The who and why of pain: analysis by social class.

Physicians with an interest in pain have long suggested that the poor complain more and have a higher prevalence of neuroticism than do higher social groups. This assumption was tested by analysing the pain patterns in 500 consecutive patients attending a pain relief clinic. Results implied that scores for presenting pain, anxiety, and depression were similar to all social groups. After treatment scores for residual pain were significantly lower in all social classes, with greatest reduction in classes III, IV, and V. Almost identical results were obtained in a subgroup of patients with cancer but not in a subgroup with sciatica. That patients from the lower social classes have a higher perception of pain and are more neurotic than other group is a myth, probably resulting from poor communication between clinicians and patients of dissimilar socioeconomic class.