Relevance of a biocultural approach in the assessment of chronic pain: A comparison between Peruvian women living in Nasca and Lima

Objectives Pain is an unpleasant experience with complex neurobiological, psycho-social and cultural components. The latter deeply affects both its perception and representation. The aim of this study was to check the relationship between psychological, cultural aspects and environmental factors in Peruvian women with chronic pain, comparing the inhabitants of Nasca to those of Lima (that is, people belonging to the same ethnic group, but following different life styles). Subjects and Methods The groups living in Nasca (NG) and Lima (GL) included 242 and 121 participants, respectively, and had similar age range. The subjects filled out the Spanish version of the McGill Pain Questionnaire, and the Ethnicity and Pain Questionnaire (EPQ), according to Bates. Results Both groups showed a similar Pain Rating Index (PRI), while the Present Pain Index (PPI) was significantly lower in group NG. No group differences in the Locus of Control (LOC) was found, but GN subjects with internal LOC reported a significantly lower PPI. On the other hand, GL showed a higher score in most items of EPQ. Despite the lower PPI, GN was significantly more affected by pain in most daily activities and reported a significantly higher pain duration (45 ±73.8 vs. 23±18.6 months). Conclusions Our data confirm the complex relationship between pain, provider's capability of understanding and treating it, socioeconomic and cultural components, making pain medicine far from being a matter of pharmacological or interventional manipulation of pain pathways only.