Abstract
Racial and ethnic disparities in pain perception diagnosis and management have become apparent in different specialities.1,2 We aimed to assess the differences in symptom perception, as expressed in the oswestry disability score, between different ethnic groups in a UK population before and after surgery.
Oswestry Disability Scores (ODI) (completed at every outpatient visit), and other information were obtained retrospectively for 1568 patients seen at our spinal unit over the last two years. Statistical analysis using analysis of variance (ANOVA) was used to determine any true difference in ODI scores between Caucasian, Afro-Caribbean and South Asian different groups pre and post surgery.
Overall scores were significantly higher for the South Asian group when compared with the white using analysis of variance (ANOVA) p< 0.001. Afro-Caribbean patients also showed a trend to higher overall scores from the white group p=0.091 (least squares difference post-hoc test).
From a total of 280 patients who had undergone surgery, South Asians had significantly higher pre-operative scores compared to Caucasians (p> 0.001). Afro-Caribbean’s also scored higher than Caucasians pre-operatively although the difference was not significant (p=0.091). Scores for South Asians and Afro-Caribbean’s remained higher than those for Caucasians postoperatively. All groups however, did show a statistically significant reduction in ODI score compared to the pre-operative score.
Despite the differences in symptom perception or expression we have found to exist between ethnic groups, we conclude that in appropriately selected patients, this does not affect their ability to benefit from surgery
Ethics approval: none
Interest statement: none
Correspondence should be addressed to BASS/BCSS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
1 Acculturation and the prevalence of pain amongst South Asian minority ethnic groups in the UK. Rheumatology, June 1, 2007; 46(6): 1009–1014. Google Scholar
2 Robert R. Edwards, MA, Daniel M. Doleys, PhD, Roger B. Fillingim, PhD and Daniel Lowery, BA. Ethnic Differences in Pain Tolerance: Clinical Implications in a Chronic Pain Population. Psychosomatic Medicine2001;63:316–323 Google Scholar
