Gender-based differential management of acute low back pain in the emergency department: A survey based on a clinical vignette

Abstract

Background: Women may receive suboptimal pain management compared with men, and this disparity might be related to gender stereotypes. Objectives: To assess the influence of patient gender on the management of acute low back pain. Design: We assessed pain management by 231 physicians using an online clinical vignette describing a consultation for acute low back pain in a female or male patient. The vignette was followed by a questionnaire that assessed physicians’ management decisions and their gender stereotypes. Methods: We created an online clinical vignette presenting a patient with acute low back pain and assessed the influence of a patient’s gender on pain management. We investigated gender-related stereotyping regarding pain care by emergency physicians using the Gender Role Expectation of Pain questionnaire. Results: Both male and female physicians tended to consider that a typical man was more sensitive to pain, had less pain endurance, and was more willing to report pain than a typical woman. These stereotypes did not translate into significant differences in pain management between men and women. However, women tended to be referred less often for imaging examinations than men and were also prescribed lower doses of ibuprofen and opioids. The physician’s gender had a modest influence on management decisions, female physicians being more likely to prescribe ancillary examinations. Conclusion: We observed gender stereotypes among physicians. Our findings support the hypothesis that social characteristics attributed to men and women influence pain management. Prospective clinical studies are needed to provide a deeper understanding of gender stereotypes and their impact on clinical management.

Effectiveness of simultaneous bilateral visual diaphragm biofeedback under low back pain: influence of age and sex

“…Non-specific low back pain (NSLBP) has been stated as the most common musculoskeletal condition, providing an 80% rate of estimated cumulative incidence among the population throughout their working lives, and is associated with greater disability and reduced quality of life and other biopsychosocial factors ( Maher et al, 2017 ). Sex and age distribution were linked to different prognoses, pain sensitivity, and response to NSLBP management ( Lobo et al, 2017 ; Alhowimel et al, 2018 ; Ferrer-Peña et al, 2018 ; Schilter et al, 2024 ). The point, year, and life prevalence of NSLBP reached ratios of up to 67%, 94%, and 84%, respectively ( Farahbakhsh et al, 2018 ).…”