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I know our society has gone through major shifts in describing the differences between boys and girls. For awhile there it was like we were supposed to believe everyone was the same regardless of sex. But I work as a pediatric aid in a large hospital. And I can tell you that when it comes to pain in children, girls seem to have a much bigger reaction to pain. This seems true even if it doesn't hurt more than what boys would say. Can you explain this to me? Why the differences?
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Your observations have been noted and reported by others as well. Girls do seem to have a greater reaction to the unpleasantness of the after-surgery pain and symptoms than boys do. They don't seem to experience greater intensity of pain, just exhibit a greater reaction or response to the pain.
Of course, gauging pain in children can be a challenge since they don't always have the words to express themselves. This is especially true in younger children. That's why nursing staff most often use the Faces Pain Scale to assess and measure pain in children. The child points to the face that best describes their pain from a happy, smiling face (no pain) to a very sad, frowning face (worst pain).
But researchers are exploring better ways to reliably measure pain in children and teens. One tool that is being modified and tested is the Child Pain Anxiety Symptoms Scale or CPASS. It is a way to gauge how much pain, anxiety, and pain-anxiety children have and how sensitive they are to anxiety.
Anxiety sensitivity is the extent to which anxiety-related symptoms can predict a poor outcome. In other words, the presence of anxiety symptoms such as increased heart rate and feeling nauseated is linked with physical ailments, psychologic disturbances, and the development of chronic (long-lasting) pain.
Assessing children for pain anxiety in the early stages of pain might help us identify who is at risk for poor outcomes related to pain. Then we could potentially do something about it as soon as possible. When the CPASS was used with children after surgery, they found exactly what you are reporting.
They found that after orthopedic or general surgery girls have more general anxiety and anxiety sensitivity than boys. Girls were more likely to experience pain right after surgery as more unpleasant (but not more intense) than boys. Two weeks later (after discharge from the hospital), they scored their pain the same as boys.
Analysis of the test and test scores showed that the CPASS measured responses equally between boys and girls. In other words, the differences reported weren't because of the test but a true measure. The test was able to measure the changes experienced by the children from early on after surgery to the two-week post-operative time period.
So anxiety and the child's interpretation of his or her symptoms may be part of the differences between boys and girls. But what makes girls more susceptible to the effects of anxiety remains to be determined.
There may be other factors that determine the difference between boys' and girls' responses to pain. The CPASS was originally designed for adults and then modified for children, so it's possible that there are other dimensions of the pain experience (besides anxiety) that are important. Further study is needed to sort this out as well.
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