The gender pain gap (GPG) highlights disparities in how pain is perceived, treated and managed between genders and shines a spotlight on the need for better women’s healthcare.

Ongoing research reveals biases, stereotypes and disparities in pain management contributing to the unequal identification and treatment of women’s pain.

What is the gender pain gap?

The gender pain gap refers to the phenomenon in which pain in women is more poorly understood and more mistreated compared to men’s pain due to systemic gaps and biases. Dr Bill Laughey, Senior Medical Scientist at Reckitt, explains: “Women actually experience pain more frequently than men, which on average is more disruptive to their lives. Yet, unfortunately, we — as a society — don’t take pain in women as seriously.”

Nurofen’s mission is to help women receive a timely diagnosis, ensuring that they are treated fairly and their pain is validated. “We want a more compassionate society. We want to help close the gap for good,” adds Dr Laughey.

Gender Pain Gap Index Report

According to Nurofen’s Gender Pain Gap Index Report, one in four women versus one in six men felt that, generally, no one took their pain seriously.¹ More concerningly, only 47% of women surveyed received a diagnosis for their pain within 11 months, compared with 66% of men.² This might prevent women from seeking appropriate pain treatment. When adding issues such as menstrual pain or gynaecological concerns, which can be uncomfortable to discuss, the need for change becomes more urgent.

By sharing your experiences and openly discussing your pain, we can help to raise awareness of the gender pain gap to fight for change.

Pain Pass enhances patient dialogue

The report also highlights that women find it challenging to talk about their pain. In fact, one-fifth (20%) of women want more resources to aid better conversations between them and their healthcare professionals.² Recognising this need, Nurofen created a Pain Pass tool for patients, available for free.

“We’ve developed a Pain Pass tool in collaboration with leading pain specialists to help empower and equip women to get the right support, diagnosis and treatment for their pain,” says Dr Laughey. The Pain Pass is available online or as a pocket-sized foldaway. To date, it has been distributed in over 2,300 GP surgeries and is available in high street pharmacies.

“The Pain Pass is essentially a pain diary, to empower women and enable better conversations with healthcare professionals. It provides a pain tracking calendar and provides adjectives to help describe pain, such as numbing, dull or aching pain,” says Dr Laughey. “Feedback has been extremely positive. We encourage patients to use the tool as a resource to advocate for themselves and improve treatment plans for pain.”

Dr Laughey insists: “We urge women to download the pain pass tool and use it as a resource to advocate for themselves. By sharing your experiences and openly discussing your pain, we can help to raise awareness of the gender pain gap to fight for change.”

Collaboration as key to change

“We know we can’t address this change alone, so we are partnering with academic institutions such as Oxford University and The University of Manchester to advance research into the gender pain gap,” Dr Laughey continues.

“We have created a free Gender Pain Gap training programme for healthcare professionals, leveraging insights from research carried out with leading women’s health charity Wellbeing of Women. We are excited to announce that over two-thirds of Superdrug’s pharmacists, pharmacy assistants and nurses have completed the training,” he adds.

Campaigning to close the gap

“We see our campaign as being aligned with what the UK Government is hoping to do in terms of improving women’s health — by driving education initiatives, supporting medical research into women’s health and attending professional conferences,” says Dr Laughey. “By sharing experiences and openly discussing pain, we can help to raise awareness of the gender pain gap to fight for change.”

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Codeine-free over-the-counter analgesics — which combine paracetamol and ibuprofen — can offer patients a more effective pain relief option that may help reduce opioid dependence.

Much has been written about the scourge of opioid addiction in recent years. Yet, in the UK, there’s a temptation to think that this issue only affects other countries. That’s just not the case, insists Dr Hartley Atkinson, Managing Director, AFT Pharmaceuticals.

Opioid epidemic affects the UK

According to one study in the British Journal of Pain, the UK had the world’s highest rate of opioid consumption in 2019.¹ Too many people are using opioids to manage everyday moderate pain such as headaches, toothache, sore throat and sprains; yet sustained long-term use of these drugs increases the likelihood of addiction. “Studies have shown that 10% or more of patients who are discharged from hospital on opioids are still using them three months later,² and that’s just not appropriate,” says Dr Atkinson.

Our studies have shown that relief is around 80% stronger than paracetamol alone and around 30% stronger than ibuprofen alone.⁴

Faster pain relief

Part of the answer is to give healthcare professionals and patients a range of different pain relief options. For example, Dr Atkinson’s company has created a specific, over-the-counter, codeine-free analgesic, which combines 500mg of paracetamol and 150mg of ibuprofen (both non-opioids) per tablet.

“We found that combining paracetamol and ibuprofen in these ratios produces a very good level of pain relief,” reveals Dr Atkinson. A clinical study has indicated codeine combined with paracetamol boosts pain relief by only 5% compared to paracetamol alone.³ “Our studies have shown that relief is around 80% stronger than paracetamol alone and around 30% stronger than ibuprofen alone.⁴ Combining paracetamol and ibuprofen also offers faster pain relief. We discovered the medication produces meaningful pain relief in about 42 minutes, whereas simply taking ibuprofen on its own takes around an hour to produce the same effect.”

Playing a part in reducing opioid use

Dr Hartley believes this pain relief — which has been available in UK pharmacies for around a year — could play a role in helping to combat the opioid crisis. “Doctors will still need to consider giving their patients combinations of multiple painkillers,” he says. “But having access to an additional strength analgesic gives them options, which is what they have been asking for. It can minimise the amount of time that a patient spends on opioids — or help them avoid opioids altogether.”

Disclaimer:
This article is for informational purposes only. For professional medical advice, consult your GP.

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Explore Frida Kahlo’s raw portrayal of chronic pain in ‘The Broken Column.’ Discover how her art reflects resilience through her pain and suffering.

Pain is invisible and hard to explain. People often feel disbelieved, even ridiculed. That emotional abandonment is pure suffering. It’s time to see pain to look at who we really are.

Expressing pain through art

The images of Frida Kahlo are universal. Her striking dark features, prominent monobrow and hundreds of self-portraits hang in galleries, are stuck on cushions and have become the symbol for much feminist discourse.

But did you know that Kahlo lived with chronic pain for most of her life? After being hit by a bus at the age of 18, Kahlo was left with multiple injuries and persistent pain. She began encapsulating her pain through art.

She shows that she is as beautiful and important as a person living with chronic pain.

The Broken Column (1944)

Kahlo painted The Broken Column (1944) following an unsuccessful surgery on her spine. Kahlo is centre frame, partially naked and covered in nails. Her body is wrapped in white straps, holding her together. Her body is ripped in two, split by a cracked column that stands jarringly inside her body as if to represent her pain.

Her hair flows down her back, her breasts exposed and she holds a white cloth to cover her lower body. Parallels can be drawn between Kahlo and The Birth of Venus (1483). Botticelli imagines Venus with her hair flowing, breasts partially exposed and covering her ‘modesty.’ Kahlo takes autonomy of her own body depicting it just as beautiful as the divine female.

Look me in the eye

Kahlo looks straight ahead at the viewer, giving the painting an intense yet intimate feeling. She stands strong in the face of her physical restraints and pain. As we gaze and marvel at her body, she does the same to us despite the limits of her painted form. Her eyes follow you, daring you to stop and stare.

Kahlo depicts her physical pain with such raw beauty; it is physically a part of her, but it does not define nor overshadow who she is. She shows that she is as beautiful and important as a person living with chronic pain. She bares herself to us as she is and stands just as tall. This is who she really is.

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Pain should be a vital sign. Learn why it’s crucial for healthcare to prioritise pain assessment, ensuring better patient care and comprehensive health monitoring.

Healthcare professionals routinely monitor four measurable vital signs: (1) body temperature; (2) pulse rate; (3) respiration rate (rate of breathing); and (4) blood pressure.

Assessing pain as a vital sign

Currently, pain is not considered to be ‘vital.’ It cannot be measured. Yet, in ‘UK Pain Messages 2024’, the British Pain Society states:

• Approximately 8 million adults report moderate to severely disabling pain. 
• Around 43% of adults (almost 28 million people) live with a degree of chronic pain.
• In older age groups, the rates are higher, with up to 62% of those aged 75 and over reporting chronic pain symptoms.

Pain is a critical indicator of underlying conditions.

Steps to elevate pain as a vital sign

1. Standardise assessment tools: Implement consistent, validated pain assessment tools and pain scales across all healthcare settings to ensure that pain, like other vital signs, is regularly monitored.
2. Education and training: Educate healthcare professionals on the importance of pain assessment and management, including recognising different types of pain and understanding appropriate treatment options.
3. Policy integration: Incorporate pain assessment protocols into clinical guidelines and hospital policies, making it a routine part of patient evaluations.
4. Patient-centred approach: Encourage open communication with patients about their pain, ensuring that their experiences are validated and addressed.
5. Patient-centred language:Understand that patients use a wide range of words to describe their pain. It might ‘ache,’ ‘burning’ or ‘over-sensitivity’ — and they may deny ‘pain.’
6. Regular audits and feedback: Conduct regular audits to ensure pain is being assessed and treated effectively, providing feedback and making necessary adjustments to improve care.
7. Balanced pain management: Combine pain assessment with strategies to prevent over-reliance on opioids, using a multidisciplinary approach to pain management.

Value in promoting pain awareness

Viewing pain as a vital sign encourages healthcare providers to assess pain, which improves patient care. Pain is a critical indicator of underlying conditions. Neglecting it can lead to unnecessary suffering and delayed treatment.

As a vital sign, clinicians will have to consider it as an integral part of patients’ overall health, ensuring that it is monitored and managed. This approach ensures patients — not just the condition — receive treatment.

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Menstrual health has long been a deprioritised and underfunded area. Learn why the state of endometriosis care must be addressed urgently.

The latest Endometriosis UK research shows that, on average, it takes 8 years and 10 months to get diagnosed with endometriosis in the UK. Since 2020, gynaecology waiting lists in England have grown faster each month than any other elective speciality in percentage terms.

Improving endometriosis care

Delays in diagnosis and treatment times can have a devastating impact on a patient’s life including their physical and mental health, education, relationships, fertility and work. Not only can the disease worsen if left untreated, but the impact on someone’s life cannot be overstated.

Implementing key changes to endometriosis care would not only reduce pain and suffering for those with endometriosis, but it would also save the NHS time and resources. The new Labour Government now has an opportunity to assess and change how endometriosis care is delivered and to provide long-awaited hope for the 1.5 million with endometriosis in the UK.

Endometriosis must be recognised as a chronic
condition and given parity with other chronic
conditions, such as diabetes and bowel disease.

Endometriosis as a chronic condition

Endometriosis must be recognised as a chronic condition and given parity with other chronic conditions, such as diabetes and bowel disease. This is highlighted as one of the changes recommended by a new report published this July, ‘A long and painful road’, by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD).

The report calls for a step change in how endometriosis care is provided in the NHS. It evidences the issues faced today by those with endometriosis, and the recommendations show how improvements can — and must — be made.

Identifying endometriosis symptoms

Currently, endometriosis symptoms are generally treated as multiple acute (one-off)

episodes, with symptoms often unrecognised by healthcare practitioners as potentially being endometriosis. The need for care pathways, holistic and medical management supporting mental and physical health, plus follow-up if symptoms recur, are highlighted in the NCEPOD report — all of which Endometriosis UK has long been calling for.

Ultimately, we need every healthcare practitioner to recognise endometriosis symptoms so that anyone experiencing them can then be placed on the right pathway and access the right care at the right time.

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Find some tips for better back health, especially while working from home. Improve posture, manage weight and stay active with simple, effective strategies.

Before the Covid-19 pandemic, it is estimated that less than 5% of employees worked from home. During the pandemic, this rose to nearer 50% of employees spending at least a part of their week working remotely. In 2024, around 25% of employees still work from home either fully or in a hybrid situation.

Your back, your priority

Approximately 2.5 million people in the UK live with a form of back pain. Reasons range from acute injury to degenerative conditions. However, most back pain is short-lived and caused by — among other things — a lack of physical activity, an increase in weight and posture problems rather than spinal damage or other health conditions.

Are you sitting comfortably?

Always sit all the way back in your chair, making your spine as long and straight as possible. If working on a computer, the screen will need to be raised anywhere between 5 and 10 inches to provide the proper height.

When sitting on a chair all day, the best way to look after your back is to get up regularly. Try to change your position at least every 20 minutes. Don’t work from sofas or chairs that are too low, deep, soft or angled backwards.

Approximately 2.5 million people in
the UK live with a form of back pain.

Choose your snacks wisely

Working from home can provide an increased opportunity to reach for the biscuit tin. As Hippocrates said: ‘Let food be your medicine and medicine be your food.’ Wherever possible, choose fruit or vegetables to quell the hunger pangs between meals. Avoid the temptation for those tasty morsels that are high in sugar and rich in fats.

Walking keeps back mobile and relieves pain

Recently, an Australian WalkBack study highlighted that ‘walking’ is a good way to keep the back mobile and take our mind off the pain. Who would have thought that something so simple and free could be so effective? Walking provides options for all — whether that is around the room, the garden, to the local shop or even further afield, the opportunities to stretch our legs in this way are without limits.

When to get help for back pain

Chronic low back pain often has no specific cause, but serious conditions must be ruled out by a medical professional if symptoms persist. Seek immediate help if you experience sudden shooting pains, numbness, reduced muscle strength or bladder/bowel issues.

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Patients suffering from chronic conditions such as back pain and arthritis could benefit from one of the new technologies transforming the management of long-term pain.

With increased waiting times for NHS surgery, helping people manage their pain while waiting for surgery is more important than ever. In some cases, surgical ‘waiting lists’ are now seen as ‘preparation lists’ where patients are being provided with information to prepare for surgery. This includes pain management strategies through ‘waiting well’ initiatives.

Chronic pain management

Chronic pain is one of the most common and debilitating conditions. It can affect patients suffering from conditions such as back pain and arthritis, whether or not they are in line for a surgical procedure.

There are a number of new advancements in pain management that are on the horizon. Outlined here are just a few in the pipeline that are aiming to relieve back and joint pain.

Spinal cord stimulation

Procedures such as spinal cord stimulation involve sending electrical impulses to the spinal cord to alter pain signals before they reach the brain. Recent innovations include high-frequency and burst stimulation, which could offer more effective pain relief.

It is now used for conditions like persistent spine pain, complex regional pain syndrome and diabetic neuropathy. It has shown significant improvements in pain, function and quality of life for patients.

As research and technology continue to
evolve, pain management techniques
are poised to deliver better outcomes.

Nerve blocks using radiofrequency

People who can’t have joint replacements or other major surgery due to health reasons may be managed by nerve blocks using radiofrequency. For example, this includes procedures such as genicular nerve block for knees and suprascapular nerve block for shoulders.

Nerve blocks are a newer approach, which targets specific nerve regions, offering more focused pain relief than spinal cord stimulation. They are used to treat various post-surgical pain syndromes and to treat people who suffer from chronic musculoskeletal (MSK) pain conditions such as chronic low back and pelvic pain and arthritis. They have shown high success rates in improving quality of life and reducing the use of over-the-counter pain relief.

Reducing chronic pain burden

These are just a few of the innovations that not only offer new perspectives on pain physiology but also provide more personalised and effective treatment options. As research and technology continue to evolve, pain management techniques are poised to deliver better outcomes for patients, improving their quality of life and reducing the burden of chronic pain.

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Chronic pain impacts 20% of the population. We need to shift from medical treatments to holistic, supported self-management approaches.

Pain becomes chronic after three months when tissue healing has usually been completed. Moderate to severe disabling chronic pain affects around 8 million adults in the UK, disrupting lives of individuals, families and communities. Back pain is the leading cause of disability, costing UK taxpayers an estimated £10 billion annually. Our approach to managing chronic pain must change.

Medicines have limited effect on chronic pain

Pain is processed in the nervous system through many mechanisms, but most medicines target only one. Medicines may relieve many types of pain but work best when combined with regular activity, exercise or enjoyable activities. Some types of pain may not respond to medicines or only for short periods.

Opioids like codeine, morphine and tramadol cause long-term issues such as constipation, itching, weight gain, low sex drive and breathing difficulties. For any concerns, your care team or pharmacist can advise on maximising benefits and managing side effects.

Medicines may relieve many types of pain but
work best when combined with regular activity.

National survey on chronic pain

The 2024 British Pain Society (BPS) national survey on chronic pain found that 87% of patients were prescribed pain medicines, primarily opioids. Approximately 86% had taken these medicines for over two years, and 77% reported benefits. However, 67% experienced side effects, and worryingly, 69% had not been informed about long-term risks.

Former vice-chair of BPS patient committee Louise Trewern recalls: “I lived with unexplained pain for years, leading to high-dose opioid prescriptions. I transformed my life by tapering off opioids and managing my pain through activity, diet and sleep.”

Psychological approaches

NICE recommends psychological therapies, such as acceptance and commitment therapy (ACT) or cognitive behavioural therapy (CBT) in managing chronic pain for people aged 16 years and over. ACT improves quality of life by enhancing sleep and reducing pain and psychological distress. These therapies can be provided by trained professionals through the NHS or privately.

BPS honorary member Pete Moore moved from relying on medicines to self-management after attending a Pain Management Programme in 1996. Since then, he has not needed to take medicines. “Empower patients to understand their pain and then take up self-management strategies,” Moore advocates.

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To address migraine pain, we must uncover how this common condition affects different people. Explore hormone influences in women, underfunded research and tailored treatments.

Around 10 million people live with migraine in the UK; approximately 70% are women. Female hormones increase the likelihood of a migraine attack, with worsening attack occurrence after puberty, across the menstrual cycle and during menopause.

Underfunded migraine research

Despite how common migraine is, it is the least funded neurological condition compared to both its size and economic impact, ranked as the second most disabling disorder globally. In addition to a lack of research about the condition, there is even less that looks at the difference in sexes. This includes the relationships between sex hormones and migraine and changes across the life course, such as perimenopause.

Medication for migraine pain

Triptans are a group of medicines designed to treat migraine attacks by reducing pain and sickness at the time taken. A study by a team of Dutch researchers found that responses to triptans can vary between men and women, with women more likely to experience adverse effects. Further, the contraceptive pill can impact how effective treatments are.

While excruciating head pain is one of
the most common symptoms, migraine
is far more than a simple headache.

Personal impact of migraine

While not fatal, migraine for too long has been a lower priority than other conditions. Yet, the personal impact of living with it can be significant — impacting an individual’s mental health, education, ability to work, capacity to socialise and manage relationships.

While excruciating head pain is one of the most common symptoms, migraine is far more than a simple headache. Other symptoms can include extreme fatigue, sensory hypersensitivity, visual disturbances and vomiting. For women, we know migraine can further influence decisions not to have children and affect how they manage pregnancy, menopause and contraception.

Studying migraine by demographic

Dedicated studies on gender-related differences in migraine are needed, alongside those exploring how treatments affect different groups. This goes beyond gender, with ethnicity being another area. This will support the development of new therapies and treatment plans tailored to individuals. Ultimately, it will help reduce pain levels — both physical and mental — experienced by many living with migraine.

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