Chronic Pain Report Aims to Transform Care for Women

A report on chronic pain, supported by Health Canada, aims to reshape how the medical system understands and diagnoses pain, particularly for women suffering from ‘invisible illnesses.’ Released in March 2021 during the height of the COVID-19 pandemic, the report received limited attention. Medical professionals and advocates now hope to raise awareness about its findings and recommendations.

Chronic illnesses such as endometriosis, fibromyalgia, and myalgic encephalomyelitis (ME/CFS) often do not present visible symptoms, leading to significant underdiagnosis and misdiagnosis. Women, in particular, face challenges in being believed when reporting debilitating pain. The experiences of Shae-Lynn Bakaluk, a resident of Moose Jaw, highlight these struggles. Bakaluk endured agonizing pain for over a decade before receiving a diagnosis for her endometriosis.

Bakaluk’s journey began at age ten when she experienced severe menstrual pain, which she described as feeling like “razors” inside her body. Despite her pain, teachers dismissed her claims, suggesting she was simply avoiding physical activity. Over the years, Bakaluk attended approximately 50 medical appointments, only to be told repeatedly that she lacked sufficient pain tolerance and that nothing was wrong.

“I did start to feel like they were right, that maybe I wasn’t strong enough,” Bakaluk recounted. The emotional toll was immense, leading to feelings of isolation, anxiety, and depression. Despite her eventual diagnosis of endometriosis, she continued to face skepticism from healthcare professionals who accused her of seeking pain medication.

The issue of trust is compounded by gender bias in medicine, as Dr. Sony Singh from the Society of Obstetricians and Gynaecologists of Canada pointed out. Women, particularly women of color, often find their pain dismissed, leading to a shared responsibility among healthcare providers and families to affirm their experiences.

The connection between chronic pain and mental health is undeniable. As Dr. Singh noted, prolonged suffering without adequate support can exacerbate conditions like depression and anxiety. Bakaluk’s journey took a turn at age 21 when doctors discovered an ovarian fibrothecoma, a benign tumor. During surgery, they also identified endometriosis lesions. For Bakaluk, this diagnosis brought a sense of relief.

“I finally had a reason that I was in so much pain,” she said, reflecting on the validation she received after years of feeling disbelieved.

The case of Amanda Gibson further illustrates the complexities of diagnosing chronic pain. In 2020, Gibson began experiencing unusual symptoms, including electric shocks and persistent fatigue, but was initially dismissed by healthcare providers. After being prescribed antidepressants, she sought multiple opinions before being suggested she might have fibromyalgia, a condition characterized by widespread pain and fatigue.

As Gibson pointed out, the healthcare system often fails to adequately study and address women’s health issues. Dr. Andrea Furlan, an associate professor at the University of Toronto, echoed this sentiment, stating that chronic pain significantly impacts women’s lives, yet they are often not validated in their experiences.

The Canadian Pain Task Force, established by Health Canada in 2019, aimed to address these issues by consulting with individuals living with chronic pain. The task force’s report, released in March 2021, includes recommendations for improving recognition and management of chronic pain within the healthcare system. Unfortunately, its release coincided with a global pandemic, limiting its visibility.

Maria Hudspith, co-chair of the Canadian Pain Task Force, acknowledged the challenges of disseminating the report’s findings during such tumultuous times. She emphasized the urgency of addressing chronic pain, which significantly impacts individuals’ lives, yet remains largely unrecognized in the healthcare system.

Historically, medical training has provided inadequate focus on chronic pain, leading to a lack of understanding among healthcare providers. Hudspith noted that individuals living with chronic pain are four times more likely to experience depression and twice as likely to face suicidal ideation compared to the general population.

As the healthcare system continues to adapt, there is a growing recognition of the need for improved education and resources to support women experiencing chronic pain. With initiatives such as the Canadian Pain Task Force’s recommendations, there is hope for a future where invisible illnesses receive the attention and validation they deserve.