Study evaluates distribution and severity of pain in sexual assault victims

A majority of sexual assault victims experience severe pain in the early aftermath of the crime but less than a third of these victims receive pain medications, according to research in The Journal of Pain, the peer review publication of the American Pain Society.

One in five U.S women experiences a sexual assault in their lifetimes. Like other physical trauma, severe acute pain occurs in sexual assault cases. When physical trauma is limited, factors such as stress-induced hyperalgesia may contribute to post-assault pain. Researchers from the University of North Carolina evaluated the distribution and severity of pain in sexual assault victims who presented for medical care from sexual assault nurse examiner (SANE) programs.

This was the first prospective study of pain symptoms in the early aftermath of sexual assault. Female sexual assault survivors 18 years and older who sought a SANE evaluation within 48 hours of the crime were recruited for the study. The subjects were questioned about pain intensity in eight body regions and asked to rate pain severity on a 1- to-10 scale.

Results showed that the majority of sexual assault victims experienced severe or moderate pain in the early aftermath of the attacks. More than half of the women reported pain in four or more body regions. Less than a third said they were treated with pain medications. The study concluded that pain in the aftermath of sexual assault is not only occurring from physical trauma but also might be a neurobiological complication caused by the stress from the frightening experience.

The authors recommended that acute pain caused by sexual assault should be identified and treated promptly to reduce immediate suffering and to help improve psychological outcomes. Also, pain education for SANE program nurses and others who provide care to victims should emphasize that pain is common after sexual assault and attending clinicians should conduct pain evaluations and treat with nonsteriodal anti-inflammatory drugs and perhaps opioid medications.