Domestic violence tied to development of chronic pain

Key takeaways:

• Women who experienced domestic violence were twice as likely to report chronic pain as those who did not.
• Domestic violence in adulthood was not tied to pelvic pain, but was significantly tied to fibromyalgia.

Odds of developing chronic pain conditions were doubled for women who experienced domestic violence in adulthood vs. those without a history of violence, according to a systematic review and meta-analysis published in BMC Women’s Health.

“Previously, researchers studied health conditions and violence types separately, such as the association between sexual trauma and pelvic pain or psychological trauma and fibromyalgia,” Allison Uvelli, MD, doctorate student and research assistant in the department of medical sciences, surgery and neurosciences at the University of Siena, and colleagues wrote. “It is crucial to approach chronic pain as a broad concept because irrespective of the affected body area, individuals can seek assistance from pain therapy departments or clinics. Therefore, it would be beneficial to conduct a general screening.”

Uvelli and colleagues searched PubMed, Scopus and Web of Science and identified 37 studies published from 1994 to 2021 with adult women aged 18 to 65 years without a history of childhood abuse to assess the association between violence against women and chronic pain. All studies included the keywords “intimate partner violence,” “interpersonal violence,” “partner abuse” or “domestic violence” and “pain.”

Overall, 26 studies were cross-sectional, seven were case-control and four were cohort studies. More than half (56.7%) of the studies were from the United States, while 10.8% were from the U.K., 5.4% were from Spain and Australia and 21.5% were from other countries.

Regarding pain, general chronic pain was examined in 56.7% of studies, fibromyalgia in 18.9% and pelvic pain in 24.3%.

Women who experienced violence had increased odds of developing chronic pain compared with women with no history of violence (OR = 2.08; 95% CI, 1.8-2.41).

In studies addressing only pelvic pain, experiencing domestic violence in adulthood was not significantly associated with pelvic pain, according to the researchers. Conversely, experiencing violence in adulthood was significantly associated with fibromyalgia development (OR = 1.68; 95% CI, 1.44-1.98).

According to the researchers, health care and anti-violence workers should work together to provide holistic care and support women experiencing violence in adulthood. They also wrote that screening women with chronic pain may help to identify hidden violence.

“Considering that many women don’t refer their violence, each health care professional working with chronic pain or in the emergency room should be careful and be prepared for these situations,” the researchers wrote. “Furthermore, the same attention should be paid by the health system in general, and by the institution to provide the correct path for these women.”