Women separated from abusive partners often experience high-disability chronic pain after two years

Nov 18 2008

Many women separated from abusive partners still experience high-disability chronic pain after almost two years, according to Canadian researchers writing in The Journal of Pain , the peer review journal of the American Pain Society.

Despite ample evidence that chronic pain is a serious problem in women with a history of abuse, little is known about the severity and patterns of chronic pain in this population. The authors studied 292 abused women who had been separated for at least 20 months. They sought to describe patterns of chronic pain severity, define the relationship between chronic pain severity and disability, and document the pattern of use of select pain medications.

In the study, 35 percent of the women who survived intimate partner violence (IPV) showed high disability chronic pain and they experienced pain, on average, at three or more sites. Nearly half of those with chronic pain in the sample said they had swollen and painful joints. The authors noted that chronic stress caused by IPV may inhibit how the body naturally adapts to stress and causes imbalances in cortisol levels. Also, proinflammatory cytokines may lead to an increased autoimmune/inflammatory response and eventually cause chronic pain. Since IPV involves repeated trauma, many women sustain serial injuries before previous trauma can heal. Chronic pain also can be exacerbated by post-traumatic stress syndrome and elevated anxiety that interferes with cognitive skills for managing pain.

More than half of the women studied were unemployed, suggesting that chronic pain hampers the ability to maintain employment regardless of age or level of education. The authors reported that less than 25 percent of women with high-disability pain were taking opioids and, despite the prevalence of high-disability pain in this sample, opioid use in this group was the same as women in the general population.

They concluded these findings combined with high rates of unemployment and PTSD “raise questions about how well chronic pain is being managed” among victims of IPV.”