slew of painful chronic conditions impact women at much greater numbers than men. One such condition is fibromyalgia -- a mysterious disorder that causes widespread pain in the muscles with no perceptible cause. About 90 percent of people with fibromyalgia are women. Since there is no test for the condition, many doctors have attributed its pain to psychological disorders.

"With women, there might be an underlying assumption that the pain is related to depression or anxiety and therefore it's not treatable," said Dina Dadabhoy, a rheumatology fellow at the University of Michigan.

Last year, Orton's pain got so intense that she vomited daily and began to lose weight. Her husband finally took her to U-M, where she met pain specialist Dr. Carmen Green and began getting treatment at U-M's Interventional Pain Clinic.

"I have to tell you, I really think that you can die from severe pain," Orton said. "I'm educated and I was at a point where I couldn't advocate for myself. A lot of people don't even know what questions to ask."