Prescribing Analgesics for Low Back Pain: Is There a Gender Difference?

Background: Gender differences have been described in many fields of pain. However, research is inconclusive as to gender difference in pain management. Our study aimed to investigate gender differences in prescribing analgesics for low back pain. Methods: We designed a cross-sectional study based on data originated from computerized health records. We retrieved data on low back pain diagnosis, among patients aged 18-64 years during 2016. Visits due to trauma and fracture were excluded, as were visits of patients with known neoplasm, or neurological or congenital defects. Data included demographics and the analgesics prescribed. Results: The cohort comprised 45,479 patients; of them, 55% were women. The mean age was 42.9 ± 12.6 years. Analgesics were prescribed to 49% of the men and 47% of the women (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.03-1.11). The distribution of analgesics was similar between the genders: overall, 73% nonsteroidal anti-inflammatory drugs, 23% opioids, 4% other analgesics, mainly paracetamol and dipyrone. A higher proportion of men were prescribed strong opioids than women: 17% versus 8% (OR 2.36, 95% CI 2.03-2.75). Conclusion: Men and women were similarly prescribed analgesics for low back pain. Men were more likely than women to be prescribed strong opioids. Further research is needed to evaluate the outcomes of this differential treatment.