Pain Coping in Racially Diverse American Patients

Directions for Future Research

The current review calls for future research to explore race differences in intra-personal and interpersonal values as they relate to pain. According to the authors, this may be the key to understanding race differences and moving towards culturally-sensitive care.

“We tend to assign positive or negative labels to different pain coping strategies, but all coping strategies are adaptive. Catastrophizing may be the best way for someone to get sympathy and social support in their environment. We need to look at the flip side — what purpose does this coping mechanism serve for this person?” said Dr Hirsh.

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Another important area of research might be to test these results on black individuals who live in a majority black culture. “It could be that what we are testing is not racial differences as much as it is minority differences,” Dr Edwards noted.

Key Takeaways for Primary Care

“The most important thing about this review for a primary care provider is that it summarizes a wide and diverse amount of literature on what we know about race and pain coping,” Dr Hirsh said.

Primary care providers need to be sensitive to racial and cultural differences in pain experience and pain coping. Assessing pain coping strategies can lead to pain management that is sensitive to cultural and individual differences.1,2

“Coping strategies matter. Poor coping can lead to poor choices. In a recent study, African Americans were more likely to rely on prayer for treatment of bone-to-bone osteoarthritis pain than joint replacement, [rejecting] a treatment that has a good chance of helping. Better coping may result in better outcomes,” Dr Edwards emphasized.

“There are no easy answers, but even the simple act of taking the time to assess coping strategies can be educational. It may offer the patient a chance to reflect on how they cope and to realize that better choices may actually help,” Dr Hirsch concluded, noting that making this effort may also be an important educational experience for primary care providers. 

References

1. SM, Miller MM, Hirsh AT. Differences in pain coping between Black and White Americans: A meta-analysis. J Pain. 2016 Jan 12. pii: S1526-5900(16)00019-5. doi: 10.1016/j.jpain.2015.12.017. 

2. Campbell CM, Edwards RR. Ethnic differences in pain and pain management. Pain Manag. 2012 May; 2(3): 219-230. Campbell CM, Edwards RR. Ethnic differences in pain and pain management. Pain manag. 2012;2(3):219-230. doi:10.2217/pmt.12.7.