According to Green, where a woman is in her menstrual cycle as well as her life cycle (pre- or post-menopause) influences her hormone levels, especially estrogen, and this can make a difference in her response to pain stimuli.
Although Dr. Robert Bonakdar, director of pain management at the Scripps Center for Integrative Medicine in La Jolla, Calif., says he hears this kind of thinking about alternative approaches, there's no truth to it. He also often hears that patients think they need to choose either a conventional medical route or an alternative one to manage pain, but in his opinion it's fine to blend the two.
Bonakdar likes to make a distinction between active alternative pain relief methods, such as biofeedback, guided imagery, exercise, yoga and other mind-body approaches, and passive ones, including acupuncture and massage.
In an active approach, he said, the patient "owns" the pain-relief technique. In other words, if you are using biofeedback to help relieve chronic headaches, patients first learn the tool and can put this active tool to use whenever they need to ease their pain. Active approaches are "self-dosed," Bonakdar said.
On the other hand, in a passive approach, pain relief is dependent on a visit to a practitioner so there's a reliance on someone else for treatment.
If a patient has tried a passive method for pain, Bonakdar says he might ask, "Did you do a full course of treatment for pain relief and did you transition to anything active?" For example, he says, in most of the better research trials on the use of acupuncture for pain relief, the patient received 12 to 20 treatment sessions.
Of course, having reasonable expectations is a good idea, whether the pain relief method is an alternative approach or a conventional one, such as a drug.
"If a person was taking a pain medication and stopped it, they wouldn't expect the pain-relief effect to last," Bonakdar said. The same holds true for alternative approaches to pain.
Kids might not always let you know about pain through their words, but they may do so through their actions and behaviors.
Children are more likely to express their suffering in a variety of ways, often based on their development, age and verbal abilities, Zeltzer said. They can also express pain nonverbally. Infants who are in extreme pain for long periods of time may communicate their discomfort by shutting down or seeming listless and passive.
Another telling sign is when a young child becomes quieter and more withdrawn. School-age children may express their pain behaviorally through crying, flailing, kicking or by withdrawing. Teens may clench their fists and tighten their muscles to appear stoic and strong.
Zeltzer added that there is also a difference between a child's reaction to acute and chronic pain. She said that kids tend to be very behaviorally expressive when it comes to acute pain, such as being injured, getting a shot or needing stitches. They might cry, flail or scream.
With chronic pain, she explained, kids look like they're sapped of energy. They look pale, and not interested in playing or engaging with their environment.