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Vol.1 , No. 5, Publication Date: Dec. 11, 2015, Page: 67-73
| [1] | Mona H. Mathna, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Menoufia University, Egypt. |
| [2] | Joy C. MacDermid, Department of Physical Therapy, University of Western Ontario, London, ON. |
Since chronic pain is a complex phenomenon, a conceptual model may be useful in understanding this complexity. One conceptual model commonly used to explain chronic pain is the neuromatrix pain theory, which aims to explain the integrative role of the brain in pain generation. While this model does not specifically identify aspects of sex and gender that might affect pain; it may lend itself to this application. The objective of this paper is to explore the influence of gender and sex in the context of the neuromatrix theory for better understanding of the widely reported gender/sex difference in chronic pain experience. Understanding the difference between the meaning of gender and sex is essential, because this can help identifying and organizing the role of both gender and sex as different inputs to the neuromatrix. Sex refers to the biologic condition of an individual as being female versus male, while gender refers to the social role with which an individual identifies. Gender can influence the cognitive and affective components of pain. So, gender can be considered as cognitive and/or affective inputs to the neuromatrix, which can modulate the pain neurosignature within the neuromatrix and consequently influences pain responses. However, sex hormones play a vital role in production of sex difference in pain response. Estrogen can influence pain processing before the level of the neuromatrix resulting in change in the sensory signaling input to the neuromatrix. It can also influence the different anatomical constitutes of the neuromatrix. Another contributing finding that can help explaining the sex difference and also the individual variations among women in pain response is the genetic expression of estrogen receptors within the neuromatrix. Eventually, it seems that there are multiple inter-related factors that may interact to modulate the pain neurosignature within the neuromatrix and produce the gender/sex difference in pain response. Considering these factors can guide pain management in women, and can also identify sex/gender as predictors of chronic pain that may become future treatment targets.
Keywords
Neuromatrix Pain Theory, Pain, Sex, Gender
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