Women More Affected by Migraine, Neck, Back Pain, Spain Health Survey Finds

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The study compared females and males who suffer from migraines and other painful conditions who took part in a national health survey in Spain.

A recent observational study using national health data examined the prevalence of chronic neck pain, chronic low back pain, and migraine headache by gender in Spain, and to identify sociodemographic and health-related characteristics linked with each.

The authors wrote that, to their knowledge, this area has not been explored previously. It is already known that women suffer from migraines more than men; the authors also noted that men and women have different responses to pain, with females reporting longer-lasting and more severe symptoms.

In general, the 3 conditions are linked with more disability, more disability-adjusted life-years, more years lived with disability, higher loss of productivity, poorer quality of life, and increased health care use.

For this study, researchers analyzed results from the 2017 Spanish National Health Survey, which included responses from 22,511 persons 18 years of age or older (10,304 males and 12,207 females). The 3 pain conditions were the dependent variables. Sociodemographic characteristics, self-reported health status, lifestyle habits, comorbidities, and pain features were analyzed by using logistic regression models; the analysis was conducted separately by gender.


The survey asked 3 questions about pain, and all questions had to be answered in the affirmative:

  • Do you have or have you ever had any of the following diseases/health conditions (followed by a list of 32 conditions)
  • Have you suffered this disease/health condition in the past 12 months
  • Was this disease/health condition diagnosed by a medical doctor

Compared with men, women self-reported a higher prevalence of all 3 conditions (P < .001):

  • Neck pain: odds ratio (OR) = 2.08; 95% CI, 1.92-2.23
  • Migraine: OR = 2.38; 95% CI, 2.17-2.59
  • Back pain: OR = 1.40; 95% CI, 1.34-1.52)

Both genders shared most sociodemographic and health-related factors that are significantly associated with the 3 pain conditions; for both groups, anxiety and/or depression and poor self-rated health were linked with a significantly increased prevalence of all conditions.

Gender-specific differences were seen in several areas. For men, drinking alcohol was linked with a higher prevalence of migraine and back pain.

For women, there was an association between the presence of back pain and a higher prevalence of migraine. In addition, for women only, there was a link between the presence of heart disease and a higher prevalence of all 3 pain conditions. In addition, females had a worse intensity of pain, except for when cancer or all 3 conditions were present together, and used more pain medication.

Migraine and neck pain had an associated factor of comorbid respiratory disease. That finding, like the others, are in line with previous studies, the researchers reported.


Palacios-Ceña D, Albaladejo-Vicente R, Hernández-Barrera V, et al. Female gender is associated with a higher prevalence of chronic neck pain, chronic low back pain, and migraine: Results of the Spanish National Health Survey, 2017. Pain Med. Published online November 8, 2020. doi:10.1093/pm/pnaa368