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Racial Bias Found in Pain Assessment, Management, Treatment Recommendations by Clinicians

Mary Beth Nierengarten  |  Issue: October 2016  |  October 10, 2016

Saying he sympathizes with the challenges faced by clinicians when trying to determine how best to treat pain in their patients, Dr. Bradley emphasizes the need for clinicians to be aware that many patients have an enhanced sensitivity to pain that appears to be biologically related.

“When one observes enhanced patient pain behavior that is not consistent with clinical findings, one must consider whether it is appropriate to provide recommended levels of medication or other treatments for pain,” he says.

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“However, one must also consider that there are subgroups of persons who display enhanced pain sensitivity related to altered central nervous system function or other factors that are not yet identified,” he says, adding that he and his colleagues will continue to improve their understanding of ethnicity and pain to provide help to clinicians.


Mary Beth Nierengarten is a freelance medical journalist based in Minneapolis.

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Resources

  1. Hoffman KM, Trawalter S, Axt JR, Oliver MN. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci USA. 2016 Apr 19;113(16):4296–4301.
  2. Todd KH. Influence of ethnicity on emergency department pain management. Emerg Med (Fremantle). 2001 Sep;13(3):274–278.
  3. Cruz-Almeida Y, Sibille KT, Goodin BR, et al. Racial and ethnic differences in older adults with knee osteoarthritis. Arthritis Rheumatol. 2014 Jul;66(7):1800–1810.
  4. Green CR, Ndao-Brumblay SK, West B, Washington T. Differences in prescription opioid analgesic availability: Comparing minority and white pharmacies across Michigan. J Pain. 2005 Oct;6(10):689–699.
  5. Morrison RS, Wallenstein S, Natale DK, et al. ‘We don’t carry that’—Failure of pharmacists in predominantly nonwhite neighborhoods to stock opioid analgesics. N Engl J Med. 2000 Apr 6;342(14):1023–1026.
  6. Drwecki BB. Education to identify and combat racial bias in pain treatment. AMA J Ethics. 2015 Mar;17(3):221–228.

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Filed under:Practice SupportQuality Assurance/ImprovementResearch Rheum Tagged with:biasclinicianDiagnosisPainpatient careracialResearchrheumatologist

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